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Amitriptyline

Amitriptyline is a tricyclic antidepressant used to treat many types of persistent pain. 

Why have I been prescribed Amitriptyline?

  • Amitriptyline is used to treat many types of persistent pain.

  • It is especially good for nerve pain, such as burning, shooting or stabbing pain, and for pain that keeps you awake at night.

  • Amitriptyline belongs to the group of medicines called tricyclic antidepressants that are also used to treat depression.

  • The dose of amitriptyline needed for pain relief is usually lower than that prescribed for depression.

  • You may notice that information from the manufacturer does not mention pain. However, amitriptyline has been used to treat pain for many years. For more information please read ‘Use of medicines outside of their UK marketing authorisation in pain management and palliative medicine – information for patients’ by the British Pain Society.

Treatments

Pregabalin

How does it work?

  • Amitriptyline works by increasing the amount of specific nerve transmitters in the nervous system, reducing pain messages arriving in the brain.

When should I take it?

  • It is best to take amitriptyline in the evening. Start by taking it one hour before going to bed, if you find that you feel drowsy the next morning, try taking it earlier in the evening.

How is it taken?

  • The tablets should be swallowed whole, with a glass of water.

  • Amitriptyline may be taken on an empty or full stomach.

  • You will be told how much to start taking and when to increase the dose. The table at the end of the leaflet will help you remember when to increase the dose.

  • Do not take more than prescribed.

How long does it take to work?

  • Every patient is different. You may notice some initial benefit within 2 weeks, however, it may take up to 2 months for a full effect. Your doctor may need to increase the dose to get the maximum effect.

  • Amitriptyline does not work for everyone. If you do not feel any improvement in your pain, do not suddenly stop taking the tablets but speak to your doctor.

What are the possible side effects?

  • Most side effects are mild and it is expected that they tend to go away after a few doses.

  • Common side effects include; drowsiness, dizziness, dry mouth, constipation and sweating. If you have these side effects and they are severe contact your doctor or pharmacist for advice.

  • Less common side effects include fainting, trembling, irregular heartbeat, blurred vision or problems passing water. If any of these side effects occur contact your doctor or pharmacist for advice.

Can I take this medication long term?

  • Yes, if it helps. You may wish to reduce treatment every so often, to check if your pain is still a problem. This should be done with the advice of your GP or pain specialist, gradually reducing your medication over a period of time.

Can I drink alcohol?

  • Alcohol increases the sedative effects of amitriptyline, it is best not
    to drink alcohol when you start taking it. Once settled on a steady dose, you may drink alcohol in moderation but it may make you more drowsy than normal.

Can I drive?

  • Amitriptyline may cause drowsiness. If this happens, do not drive.

What should I tell my doctor?

  • If you are allergic to any drugs

  • If you are taking any other medicines or herbal medicines

  • If you are pregnant or breastfeeding, or if you are planning to become pregnant in the future

  • If you have had a heart attack recently or have any heart problems

  • If you have a history of epilepsy or fits

  • If you have glaucoma

  • If you have difficulty in passing water

  • If you have thyroid disease

  • If you have or have had a mental health problem

  • If you are taking an antidepressant medicine, especially one called a monoamine oxidase inhibitor (MAOI)

What if I forget or miss a dose?

  • Take it as soon as you remember.

  • If you only take one dose at bedtime and you miss the dose, do not take the medicine in the morning. Wait until the next night and skip the missed dose.

  • Do not take two doses together.

What if I want to stop taking amitriptyline

  • If you stop taking amitriptyline suddenly, you might experience withdrawal symptoms. Speak to your healthcare professional (doctor, nurse, pharmacist) who will be able to supervise a gradual reduction.

Further Patient Information (PDFs)