Amitriptyline for anxiety & depression.

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Is amitriptyline (elavil) right for you?

There are many different types of antidepressant medications, and it’s important to find the one that’s right for you. At Brightside, we’re here to help. Our providers are knowledgeable about each type of medication for anxiety and depression and specialize in finding the best fit for your individual needs. As part of your treatment, your provider may recommend an antidepressant called amitriptyline to help you feel better.

Amitriptyline is a commonly used medication that is often well tolerated and effective for the treatment of depression, anxiety, and other conditions. Below, we offer some helpful information about amitriptyline so you can work with your provider to determine if it’s right for you and make an informed decision about your care.

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Mimi Winsberg, MD

Chief Medical Officer
Stanford-trained Psychiatrist with 25 years of practice

Get an amitriptyline prescription and ongoing anxiety & depression care for only $95 / month.

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Step 1

Fill out our free mental health assessment.

Start with a clinically-proven set of questions to shed light on how you’re feeling. We’ll help you understand your symptoms, then recommend the best treatment plan for you–including medication, therapy, or both.

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Get matched with an expert provider for an online video consultation. Share how you’re feeling and then decide on next steps–together.

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Stay in touch with with unlimited messaging, plus monthly video sessions with your Therapist and unlimited video consults with your Psychiatric Provider.

Then measure your progress with regular check-ins to monitor your symptoms and make adjustments until your treatment is right for you.

Everything you need to know about amitriptyline

What is amitriptyline, and how does it work?

Amitriptyline, commonly sold under the brand name elavil, is a type of antidepressant known as a tricyclic antidepressant (TCA). This class of drugs includes some of the earliest antidepressants ever developed. They work by blocking the reabsorption of two neurotransmitters in the brain—serotonin and norepinephrine—in order to regulate mood and help relieve depression.

The FDA approved amitriptyline in 1961. Since then, newer classes of antidepressants have been developed that work differently and may result in fewer side effects.

Because amitriptyline can have significant side effects, it is not generally used as a first-line prescription treatment for depression. However, amitriptyline may still work well for some patients—particularly those for whom other treatments have not been effective.

Together, you and your provider can weigh the pros and cons of amitriptyline and determine if it’s the right choice for you.

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What conditions does amitriptyline treat?

At Brightside, our psychiatric providers specialize in personalizing treatment for each person. We give you the personal attention and expert advice you deserve and can count on—we explain all your options and use our expertise to find the medication that’s right for you. It’s important to us that you understand how medications work and what to expect so that your treatment is worry-free.

Amitriptyline is an FDA-approved medication for the treatment of depression in adults. At Brightside, we use amitriptyline to treat a number of conditions, such as:

  • Eating disorders
  • Generalized anxiety disorder
  • Insomnia
  • Major depressive disorder 
  • Panic disorder
  • Persistent depressive disorder
  • Post-traumatic stress disorder (PTSD)
  • Postpartum depression
  • Seasonal affective disorder (SAD)
  • Social anxiety disorder

Providers may also prescribe amitriptyline for other mental health conditions, including: 

  • Anxiety
  • Eating disorders

Beyond its mental health applications, amitriptyline is sometimes prescribed to treat irritable bowel syndrome, migraines, and other types of chronic pain, including fibromyalgia and diabetic neuropathy.

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What symptoms can amitriptyline help treat?

Amitriptyline can target and treat several indicators of low mood, general depression, and anxiety.

We use this medication to treat a number of symptoms, including:

  • Anxiety
  • Depressed mood, feeling hopeless or sad
  • Excessive worry 
  • Feeling afraid as if something awful might happen
  • Feelings of worthlessness 
  • Loss of interest or pleasure in doing things
  • Low energy
  • Obsessions and compulsions
  • Outbursts of anger, irritability, or frustration
  • Poor appetite
  • Sleeping too much or too little
  • Sweating, trembling, or blushing related to social anxiety
  • Thoughts of suicide or self-harm 
  • Trouble concentrating
  • Trouble falling or staying asleep
  • Vivid flashbacks, nightmares or intrusive thoughts associated with PTSD

You may be wondering if your symptoms can be treated with amitriptyline. Making sense of different medications, their uses, benefits, and side effects can be challenging. That’s where we can help. Brightside providers have an in-depth knowledge of the strengths and drawbacks of each medication. You’ll get all the information you need to make an informed choice about your treatment.

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Will amitriptyline work for me?

At Brightside, we can help you find the right medication and the right treatment specific to your needs. We understand that you may be feeling a bit uncertain about starting a new medication and whether it will help you feel better. You’re not alone—many patients have similar questions, and we’ll work together with you to find the answers.

It’s important to keep in mind that some medications work better for certain people than others because each person is different. Your age, gender, genetic background, and other variables—including other medications you may be taking—can affect how well you respond to a certain antidepressant.

To ensure that your antidepressant is a fit for your health situation, our medical providers will get to know your individual health history. We offer consultation and telehealth services within 48 hours to better understand your symptoms and specific health needs.

Amitriptyline can be prescribed in varying dosages. Your provider will likely start you on a lower dose and increase your prescription as needed. You can expect to see an improvement in your depression and anxiety symptoms within 4-6 weeks after beginning amitriptyline. We understand that this can feel like a long time, but it’s important to continue taking your medication even if you don’t feel improvement right away.

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How long do people generally take amitriptyline?

