Elavil is a popular brand of amitriptyline, a medication most commonly used to treat depression and anxiety. Amitriptyline is a tricyclic antidepressant (TCA), which is one of the earliest types of antidepressant ever developed. They work by rebalancing the chemicals of the central nervous system, which is why they have also shown to help people with chronic pain.
As an antidepressant, TCAs have been mostly phased out in favor of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which tend to have fewer side effects. However, Elavil is still commonly prescribed because of its effects on chronic pain as well as any depression or anxiety stemming from that pain.
Amitriptyline is prescribed for pain stemming from arthritis, fibromyalgia, damaged nerve endings (neuropathic pain) and some cases of unexplained chronic back and neck pain.
Common side effects of Elavil include:
- Dry mouth
- Blurred vision
- Weight gain
- Trouble urinating
- Increased appetite and weight gain
- Loss of libido
Patients have also reported increased feelings of anxiety and depression, particularly at the start of treatment. As with most antidepressants, Elavil carries a black box warning — the most severe warning offered by the FDA — because of the risk of developing suicidal thoughts. This is most likely to affect people under the age of 24. If you are taking amitriptyline and begin experiencing low moods, a desire to harm yourself or extreme anxiousness, consult a doctor right away.
Nowadays, Elavil is mostly used to treat chronic pain because more advanced antidepressants with fewer side effects are available. In the early days, when it was commonly used as an antidepressant, doses tended to be higher, but side effects were significant. Now, taking Elavil usually involves a lower daily dose (usually 75–150 mg), which can be enough to help with the pain without experiencing the worst of the side effects.
Elavil comes in several dosages: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg and 150 mg. The medication is taken orally, either with several smaller doses throughout the day or one larger dose. If it is only to be taken once a day, it is preferable to take Elavil at nighttime because it tends to make people feel drowsy.
Elavil should be taken regularly and at set times for best results. If you forget to take a dose, just take it as soon as you remember. However, if you don’t remember until a few hours before the next dose, just skip it: doubling down on a dose can lead to increased negative side effects or an overdose (see below).
It will probably take at least a week for you to feel the benefits and could take up to four weeks. Many people feel the worst of the side effects at the beginning of the treatment, with these easing off after two or three weeks. If your side effects do not ease off or if they get worse, contact your doctor to discuss your options.
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There is anecdotal evidence that large doses of amitriptyline can cause a ‘high’ or hallucinations; however, there have been no formalized studies around this. Trying to reach these large doses is extremely dangerous and can significantly worsen side effects as well as lead to a potentially fatal overdose. Signs of an amitriptyline overdose can include:
- Fast or uneven heartbeat
- Enlarged pupils
- Muscle stiffness
Despite the potential for a high, addiction to amitriptyline is not widely reported, probably because extremely high doses would be required to get an effect.
On the other hand, as is the case with several antidepressants, discontinuation of Elavil can cause withdrawal effects if done too suddenly. The most common withdrawal symptoms for amitriptyline are headaches, fatigue and dizziness. However, other effects have been noted including:
- Anger and irritation
- Body aches
- Flu-like symptoms
- Hypersensitivity to light and/or sound
You are more likely to experience withdrawal symptoms from amitriptyline if you were taking the medication for a long time (i.e., years) rather than a shorter course of treatment. You may also experience worse symptoms if you were taking a higher dose.
Always consult with your doctor before coming off Elavil, and reduce your dose very gradually. This will make the process easier and cause less shock to your central nervous system than quitting cold turkey. The weaning period will depend on how long you had been taking Elavil and at what dosage, with the decrease being slower and more gradual if your body has been used to it for a long time.