Elavil (generic)

Elavil (amitriptyline) 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 Elavil (amitriptyline) in 1961. Since then, newer classes of antidepressants have been developed that work differently and may result in fewer side effects.

Because Elavil (amitriptyline) can have significant side effects, it is not generally used as a first-line prescription treatment for depression. However, Elavil (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 Elavil (amitriptyline) and determine if it’s the right choice for you.

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.

Elavil (amitriptyline) is an FDA-approved medication for the treatment of depression in adults. At Brightside, we use Elavil (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 Elavil (amitriptyline) for other mental health conditions, including: 

• Anxiety
• Eating disorders

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

Elavil (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 Elavil (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.

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.

Elavil (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 Elavil (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.

Before you start taking Elavil (amitriptyline), you may have some questions about how long you’ll need to take this medication. The length of time you take Elavil (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 Elavil (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.

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.

Elavil (amitriptyline) has long been used successfully for treating depression in adults. It was FDA-approved as an antidepressant in 1961. Elavil (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: https://pubmed.ncbi.nlm.nih.gov/12804503/] showed that Elavil (amitriptyline) was at least as effective in treating depression as some newer classes of antidepressants. However, Elavil (amitriptyline) has more side effects when compared to newer drugs in its class. Therefore, Elavil (amitriptyline) is not typically prescribed as a first line depression treatment.

Many people worry that antidepressants will alter their personality or change who they are. As long as you’re taking the right dosage, Elavil (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.

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

Patients using Elavil (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 Elavil (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 Elavil (amitriptyline).

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

Do not take Elavil (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 Elavil (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.

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.

If you are pregnant or plan to become pregnant, you should talk to your provider before making any medication changes. Elavil (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 Elavil (amitriptyline) could potentially negatively impact a developing baby.

We do know that Elavil (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 Elavil (amitriptyline), discuss your case with your provider to see if the benefits of continuing with Elavil (amitriptyline) during pregnancy and nursing outweigh any potential risks to your baby.

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

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

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