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Elavil (Amitriptyline) Side Effects, Withdrawal and FAQs

Elavil (Amitriptyline) ranks number one of all antidepressant drugs for death due to suicide.
An astounding 2 of every 5 antidepressant related suicides link to amitriptyline, according to a 2017 report by Dr. J Craig Nelson (UCal), and Dr. Daniel A. Spyker (Oregon Health and Science U in Portland). (1)

Elavil (Amitriptyline) was one of the very first drugs ever produced in the class of antidepressants called “tricyclics”, first marketed in the 1960’s. The word tricyclic comes from the triple ring of atoms that comprise the drug’s structure. The toxicity of this drug has become renowned. Those attempting suicide with it are usually successful, as Elavil’s lethal effects are tragically well documented over the last nearly six decades.  Overdoses are tragically frequent as well, due to not only the toxic effects on neurochemistry, but on the heart and respiratory systems as well.

Below we have collated important and useful information concerning this neurotoxic substance, but there may be other questions you have about which you should consult with your doctor or caregiver especially if you have not yet begun a prescription.

Below, we will cover side effects, helpful information regarding Elavil (Amitriptyline) withdrawal, and other information that may be useful in deciding whether to begin treatment with the drug, and to acquire some familiarity with how the drug can potentially affect various functions of the body, including the heart, the digestive and urinary tracts, and the brain.

What is Elavil (Amitriptyline) Used For?

Elavil is a tricyclic antidepressant that has mainly been used in the treatment of mood disorders such as depression and anxiety, and is also prescribed to improve sleep.

Elavil arrived to a relatively eager-eyed consumer base along with a rash of new drugs and new discoveries about the human body, genes, hormones and much new information that rode in on the post WWII wave of cultural, economic, political and social change.

Prescription drugs were beginning to establish themselves in mainstream treatment of physiological illnesses, for example, with the advent of new vaccines. Food preservatives were being developed that would alter the food industry forever. And, mental health treatment was quickly transforming to a system that relied much more than before on chemical-based remedies rather than psychotherapy.

The 1950’s decade was a time of discovery and experiment, and drugs like Elavil emerged at the dawn of the 1960’s. The drug was tried out on a surprising number of conditions, on all ages, including very young children.  However, prescribing Elavil for anyone under the age of 25 is now not recommended due to the serious risk of suicidality, as the FDA black box warning most clearly stipulates.

Here are some of the purposes for which Elavil (Amitriptyline) has been prescribed:

  • SAD (social anxiety disorder, or panic disorder)
  • GAD (generalized anxiety disorder)
  • MDD (major depression disorder)
  • Premenstrual symptoms
  • ADHD (attention-deficit hyperactive disorder)
  • OCD (obsessive compulsive disorder)
  • Anorexia Nervosa (eating disorder)
  • Bulimia (eating disorder)
  • Bipolar Disorder
  • BPD (borderline personality disorder)
  • Parkinson’s Disease
  • Headache
  • Fibromyalgia
  • Quitting smoking
  • Tourette Syndrome
  • IBS (irritable bowel syndrome)
  • Bedwetting
  • Narcolepsy
  • Chronic hiccups
  • Insomnia
  • BDD (body dysmorphic disorder)
  • And a host of other conditions.

 

Elavil (Amitriptyline) Alternative Names and Slang

Elavil has not earned any common street names, as it rarely ever made its way into the world of recreational use/abuse despite its euphoric and hallucinogenic effects at high doses.  Due to the toxicity of the drug on the brain and the cardiovascular system at such high levels, recreational use would not uncommonly be fatal.

US drug makers no longer use the brand name “Elavil”, having changed it to Endep instead. In the US, the drug is mostly prescribed as a drug of last resort, opting for a tricyclic when other types of antidepressants have not worked.

Other brand names for Amitriptyline number in the hundreds. As of 2017, 64 different drug manufacturers produce this drug under many names, such as:

  • Vanatrip
  • Amilite
  • Amitrip
  • Amiwel
  • Eliwel
  • Dot Trip
  • Gentrip
  • Mitrip
  • Nextrip
  • And so on.

 

Elavil (Amitriptyline) Side Effects

Some of the most common and relatively mild side effects for Elavil (amitriptyline) have been reported as constipation, urinary retention, a feeling of drowsiness, dizziness or feeling lightheaded, dry mouth, weight gain, and blurred vision.

Note – To reduce lightheadedness, it may help to remember to get up from a lying or sitting position more slowly than normal.

However, there are other side effects that may present and should be monitored carefully should they worsen or become hard to tolerate, as this could signal that medical attention is needed on an immediate basis. The following adverse effects can be serious and should be watched for carefully:

  • Cognitive impairment
  • Memory loss
  • Long term use is connected to increased incidence of dementia (2)
  • Increased suicidality, thoughts of suicide, obsessive thoughts of death, hurting oneself, hopelessness, etc.
  • Cardiac arrest
  • Stroke
  • Coma
  • Seizures
  • Numbness or tingling
  • Tardive Dyskinesia
  • Anxiety
  • Emotional blunting
  • Nightmares
  • Insomnia
  • Abnormal involuntary movements
  • Confusion
  • Restlessness
  • Akathisia (internal profound and unrelenting restlessness usually accompanied by rocking, pacing, twisting, marching, etc.)
  • Sexual dysfunction
  • Tachycardia
  • Overdose leading to coma, delirium, cardiac arrest
  • Dry mouth
  • Increased body temperature
  • Blurred vision
  • Constipation/urinary retention
  • High or low blood sugar levels
  • Testicular swelling in males, and swelling of breast tissue in females
  • Note: Amitriptyline has more than 250 major interactions with other medications including common cold and cough remedies, sedatives, histamines, oral contraceptives, and even alcohol. Avoiding all other medications and drugs is essential to your health and safety, whether prescribed or gotten over the counter. Consult with your caregiver before taking any other drug, medicine or alcohol if you are taking Amitriptyline.

