Elavil (amitriptyline) is part of a group of medications called tricyclic antidepressants. This category of medication gets its name from its three-ringed chemical structure. Elavil is only available via prescription, and is primarily prescribed to control the thoughts, behaviors, and other symptoms associated with depression in adults and teenagers. In some cases, this drug may be used as part of a treatment plan for migraines, postherpetic neuralgia, and some cases of disordered eating.

Dosage FAQs

  • How should I take this medication?
    Elavil is sold as a tablet and may be taken from one to four times per day, depending on the dosage your physician prescribes. Your dosage may be adjusted by your doctor as needed to control or relieve your symptoms. It may take up to several weeks before this medication accrues in your system enough to feel the full therapeutic effects. You should take this medication each day exactly as directed, even if you feel as if you know longer need it
     
  • What should I do if I miss a dose?
    Take the dose you missed as soon as possible. If it will soon be time for your next scheduled dose, then skip the missed dose completely. Do not take a double dose of this medication to make up for a missed dose. Taking too much of this medication too quickly may lead to an overdose.
     

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    What should I do if I take too much of this medication?
    Call your doctor or call a poison control center immediately. Seek urgent medical attention. An overdose of this medication may be fatal. Signs of overdose include drowsiness, confusion, agitation, feeling hot or cold, irregular heartbeat, weakness, muscle rigidity, lightheadedness, seizure, or coma.
     
  • What can be done to make sure I get the most out of my treatment with this medication?
    Several mental health conditions for which this drug is prescribed have also shown positive results when treated with psychotherapy. If you are prescribed this drug for disordered eating or symptoms of depression, consider finding a therapist or counselor to complement your drug treatment. A qualified mental health professional can teach you more about what you are experiencing, help you develop a positive self-care strategy, and work toward a better, longer-lasting mental health outcome for you than may be possible from treatment with medication alone.
     
  • How should I store this medication?
    Keep this medication at room temperature (about 68 to 77 degrees Fahrenheit or 20 to 25 degrees Celsius) and away from moisture. Keep this medication out of the reach of children and ensure it is kept in a bottle with a child-proof lid.

Important Information Before Use

Some antidepressant drugs have led to an increase in suicidal thoughts and behavior in children and adolescents under the age of 24. These effects are most likely to occur during the first few months of treatment or if the dosage is altered. Young people with a family history of mental health issues may be more at risk for developing suicidal thoughts. Call your doctor right away if you notice any sudden or severe changes in thinking, mood, emotions, or actions, especially if these changes worry you.

If you are currently taking or have recently taken a monoamine oxidase inhibitor (MAOI), especially within the last two weeks, your doctor should know before you begin treatment with this drug. Do not use this medication if you have ever had a heart attack. If you are over 65 years old, your doctor may suggest an alternative medication for depression; Elavil is not recommended for use by elderly persons.

Be sure to disclose your entire health history and let your doctor know if you have ever experienced glaucoma, issues with your prostate, seizures, a history of schizophrenia, liver, kidney, or heart disease, or thyroid issues. Tell your doctor if you currently drink alcohol in excess, or if you have experienced alcohol addiction in the past. If you have had any reactions to similar medications, be sure to inform you doctor of which ones and what type of reaction you had.

If you are regularly taking any other prescription medications or dietary supplements, ask your doctor or pharmacist about interactions before taking Elavil. This drug may interact with other medications or supplements including:

  • MAOIs
  • Antihistamines
  • Other antidepressant medications
  • Antacid medications
  • Herbal supplements such as St. John's wort
  • Medications for sleep issues
  • Antipsychotic drugs
  • Blood pressure pills
  • Some vitamins and minerals

Considerations During Use

If you are prescribed this medication, please be aware that it includes several significant risks. Your doctor and/or pharmacist should cover the following warnings with you prior to treatment:

  • If you are pregnant or become pregnant while taking Elavil, you should talk to your doctor about alternative treatments for depression. Though there is not much data from controlled human studies, animal studies indicate that use of this drug during pregnancy may result in a variety of congenital malformations. Newborns may also experience withdrawal symptoms and show more excitability than babies that were not exposed to this medication. Amitriptyline, the active ingredient in this medication, may pass into breast milk and harm a nursing infant.
  • This drug may slow your reflexes, dull your thinking, and cause drowsiness; avoid driving or working with heavy machinery until you are certain of how this medication affects you.
  • Avoid drinking alcohol while taking this medication as dangerous side effects may occur.
  • Avoid excessive exposure to sunlight or sun lamps. Do not use tanning beds during treatment. This medication may make your skin more sensitive to sunlight and more susceptible to sunburns. If you need to go outside, use sunscreen (at least SPF 15) or wear clothing that will protect your skin.
  • Do not eat grapefruit, drink grapefruit juice, or eat grapefruit products as these may interact with the medication.
  • If you are having any kind of surgery, including oral surgery, please inform your surgeon or anesthesiologist you are taking this medication.

Potential Side Effects

Call your doctor if you experience serious or severe side effects after taking this drug. Serious side effects from this medication may include:

  • Abnormal or rapid heartbeat
  • Chest pain
  • Numbness in arms or legs
  • Facial or tongue swelling
  • Hives or severe rash
  • Faintness or dizziness
  • Unusual, uncontrollable shaking
  • Spasms in the back, neck, or jaw
  • Speech difficulties
  • Hallucinations
  • Yellowed skin or eyes
  • Bruising or bleeding

Less serious side effects may include:

  • Physical or mental fatigue
  • Headaches
  • Confusion
  • Numbness or tingling in extremities
  • Dry mouth
  • Weight gain or increase in appetite
  • Nausea, vomiting, or constipation
  • Difficulty urinating
  • Nightmares
  • Excessive sweating
  • Blurred vision

How to Safely Withdraw

See your doctor before reducing or discontinuing this medication; do not stop taking Elavil abruptly. Slowly tapering off of this medication will help to reduce withdrawal symptoms. Possible symptoms of withdrawal include:

  • Return of depression
  • Headaches
  • Dizziness
  • Nausea or stomach upset

References:

  1. Citizens Commission on Human Rights International. (2012). The side effects of common psychiatric drugs. Retrieved from http://www.cchrint.org/pdfs/The_Side_Effects_of_Common_Psychiatric_Drugs.pdf
  2. Drugs.com. (2009). Elavil. Retrieved from http://www.drugs.com/elavil.html
  3. Medline Plus. (2010). Amitriptyline. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682388.html
  4. RxList. (2010). Elavil. Retrieved from http://www.rxlist.com/elavil-drug.htm

Page content reviewed by James Pendleton, ND.