Conditions the medication is used for: Depression, Bedwetting, Insomnia

Other names for the medication: Amitriptyline, Triptafen, Triptafen-M

The medication may look like: Amitriptyline comes in tablet form, 10mg,25mg, 50mg. Amitriptyline also comes in an oral solution, 25mg/5ml. Triptafen comes in tablet form coloured pink, 25mg. Triptafen M comes in tablet form also coloured pink, 25mg

What is this medication used for?

Amitriptyline is one of a group of medicines called the tricyclics. It is mainly used to help treat the symptoms of depression. It can also be used to help stop migraines, insomnia (in low dose), pain caused by nerve damage, urge incontinence (when you don’t get to the toilet in time) and bed-wetting. Amitriptyline is made as tablets and a syrup.

What is the usual dose for this medication?

The usual dose of amitriptyline should be around 125-150mg a day for depression.

How and when should I take the medication?

How to take:

Swallow the tablets with at least half a glass of water whilst sitting or standing. This is to make sure that they reach the stomach and do not stick in your throat. For the liquid, use a medicine spoon, dropper or oral syringe. Your mouth may feel a little numb after taking the liquids as it can have a local anaesthetic effect, this is common and nothing to worry about.

When to take:

Take your medication as directed on the medicine label. Try to take it at regular times each day. Taking it at mealtimes may make it easier for you to remember as there is no problem about taking it with or after food. If the label says to take it once a day this is usually best at bedtime as it may make you sleepy at first.

What are the alternatives to this medication?

This will depend on what you are taking it for. There are many other medicines (e.g. SSRIs), talking therapies and treatments for depression and other symptoms. See  “Handy chart” to help you compare the medicines, how they work and their side effects.

How long does the medication take to work?

This will depend on what you are taking it for. For depression, the effect will start in a week or two, and carry on building for the next few weeks. Please look at one of the “Handy charts” or on our website for more help.

How long will I need to keep taking this medication for?

This will depend on what you are taking it for and how well you are doing. Please see the “Handy charts” on our website for more help and advice.

Can I just stop taking this medication?

It is unwise to stop taking it suddenly, even if you feel better. Your symptoms can return if treatment is stopped too early. This may occur some weeks or even months after the medicine has been stopped. When the time comes, you should withdraw amitriptyline by a gradual reduction in the dose taken over a period of several weeks. You should discuss this fully with your doctor.

What should I do if I forget to take a dose or overdose?

Take the missed dose as soon as you remember unless it is within about 8 hours of your next dose. If you remember after this just take the next dose as normal. Do not try to catch up by taking two doses at once as you may get more side-effects. If you have problems remembering your doses (as very many people do) ask your pharmacist, doctor or nurse about this. There are some special packs, boxes and devices that can be used to help you remember.

Can I drink alcohol while on this medication?

If you drink alcohol while amitriptyline it may make you feel more sleepy. This is particularly important if you need to drive or operate machinery and you must seek advice on this.

Will this medication affect my other medications Including the Contraceptive pill?

Amitriptyline has a few interactions with other medicine

  • The effects of amitriptyline can be increased by some antipsychotics, some heart drugs and SSRIs
  • If amitriptyline is taken with benzodiazepines (e.g. diazepam) or alcohol, it will cause more sleeping   
  • There can be problems if taken with other antidepressants e.g. SSRIs (inc. fluoxetine), venlafaxine etc.
  • You should have no problems with "The Contraceptive Pill" and amitriptyline.

Not all of these interactions happen in everyone. Some of these medicines can still be used together but you will need to follow your doctor's instructions carefully. There are many other possible drug interactions.

What sort of side-effects might I get from taking this medication?

Side effect

What happens

What to do about it

VERY COMMON (more than about 1 in 10 people might get these)

Sleepiness

Feeling sleepy, drowsy or sluggish. It can last for a few hours after taking your dose.

Don't drive or use machinery. Ask your doctor if you can take your amitriptyline at a different time.

Constipation

When you want to poop but can't (the opposite of diarrhoea). You can't pass a motion.

Make sure you eat enough fibre, cereal or fruit. Make sure you are drinking enough fluid. Make sure you keep active and get some exercise e.g. walking. If this does not help, ask your doctor or pharmacist for a mild laxative.

Dry mouth

Not much saliva or spit.

Suck sugar-free boiled sweets or gum. If it is bad, your doctor may be able to give you a mouth spray.

Blurred vision

Things look fuzzy and you can't focus your eyes properly.

Do not drive with blurred vision. This should wear off after a few weeks. If it does not wear off, see your doctor if you are worried.

Weight gain

A bigger appetite. Putting on weight.

A diet full of vegetables and fibre may help prevent weight gain.

COMMON (fewer than about 1 in 10 people might get these)

Nausea

Feeling sick.

If it is bad contact your doctor. Take each dose with or after food.

Headache

Your head is pounding and painful.

Try paracetamol. Your pharmacist will be able to advise if this is safe to take with any other medicines you may be taking.

Urinary retention

Not much urine passed. Feeling you haven’t fully emptied your bladder.

Contact your doctor now.

Postural hypotension

A low blood pressure - this can make you feel dizzy when you stand up.

Try not to stand up too quickly. If you feel dizzy, don't drive.

Palpitations

A fast heart beat.

It is not usually dangerous. It can easily be treated if it lasts a long time. Tell your doctor about it.

Sexual dysfunction

Finding it hard to have an orgasm. No desire for sex.

Discuss with your doctor.

UNCOMMON (fewer than about 1 in 100 people might get these)

Tremor

Feeling shaky.

Contact your doctor now.

Skin rashes

Blotches on the skin.

Stop taking and contact your doctor now

 

Do not be worried by this list of side effects. Some people get no side effects at all and others may get some effects that are not listed in this table. If you think you might have a side effect to your medicine, you should ask your doctor, nurse or pharmacist.

Will I need to have blood tests?

You should not usually need any blood tests unless you are taking a high dose. If you have bipolar disorder,  schizophrenia or other long-term mental health problem, it is important to look after your physical health as well. National guidelines recommend that you should at least have your blood pressure, weight, blood glucose and blood fats (e.g.  lipids, cholesterol) checked regularly. This may be done by a hospital to start with, but after that your GP should arrange for all these to be checked at least every year. And then to do something about it if there is anything that needs treating.

Can I drive or cycle while on this medication?

Amitriptyline can affect your driving in two ways. Firstly, you may feel sleepy and/or get blurred vision at first when taking amitriptyline. Secondly, it can slow down your reactions or reflexes. This is especially true if you also have a dry mouth, blurred vision, constipation etc (the so-called "anticholinergic side effects") until these wear off, or you know how amitriptyline affects you, do not drive or operate machinery, you should be careful as it may slow down your reaction times or reflexes even though you feel well.

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