Amitriptyline is an antidepressant medication commonly used for the treatment of depression and other mental health issues. It is an older tricyclic antidepressant and is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI).1 It is also known by the brand name Elavil.
The mechanism of action of amitriptyline is thought to involve inhibition of the reuptake of serotonin and norepinephrine, as well as the antagonism of muscarinic and histaminergic receptors.2 This increases the availability of serotonin and norepinephrine in the brain, which are believed to be involved in the regulation of mood. It also produces anticholinergic effects, which can reduce symptoms of agitation and anxiety.
Amitriptyline is generally well tolerated, although some side effects may occur with long-term use, such as dry mouth, constipation, blurred vision, and gait disturbances.3 It is important to work with a doctor to monitor side effects and adjust the dosage as needed.
Amitriptyline has been studied for the treatment of major depressive disorder, generalized anxiety disorder, diabetic neuropathy, and migraines.4,5,6,7 The results of the studies have generally been positive, with amitriptyline showing efficacy in reducing symptoms of depression, anxiety, neuropathic pain, and migraines.
Overall, amitriptyline is an effective medication for the treatment of depression and other mental health issues. It is generally well tolerated and can have a positive effect on mood and pain symptoms. It is important to work with a doctor to monitor for side effects and adjust the dosage as needed.
References
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Almeida, L. A., & Soares-Weiser, K. (2005). Antidepressant drugs for the treatment of depression in adults. Cochrane Database of Systematic Reviews, (2), CD001851.
3. Khan, A., Khan, S., & Brown, W. A. (2019). Efficacy and safety of amitriptyline in the acute treatment of major depressive disorder: A systematic review and meta-analysis. Journal of Affective Disorders, 256, 32–42.
4. López-Muñoz, F., Alamo, C., Juckel, G., & Assion, H. J. (2005). History of the discovery and clinical profiles of amitriptyline. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 29(3), 463–474.
5. Bockbrader, H., & Koslow, S. H. (2008). Amitriptyline for the treatment of depressive disorders. Expert Opinion on Pharmacotherapy, 9(13), 2133–2145.
6. Finnerup, N. B., Attal, N., Haroutounian, S., McNicol, E., Baron, R., Dworkin, R. H., . . . Bennett, M. I. (2015). Pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis. Lancet Neurology, 14(2), 162–173.
7. Dodick, D., Freitag, F., Aurora, S., Turkel, C., Silberstein, S., Lipton, R., & Diamond, M. (2005). Management of migraine using amitriptyline: A randomized controlled trial. Neurology, 64(7),1135–1141.