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Side Effects of Amitriptyline (Elavil, Endep, Vanatrip)



Amitriptyline, commonly referred to by its trade name Elavil, is a tricyclic antidepressant medication. It is commonly used in the treatment of a number of mental health issues. These include: major depressive disorder, bipolar disorder, anxiety disorder and attention deficit hyperactivity disorder (ADHD). It is also used to prevent migraines and a number of conditions that cause neuropathic pain such as postherpetic neuralgia. Amitriptyline is metabolized to its active metabolic form nortriptyline, which inhibits reuptake of catecholamines such as noradrenaline and serotonin. It belongs to the tricyclic class of antidepressants.

Serious Side Effects of Amitriptyline

Serious reactions to amitrptyline according to the National Institutes of Health (Aug 2010) include:

  • Uncontrollable shaking of a part of the body
  • Fainting
  • Seizures
  • Unusual bleeding or bruising
  • Hallucinating
  • Slow or difficult speech
  • Crushing chest pain
  • Irregular heartbeat
  • Common Side Effects of Amitriptyline

    Amitriptyline acts to block the reuptake of 5HT and noradrenaline. As it works on a number of neurotransmitters, which regulate a multitude of different functions in the human body. Adverse reactions, according to the amitriptyline drug label, as reported by the FDA, include:

  • Serotonin syndrome
  • Comas
  • Seizures
  • Disorientation
  • Ataxia
  • Tremors
  • Numbness
  • Paresthesia (pins and needles)
  • Sleep disturbance
  • Restlessness
  • Drowsiness
  • Headaches
  • Tinnitus (ringing in ears)
  • Dysarthria (difficult speech)
  • Myocardial infarction
  • Stroke
  • Tachycardia (increased heart rate)
  • Hypotension (low blood pressure)
  • Hypertension (high blood pressure)
  • Palpitations
  • Syncope (fainting)
  • Mania
  • Constipation
  • Dry mouth
  • Nausea
  • Diarrhea
  • Black tongue
  • Tremors
  • Hepatitis (inflammation of the liver)
  • Alopecia (balding)
  • Increased sweating
  • Rashes
  • Anorexia
  • Blurred vision
  • Weight gain
  • Weight loss
  • Increased appetite
  • Less Common Side Effects of Amitriptyline

    Rare adverse reactions to amitriptyline include:

  • Vivid dreams
  • Impotence
  • Tremor
  • Confusion
  • Nasal congestion
  • Understand Your Risk for Side Effects with the Rxight® Genetic Test

    Amitriptyline is metabolized by a significant family of liver enzymes with significant interindividual genetic variations – a process which is measured by the science of pharmacogenetics. Certain variations in the genes that encode for these liver enzymes are associated with increased side effects when taking amitriptyline. Other studies have demonstrated that gene variants may result in reduced or non-existent therapeutic efficacy. As such, it is recommended that amitriptyline is avoided in ultra-rapid metabolizers, and the starting dose is altered in poor metabolizers. You can understand such your genetic metabolic risk with a dna test.

    How Does Pharmacogenetic Testing Work?

    The propensity toward side effects is due to genetic differences between patients. The Rxight®pharmacogenetic testing program is designed to evaluate your unique reactions to Elavil and other tricyclic antidepressants and thus help obviate potential side effects. All that is required is a simple DNA cheeks swab from a participating pharmacist, after which your sample will be sent to our lab for processing. Hundreds of different prescription medications and over-the-counter products across 50 clinically significant medication classes are analyzed. Rxight® is the most comprehensive CLIA-certified PGx testing service available.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Read more about Rxight® pharmacogenetics