What Are the Side Effects of Elavil (Amitriptyline)?

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Elavil is a medication used primarily for the treatment of depression. It is what’s known as a tricyclic antidepressant. It can also be used to treat some symptoms of mood disorders, eating disorders, nerve pain, and anxiety.

In 2000, Elavil was discontinued by the Food and Drug Administration (FDA) due to the severe side effects people experienced while using the medication.

The reasons why the brand name form of the drug was discontinued remain unclear. It’s thought that Elavil was discontinued because of the risk it posed of developing a heart condition while using the medicine. However, in 2017 the FDA put out a notice stating that the reason for discontinuing the drug was unrelated to its safety or effectiveness.

Although you cannot get the brand name version, you can still get the generic alternative of Elavil, amitriptyline. Amitriptyline works by increasing the levels of chemical messengers like serotonin and norepinephrine in your brain. 

This article breaks down the common and severe side effects you might experience while using Elavil, how to cope with these side effects, and outlines any potential risks of taking the drug.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Side Effects of Elavil 

Even in its generic form, the side effects you might experience when using Elavil can be split broadly into two categories: mild or severe.

In other words, there are common side effects that typically go away with time and are usually nothing to worry about. On the other hand, there are more severe side effects that might require you to speak to your doctor about possibly lowering your dose or discontinuing the medication. 

Common Side Effects 

Although Elavil was discontinued, the generic form of the drug is still available and prescribed by doctors. It’s safe to take, and most people who use the medication will only experience a few mild side effects.

The most common side effects of Elavil include: 

  • Drowsiness 
  • Weight gain 
  • Dizziness 
  • Weight fluctuation 
  • Blurred vision 
  • Constipation 
  • Headaches
  • Dry mouth 
  • Lightheadedness 
  • Difficulty urinating

While these might only be milder side effects of Elavil, it’s important to speak to your doctor immediately if they remain persistent or worsen. 

Severe Side Effects

Experiencing severe side effects while using Elavil is uncommon. However, there have been reports of the following side effects sometimes occurring while using this medication:

  • Changes in your vision 
  • Seizures 
  • Being unable to urinate 
  • Bruising or bleeding 
  • Severe stomach pain
  • Muscle spasms 
  • Difficulty having sex 
  • Developing a mask-like face 
  • Hallucinations 
  • Tremors 
  • Fainting
  • Difficulty speaking 
  • Numbness in the arms or legs

If you notice any of the above side effects, consult your doctor immediately. However, you shouldn’t discontinue the medication without talking to your doctor first. Suddenly stopping Elavil could cause withdrawal symptoms like anxiety, nausea, headaches, and dizziness.

If your doctor intends to have you discontinue Elavil, they will most likely gradually reduce your dose to wean you off of the medication.

Neuroleptic Malignant Syndrome

In sporadic cases, Elavil could cause a condition called neuroleptic malignant syndrome (NMS). NMS is a reaction to antipsychotic drugs that causes muscle stiffness, fever, or an altered mental state.

Symptoms of NMS include:

  • Irregular heartbeat
  • Muscle stiffness
  • Excessive sweating
  • Severe confusion

If you develop any of the above symptoms while taking this medication, you should get medical help immediately. 

While there are very few reports of people developing an allergic reaction to Elavil or amitriptyline, it is possible. Symptoms of an allergic reaction to a medication typically include a swollen face, tongue, or throat, itching, dizziness, or trouble breathing. 

Coping With the Side Effects of Elavil 

While the more common side effects of this medication are not deadly, they can be bothersome. While using this medication, there are some safe ways to cope with the common side effects. For instance, if you are constantly constipated, you should increase your fiber intake and drink a lot of water.

People who experience dry mouth could also increase their water intake or chew on some ice chips for relief. 

If you experience headaches while taking Elavil, it’s safe to take over-the-counter pain medications like acetaminophen (e.g., Tylenol). But, if the headaches persist or increase in severity, you should speak to your doctor about them. 

Elavil has sedative effects and could cause you to become a little dizzy or drowsy. So, it’s advisable to take this medication in the evening and avoid driving or operating any heavy machinery after taking this medication.

Warnings and Interactions 

Before prescribing Elavil, a doctor will take a thorough look into your medical history and find out if you are taking any other medications.

It’s essential to make a list of all medications you are on, including those you might have discontinued recently. Certain drugs interact dangerously with Elavil and, in some cases, could cause fatal results. 

Let's take a look at some of the drugs that can interfere with Elavil and discuss who should not take Elavil.

Drugs That May Interfere With Elavil

Here are some drugs or substances that may negatively impact the efficacy of Elavil.

MAOIs

People who are already taking monoamine oxidase inhibitors (MAOIs) or have just recently stopped using MAOIs are typically not prescribed Elavil. This is because it can cause very high fevers, convulsions, and death in the most extreme cases. There’s some evidence to suggest that when Elavil is used with epinephrine, it could cause high blood pressure.

Alcohol

Like with most medications, you shouldn’t consume alcohol when using Elavil. Alcohol could heighten its sedative effects and cause the medicine to be ineffective in treating symptoms of depression.

Who Should Not Take Elavil

Here are some populations that Elavil is not recommended for.

People With Heart Problems

One of the more uncommon side effects of using Elavil is an irregular heartbeat. This is why people with heart problems might be discouraged from taking this medication. In severe cases, Elavil has been linked to a condition called QT prolongation, which could cause seizures, fainting, and in fatal cases, death. 

Younger People

Research has linked the use of antidepressants to an increased risk of suicidal thoughts and ideation. If you or someone you know who’s on this medication notice any changes in mood or behavior, it’s crucial to speak to a doctor about it immediately. This is typically more common with younger people who are on the medication. 

Elavil is typically prescribed for people who are over 18. It might be prescribed for children with nerve pain in some instances, but this is done with caution.

Other Populations

In almost no scenario should Elavil ever be prescribed to the following people: 

  • People with liver or kidney conditions 
  • Pregnant people or people who are breastfeeding 
  • People with epilepsy or any disease which causes seizures 
  • People with glaucoma 
  • People who have allergic reactions to tricyclic antidepressants 
  • People with certain heart conditions like angina, for instance 
  • People who are already taking another type of antidepressant 

Additional Things to Know

Although Elavil and other brand-name forms of amitriptyline have been discontinued, you can still get this medication under its generic name.

Amitriptyline has been found to be effective in treating depression. It is also prescribed off-label to treat chronic pain, post-traumatic stress disorder, anxiety, neuralgia, insomnia, and irritable bowel syndrome.

Today, tricyclic antidepressants like Elavil are typically not the first option for doctors when prescribing antidepressants to people living with depression.

Selective serotonin reuptake inhibitors (SSRIs) like Prozac, Celexa, and Cipramil, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, Effexor, and Fetzima are typically tried first. Research shows that they tend to have fewer side effects than tricyclic antidepressants.

A Word From Verywell

Elavil is an effective drug for treating depression. Unfortunately, you might experience some side effects while using this drug that will range in severity. If you experience mild side effects like dry mouth, constipation, drowsiness, and headaches, they are typically nothing to worry about. However, more severe side effects like tremors, seizures, and fainting should be reported to your doctor immediately. It's essential to pay close attention to changes in your body and mood while using this drug and tell your doctor of any uncomfortable changes.

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