Amitriptyline for depression

About amitriptyline for depression

Amitriptyline is an antidepressant medicine. It's used to treat low mood and depression.

This medicine is only available on prescription. It comes as tablets and as a liquid.

Amitriptyline is also used for some types of pain and to prevent migraines. Find out more about amitriptyline for pain and migraine.

Key facts

Who can and cannot take amitriptyline

Most adults can take amitriptyline. It can also be taken by young people aged 16 to 17 years for depression or low mood.

Amitriptyline is not suitable for some people. To make sure it's safe for you, check with your doctor if you:

If you have diabetes, amitriptyline can make it more difficult to keep your blood sugar stable. Monitor your blood sugar more often for the first few weeks of treatment with amitriptyline and adjust your diabetes treatment if necessary. Speak to your doctor if your blood sugar levels are causing you concern.

How and when to take amitriptyline for depression

You'll usually take amitriptyline once a day. It's best to take it before bedtime because it can make you feel sleepy. If you find that you are still feeling drowsy in the morning you could try taking it earlier in the evening.

Dosage and strength

Amitriptyline tablets come in different strengths of 10mg, 25mg or 50mg.

Amitriptyline liquid also comes in 3 different strengths containing 10mg, 25mg or 50mg of amitriptyline in a 5ml spoonful.

The usual dose of amitriptyline for depression in adults is 50mg to 100mg a day. This may go up to 150mg a day if you need a stronger dose, but only under the supervision of a specialist.

Young people aged 16 to 17 years and older people sometimes start on a lower dose of 25mg to 50mg a day to reduce the chance of side effects.

The maximum dose of amitriptyline is 150mg per day.

Sometimes, when you're just starting treatment, you may be told to take a lower dose, 2 or 3 times a day, until you get used to the medicine. This is because taking a smaller dose 2 or 3 times a day for a while can reduce the chance of you having side effects.

How to take it

Amitriptyline does not usually upset your stomach, so you can take it with or without food.

Swallow the tablets whole with a drink of water. If you chew them, they taste bitter.

The liquid comes with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

What if I forget to take it?

If you take amitriptyline once a day and forget a dose, leave your missed dose and take your next one the next day at the usual time.

If you take amitriptyline 2 or 3 times a day and forget a dose, take it as soon as you remember unless it's close to the time for your next dose.

Never take 2 doses at the same time to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

The amount of amitriptyline that can lead to an overdose varies from person to person.

Taking more than your prescribed dose of amitriptyline can:

Contact 111 for advice now if:

  • you've taken more than your prescribed dose of amitriptyline

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the amitriptyline packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Side effects

Like all medicines, amitriptyline can cause side effects in some people, but many people have no side effects or only minor ones. Some of the common side effects of amitriptyline will gradually improve as your body gets used to the medicine.

Common side effects

Keep taking the medicine but talk to your doctor or pharmacist if these common side effects bother you or do not go away:

Serious side effects

It happens rarely, but some people have a serious side effect after taking amitriptyline.

Call a doctor straight away if:

Call 999 and ask for an ambulance if:

  • you have weakness on one side of your body
  • you have trouble speaking or thinking
  • you lose your balance or have blurred eyesight

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to amitriptyline.

These are not all the side effects of amitriptyline. For a full list see the leaflet inside your medicines packet.

How to cope with side effects of amitriptyline

What to do about:

Pregnancy and breastfeeding

Amitriptyline and pregnancy

If you are already taking amitriptyline, you may be advised to continue taking it during pregnancy, especially if you take it to treat depression.

If you become pregnant while taking amitriptyline, speak to your doctor. Do not stop taking your medicine unless your doctor tells you to.

Your doctor can explain how taking amitriptyline can help you and how it might affect you. They will also help you choose the best treatment for you and your baby.

Amitriptyline and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take amitriptyline while breastfeeding.

Amitriptyline passes into breast milk in very small amounts, so it's unlikely to cause any harm to your baby.

It's important to keep taking amitriptyline to keep you well. Breastfeeding will also benefit both you and your baby.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, then talk to your midwife, health visitor or doctor as soon as possible.

For more information about how amitriptyline can affect you and your baby during pregnancy, find out more on the Best Use of Medicines in Pregnancy (BUMPS) website.

Cautions with other medicines

Many medicines and amitriptyline can affect each other and increase the chances of side effects.

Always check with your doctor or a pharmacist before starting any new medicine while you are taking amitriptyline.

Taking amitriptyline with opioid medicines can increase your risk of becoming very drowsy and having breathing problems. Opioid medicines include:

Tell your doctor if you have ever taken any other medicines for depression. Some antidepressants can affect the way amitriptyline works and cause very high blood pressure. This can happen even after you have stopped taking them.

Mixing amitriptyline with herbal remedies and supplements

Do not take St John's wort, a herbal remedy for depression, while you're taking amitriptyline as this will increase your risk of side effects.

There's very little information about taking amitriptyline with other herbal remedies and supplements. They are not tested in the same way as medicines.

Common questions about amitriptyline

How does amitriptyline work in depression? When will I feel better? How will it make me feel? How long will I take it for? Are there any long-term side effects? Is it addictive? What will happen when I stop taking it? Will I gain or lose weight? Can I drive or ride a bike? Is amitriptyline better than other antidepressants? Are there other treatments that will help? Can I drink alcohol with it? Is there any food or drink I need to avoid? Will it affect my contraception? Will it affect my sex life? Will it affect my fertility? Will recreational drugs affect it?