Amitriptyline

What is Amitriptyline?

Amitriptyline is a tricyclic antidepressant that can help treat depression. Tricyclic antidepressants are among the oldest medications used for depression, having been introduced in the 1950s. They’re distinguished by their chemical structure (three interconnected rings of atoms), and because they work on two major brain chemicals at once (serotonin and norepinephrine), they can provide an effective option when standard SSRIs don’t work. They don’t tend to be prescribed as a first-line option for depression because they’re more likely to cause side effects.^[1]

Specifically, Amitriptyline works by blocking the reabsorption of serotonin and norepinephrine, which can help regulate mood. It might take several weeks to notice the full benefits. Amitriptyline comes in many doses and is taken once or twice a day.

How does Amitriptyline work?

Amitriptyline treats depression by blocking the reabsorption of serotonin and norepinephrine. This increases the levels of both chemicals in the brain, which helps improve your mood. Serotonin helps regulate mood and sleep, while norepinephrine helps regulate your emotions. Having higher levels of these neurotransmitters in your brain can help treat symptoms of depression.^[2]

What doses of Amitriptyline are there?

Amitriptyline is available in three doses: 10 mg, 25 mg, and 50 mg. The typical dose for depression is 50 mg a day (25 mg twice a day), although some people, like older people or people with heart problems, might be prescribed 10 mg or 25 mg a day to help with side effects. Your dose can gradually be increased until you reach a dose both you and your clinician are comfortable with (up to a maximum of 150 mg per day).

How to take Amitriptyline

Swallow the tablets whole with water. Don’t crush or chew them. You should take Amitriptyline at the same time(s) every day for best results. After a week of treatment and increasing your dose, we’ll review how your medicine is working for you and whether you’re experiencing any side effects.

You usually take one or two tablets daily for at least six months, although this varies person to person. You’ll also continue taking treatment for around six months after recovery to reduce the risk of relapse.

Don’t stop taking Amitriptyline without letting your clinician know. Stopping abruptly can cause withdrawal symptoms and may worsen your symptoms. If you want to stop, let your clinician know, and they’ll gradually reduce your dose.

How long does Amitriptyline take to work?

It may take a few weeks for your symptoms to start improving and more than a month to see the full benefits. If you don’t notice any changes after six weeks, inform your clinician. They may suggest increasing your dose or recommend a different medication.

What should I do if I make a mistake when taking Amitriptyline?

If you forget to take a dose, take the next dose at the usual time. Don’t take a double dose to make up for a forgotten one.

If you take more medicine than recommended, contact your doctor or visit the emergency department immediately. Don’t wait for symptoms to develop. Bring the medicine box with you so that healthcare professionals know what medication you’re taking. You may experience overdose symptoms such as:

• Fast or irregular heartbeats
• Dry mouth and tongue
• Seizures
• Fever
• Agitation