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Improves mood and relieves certain kinds of pain.

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Prescription onlyLower-cost generic available

Our bottom line

Elavil (Amitriptyline) is an older antidepressant that's sometimes used to treat pain and sleep problems, but it can have more side effects than similar medications.


  • Low doses work well to treat certain kinds of chronic pain. It can take 2 weeks to feel the full effects of the medication.
  • Low doses of Elavil (Amitriptyline) start working in 45 minutes to help you sleep better.
  • Six out of every ten people who use an antidepressant for the first time find that it works for them.
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  • When used for depression, Elavil (Amitriptyline) causes more side effects and has a higher risk of overdose than other antidepressants. It's usually used when other medications haven't worked.
  • It's more likely to cause sleepiness, nausea, constipation, diarrhea, and weight gain (1 to 5 pounds) than other antidepressants.
  • People age 65 and older have a higher risk for this medication's side effects.
  • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people age 24 and younger.
  • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.

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What to expect when you take Elavil (Amitriptyline) for Depression

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Tips from our pharmacists
  • Take at bedtime to avoid some of its side effects.
  • Can cause dizziness, drowsiness, constipation, and weight gain.
  • Stop taking it slowly to avoid getting withdrawal symptoms.
  • Tell your doctor if you notice sudden mood changes or unusual thoughts.
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Side effects for Elavil (Amitriptyline)

Manufacturers don’t say how common these side effects are

  • Abnormal heart rhythm
  • Abnormal involuntary movements
  • Abnormally fast heart beat
  • Anxiety
  • Black tongue
  • Bleeding under the skin
  • Blurred vision
  • Bone marrow depression including agranulocytosis
  • Breast enlargement and galactorrhea in the female
  • Change in brain activity
  • Coma
  • Confusional states
  • Constipation
  • Dangerously high body temperature
  • Delusions
  • Diarrhea
  • Difficulty changing eye focus
  • Dilated pupil
  • Disorientation
  • Disturbed concentration
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Electrical problems in the heart
  • Elevation and lowering of blood sugar levels
  • Eosinophilia
  • Excitement
  • Facial swelling
  • Fainting
  • Fatigue
  • Hair loss or baldness
  • Hallucinations
  • Headache
  • Heart attack
  • Heart block
  • Heart pounding or racing sensation
  • High blood pressure
  • Hives
  • Impotence
  • Incoordination
  • Increased eye pressure
  • Increased or decreased libido
  • Increased perspiration
  • Inflamed liver (including altered liver function and jaundice)
  • Lack of muscle coordination
  • Loss of appetite
  • Low blood pressure
  • Low white blood cells
  • Mouth and lip swelling
  • Nausea
  • Nerve damage
  • Nightmares
  • Numbness
  • Paralyzed intestines
  • Peculiar taste
  • Photosensitization
  • Positional low blood pressure
  • Restlessness
  • Ringing in the ears
  • Saliva gland swelling
  • Seizures
  • Skin rash
  • Sleep difficulty
  • Slurred speech
  • Stroke
  • Swelling due to excess fluid
  • Syndrome of inappropriate adh (antidiuretic hormone) secretion
  • Tardive dyskinesia
  • Testicular swelling and gynecomastia in the male
  • Thrombocytopenia
  • Tingling
  • Tingling sensation
  • Tremors
  • Upset stomach
  • Urinary frequency
  • Urinary retention
  • Urinary tract dilation
  • Vomiting
  • Weakness
  • Weight gain or loss

Risks and Warnings for Elavil (Amitriptyline)

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    • Higher risk if:
    • Age 24 years or younger

    Elavil (Amitriptyline) may increase the risk of suicidal thoughts or behavior. Watch for worsening depression or any unusual changes in mood or behavior, especially during the first few months of treatment or when the dose changes. Report anything concerning to a doctor immediately. Elavil (Amitriptyline) is not approved for use in children younger than age 18.

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Elavil (Amitriptyline)

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The FDA category for this medication is C. It is advised that you: Weigh risks vs. benefits
  • Upsides and downsides from our pharmacists
  • Low doses of Elavil (Amitriptyline) start working in 45 minutes to help you sleep better.
  • Tips from our pharmacists
  • Can cause dizziness, drowsiness, constipation, and weight gain.
  • Helped sleep at bedtime. Not as effective as Trazodone, but kept me asleep without waking up in pain.
  • If you have issues with not getting enough sleep, this medication helps with that along with my muscle tics.
  • If you have other choices TAKE THEM! I've been on this for 17 years it's destroyed my body it's given me stomach ulcers 2 heart conditions dry mouth weigh gain nightmares night sweats excessive sweating ringing ears hair loss and now I can't get off of it bc my body is so dependent on it for sleep, please don't take this med For prolonged use if you have any other options
  • Upsides and downsides from our pharmacists
  • It's more likely to cause sleepiness, nausea, constipation, diarrhea, and weight gain (1 to 5 pounds) than other antidepressants.
  • Tips from our pharmacists
  • Can cause dizziness, drowsiness, constipation, and weight gain.
  • The dry mouth and weight gain. But I was in such a black hole of depression, side effects didn't matter.They WILL GO AWAY. A surprising but fantastic result was it took away my debilitating migraines for good! Start on low dose and increase slowly. This definitely will reduce side effects. The weight gain DOES STOP!! Then you lose that excess weight. Hang through the side effects please. May take a couple of months but is worth it. Elavil SAVED MY LIFE!! LITERALLy!!
  • After trying 3 SSRIs and an SNRI I tried this medication. It was great. Slept brilliantly. Helped with my back pain too. Didn't have too many side effects, mainly drowsiness in morning for about a week. Bit of weight gain bit if you are aware you can try and control that.
  • Dry mouth is not a problem every time,just drink a water or chew gum..I benefit a lot in every aspect I expected.Weight gain has started be a real problem though recently.