 

Elavil (Amitriptyline) Withdrawal Symptoms

Withdrawal symptoms are generally not life-threatening where the taper is gradual, but they can nonetheless be very uncomfortable especially if one has been on Amitriptyline for a very long time, or the dosage was very high or is being cut too quickly.

If someone is on multiple medications, this can make the withdrawal process somewhat more complex. Always consult a medical practitioner familiar with withdrawal from prescription drugs for the safest guidance.

As is the case for many prescription drugs, the withdrawals can resemble the side effects, and re-emergence of original symptoms is also not uncommon, though they can significantly intensify during cessation, especially if the withdrawal is too rapid or sudden.

Withdrawal from Elavil can cause the following adverse reactions:

  • Nausea
  • Anger
  • Crying or other sudden emotional outbursts
  • Depersonalization
  • Hypersensitivity to lights, sound and external motion
  • Muscle pains and aches
  • Weight gain or loss
  • Sweating
  • Headache
  • Tiredness
  • Anxiety
  • Agitation
  • Malaise
  • Sleep disturbance
  • Unusual dreams
  • Rash, swelling, especially of the face and tongue
  • Vomiting
  • Diarrhea
  • Insomnia, interrupted sleep
  • Unusual dreams
  • Irritability
  • Restlessness
  • Joint pain

How Long to Elavil Withdrawal Symptoms Last?

Withdrawal is commonly reported to last a number of weeks or months until these symptoms eventually begin to fade.

Individual factors can greatly affect the time it takes to recover from withdrawal, such as age, general health, genetic factors, diet, social support or lack thereof, stress from the immediate environment, whether someone is on multiple medications, extant pathology, etc.

Discontinuing/Quitting Elavil (Amitriptyline)

Some people will experience very mild withdrawals, while others may feel so overwhelmed as to make the task near to impossible. It can happen that without proper support and guidance, the person may decide to give up completely and go back on the antidepressant. With proper step by step help, it may be possible for even the most difficult of withdrawals to be gently and correctly guided along to a successful outcome.

Can I stop Taking Elavil Cold Turkey?

Abrupt withdrawal from Amitriptyline is hard to distinguish from the signs of acute toxicity. (3)

Acute toxicity develops rapidly whatever the cause, and requires immediate hospitalization to prevent injury or death. Airway compromise, respiratory failure, coma, seizure, convulsions can all present and need intensive care to prevent irreparable damage.

Therefore, coming off tricyclic antidepressant drugs such as Elavil (amitriptyline) should never be done abruptly or too quickly. Always consult a medical caregiver/physician who is familiar with safe tapering before you begin any attempt to come off an antidepressant.

Elavil (Amitriptyline) FAQs

Below are several commonly asked questions about Elavil (amitriptyline). If you have other questions please seek additional information and consult a medical practitioner whenever possible.

Is Elavil a Narcotic?

Elavil (amitriptyline) is classed as a tricyclic antidepressant. In a general sense, any drug or even alcohol, and some foods can have a “narcotic” effect, meaning inducing dullness or mental lethargy, having a sleep-inducing or a calming effect. But in the legal sense of how drugs are classified, no, Elavil is not classified as a “narcotic”.

How Long Does Amitriptyline Stay in Your System?

Amitriptyline is metabolized rapidly in the system once ingested. Within 24 hours, roughly one-third to one-half of the drug is excreted. Certain medications can accelerate metabolization, if needed, in a medical setting such as attempting to reverse an overdose.

As a special note for pregnancy, amitriptyline crosses the placenta so it is not recommended for nursing mothers. Insufficient testing over the last 6 decades has left unanswered questions about the safety of taking this drug while pregnant.

What is the Half Life of Amitriptyline?

The half-life of Amitriptyline is estimated at 20 hours. Half-life can be dependent on unique individual factors, such as genetics, age, nutritional deficiencies, etc.

But in approximate terms, working out the half-life of amitriptyline means if you took 100 mg, after 20 hours you would still have half in your system, or 50 mg.

After another 20 hours, you would have 25 mg left, and so on. Since there are so many factors that can influence the process, these are estimates that can change a bit from person to person.

Treatment for Amitriptyline Dependence

Mild treatment for amitriptyline dependence can help alleviate the symptoms that can often accompany coming off an antidepressant.  Since genetic factors can inform some of the potential difficulties, these can be specifically tested for prior to withdrawal, and can be mitigated to a degree through nutrition and supplementation.  There are many other gentle methods to make cessation as smooth and mild as possible.

Dependence on a drug can be tough to turn around if done too quickly and without the proper care and nutritional support that the body needs to make the adjustment. Patience, compassion, targeted nutrition and other non-invasive methods can all help.

If you have questions about the best methods of treatment for antidepressant cessation, we can offer much information on request that can help in understanding the process, and the most effective methods that are available to soften and ensure a mild, comfortable taper and a maximally health-restoring experience. 


This content has been reviewed, and approved by a licensed physician.

Dr. John Motl, M.D.

Dr Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor’s of Science degree with a major in biology and minors in chemistry and philosophy. He graduated Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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