What Is Elavil (amitriptyline) Used For?
Elavil is a tricyclic antidepressant that was FDA approved to treat depression with an additional prescribing statement that amitriptyline is more likely to work when the cause of a depressive state is unknown. Though doubtlessly ignored by many prescribers, this statement singularly points to the risks of prescribing psychotropic drugs before actually investigating possible causes for unwanted symptoms.9
Amitriptyline is a relatively old drug, that came out of research for schizophrenia treatment in the 1950s. One of the drug’s strongest proponents, a psychiatrist researching for Merck named Frank Joseph Ayd, suggested using it as an antidepressant rather than as an antipsychotic drug.12 Marketed as Elavil, it was presented 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, 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-based solutions to mental unease.
The 1950’s decade was a time of discovery and experiment, and drugs like Elavil emerged at the dawn of the 1960s. 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 suicide, as the FDA black box warning most clearly stipulates. 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. Many off-label uses for Elavil13 have developed in the decades following its release, such as the following examples:
- SAD (social anxiety disorder, or panic disorder)
- GAD (generalized anxiety disorder)
- Diabetic neuropathy
- Interstitial cystitis (bladder pain syndrome)
- 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
- Headaches, migraine headaches
- Quitting smoking
- Tourette Syndrome
- IBS (irritable bowel syndrome)
- Chronic hiccups
- BDD (body dysmorphic disorder)
- In neurologically impaired children or Parkinson’s patients, to control excessive salivation
- 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.” New brand names for amitriptyline number in the hundreds in the US and around the globe. Many drugs combine amitriptyline with other types of medications.25 As of 2017, 64 different drug manufacturers produce this drug under many names, such as:
- Dot Trip
- And others. Be sure to ask your prescriber what is in your medication.
Elavil 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.13
Note: To reduce lightheadedness, it may help to remember to get up from a lying or sitting position more slowly than normal.2
However, there are other amitriptyline/Elavil 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 are adverse Elavil side effects13,23,25 — some are extremely severe that should be watched for carefully as they could signal overdose:
- Increased suicidality, thoughts of suicide, obsessive thoughts of death, hurting oneself, hopelessness, etc.
- Should be discontinued before surgical anesthesia, risk of arrhythmias
- Mania, hypomania (shorter period of manic condition)
- Risk of bone fracture due to loss of bone marrow
- Cognitive impairment
- Memory loss
- Long-term use is connected to increased incidence of dementia
- Crushing pain in the chest
- Liver impairment, liver disease
- Cardiac arrest and other heart conditions
- Seizures – lowered seizure threshold
- Swelling of the face, hands, feet, etc.
- Yellowing of the skin, eyes
- Unusual bruising or bleeding
- Uncontrollable shaking, tremors
- Numbness or tingling
- Severe rash
- Tardive Dyskinesia
- Emotional blunting
- Nightmares, vivid dreams
- Abnormal involuntary movements
- Akathisia (internal profound and unrelenting restlessness usually accompanied by rocking, pacing, twisting, marching, etc.)
- Sexual dysfunction
- Tachycardia, rapid, pounding or irregular heartbeat
- 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
- Sexual dysfunction, 6-fold higher in males than females 14,15
- May suppress the release of growth hormone16
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.
Although the exact mechanisms of amitriptyline are still unknown after 60 years, researchers suggest the drug affects at least 5 pathways and receptors, including serotonergic, dopaminergic, histamine, muscarinic, norepinephrinergic, and likely others which may explain, at least in part, why amitriptyline interacts so dangerously with SSRIs, MAOIs, SNRIs, NRIs, and many other medications.17,22,23