Before you start taking amitriptyline, you may have some questions about how long you’ll need to take this medication. The length of time you take amitriptyline may vary, depending on your specific symptoms and response to the drug. Most providers suggest taking it for at least six to 12 months after your symptoms begin to improve in order to stabilize them. Stopping earlier could cause your depression and anxiety symptoms to return.

When you and your provider agree you are ready to stop taking amitriptyline, we’ll work together so you can safely and effectively decrease your dosage. Stopping suddenly can cause side effects, including nausea, headache, and tiredness.

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How effective is amitriptyline?

Studies have shown that antidepressants relieve symptoms of depression about 40-60% of the time and additional treatments (such as therapy and lifestyle improvements) on top of medication often lead to the best outcomes.

To get the best results with medication, it’s important to consistently measure progress during treatment. This is known as Measurement Based Care, and it’s the approach we use at Brightside. It’s common to adjust the dose and/or medication when starting antidepressants until you find just the right fit.

Amitriptyline has long been used successfully for treating depression in adults. It was FDA-approved as an antidepressant in 1961. Amitriptyline is a safe and effective medication. However, it’s important to keep in mind that its effectiveness varies from person to person.

A recent study [link to:] showed that amitriptyline was at least as effective in treating depression as some newer classes of antidepressants. However, amitriptyline has more side effects when compared to newer drugs in its class. Therefore, amitriptyline is not typically prescribed as a first line depression treatment.

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Does amitriptyline change my personality?

Many people worry that antidepressants will alter their personality or change who they are. As long as you’re taking the right dosage, amitriptyline will not change your personality or blunt your emotions. Actually, it will help you feel like yourself again by improving your mood, reducing your anxiety, and helping you let go of worries.

Just remember that your symptoms won’t improve overnight. Keep taking your medication as prescribed—even when you start to feel better—and talk to your Brightside provider if you have any questions or concerns.

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Are there side effects associated with amitriptyline?

Amitriptyline is likely to cause more side effects than some newer classes of antidepressants. As a result, amitriptyline is typically prescribed as a second-line option for patients who have not had success with other antidepressants.

Patients using amitriptyline often report experiencing common but manageable, side effects including:

  • Changes in sex drive or ability
  • Confusion
  • Constipation
  • Difficulty urinating
  • Drowsiness, weakness, or tiredness
  • Dry mouth
  • Headaches
  • Nausea, vomiting
  • Weight gain or changes in appetite

Some patients using amitriptyline have also experienced more severe side effects. These include extreme chest pain, irregular heartbeat, weakness or numbness in an arm or leg, or swelling of the face and tongue. If you have a history of heart disease, you should not take amitriptyline.

Some patients have reported an increased risk of suicidal thoughts or actions while taking amitriptyline. Call 911 and seek immediate medical attention if you experience thoughts of suicide or self-harm while taking any antidepressant.

Do not take amitriptyline if you are also taking a monoamine oxidase inhibitor (MAOI) such as phenelzine, tranylcypromine, or isocarboxazid. MAOIs are often prescribed to treat depression, Parkinson’s disease, or bipolar disorder. Combining an MAOI with amitriptyline can be fatal.

At Brightside, your health and safety are our highest priorities. We make sure you get individual attention and guidance to make sure you feel your best.

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Does amitriptyline have withdrawal symptoms?

Antidepressants are not physiologically or psychologically addictive, but they can cause a discontinuation syndrome if stopped abruptly.

The discontinuation syndrome is a consequence of abruptly stopping certain types of antidepressants––particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Discontinuation syndrome can include a range of symptoms that may occur in patients who suddenly stop their SSRIs or SNRIs. These are the most common symptoms of discontinuation syndrome:

  • Feeling anxious
  • Feelings of vertigo
  • Odd sensory symptoms, such as tingling feelings in the skin or what some people describe as a “zapping” sensation in the brain
  • Trouble sleeping

Make sure to talk to your provider before stopping or changing how you take your medication so they can create a plan that gives your body enough time to adjust. This will keep you feeling well and prevent symptoms from returning.

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Can I take amitriptyline during pregnancy or while nursing?

If you are pregnant or plan to become pregnant, you should talk to your provider before making any medication changes. Amitriptyline is categorized as a Pregnancy Category Class C drug by the FDA. This classification means that while extensive research on pregnant women has not been done, research using animals suggests that amitriptyline could potentially negatively impact a developing baby.

We do know that amitriptyline is excreted into breast milk, so nursing mothers who use the drug should be aware of a possible risk of adverse reactions in their babies.

If you already use amitriptyline, discuss your case with your provider to see if the benefits of continuing with amitriptyline during pregnancy and nursing outweigh any potential risks to your baby.

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Is amitriptyline addictive?

Amitriptyline is generally considered non-addictive. However, some research has suggested that patients using tricyclic antidepressants, such as amitriptyline, can develop a dependency on them. Other studies have suggested that amitriptyline can be misused to achieve a euphoric high.

Talk with your provider about the potential risk of tricyclic antidepressant dependency before taking amitriptyline.

What does the FDA say about amitriptyline?

You can view the FDA black box warning for amitriptyline here. If you have questions about whether the black box warning for amitriptyline applies to you, please talk to your provider

Conditions we treat with amitriptyline

Brightside Psychiatric Providers prescribe amitriptyline alongside other medicines to treat conditions including:
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