If you have depression, you may be interested in learning more about amitriptyline. It’s a generic prescription drug used to treat depression in adults and some children. Amitriptyline comes as a tablet that you swallow.

If amitriptyline works for you, your doctor will likely recommend taking it long term.

This article describes amitriptyline’s side effects (also called adverse effects). For more information about amitriptyline, including details about its uses, see this in-depth article.

Some people may experience mild to serious side effects during their amitriptyline treatment. Examples of amitriptyline’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

You may experience mild side effects from taking amitriptyline. Examples of mild side effects that people taking amitriptyline have reported include:

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using amitriptyline. But it’s not clear whether this side effect occurred in studies.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop taking amitriptyline unless your doctor recommends it.

Amitriptyline may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Although less common, it’s also possible to have serious side effects from amitriptyline. Serious side effects that have been reported with amitriptyline include:

If you develop serious side effects while taking amitriptyline, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Amitriptyline has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.
‡ An allergic reaction is possible after using amitriptyline. But it’s not clear whether this side effect occurred in studies.
§ In this article, we use the terms “male” and female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with amitriptyline, visit MedWatch.

Learn more about some of the side effects amitriptyline may cause.

Risk of suicidal thoughts and behaviors in children and young adults

Amitriptyline may increase the risk of suicidal thoughts and behaviors in children and young adults. Although this was not a common side effect in amitriptyline studies, it can occur.

Due to the risks, amitriptyline has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about the risks of taking a medication.

The risk of suicidal thoughts and behaviors is higher in children and young adults ages 24 years and younger.

What might help

If you’ve experienced any mental health conditions or suicidal thoughts or behaviors, talk with your doctor before taking amitriptyline. Your doctor may monitor you more closely for these side effects during your amitriptyline treatment.

In addition, it’s important to tell your doctor about any mood changes that you experience while taking amitriptyline. You should ask a family member or caregiver to watch for changes in mood as well. Examples of these changes may include:

If you do experience mood changes while taking amitriptyline, your doctor may monitor you more closely. In some cases, they may recommend that you stop taking amitriptyline and switch to a different treatment.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Weight gain

It’s possible to gain weight from taking amitriptyline. Weight gain was reported in studies of the drug.

Keep in mind that weight loss may be a symptom of depression, which amitriptyline treats. You may have weight gain while taking amitriptyline as your depression improves. In this case, the drug may not be causing the weight gain.

What might help

If you notice weight gain while you’re taking amitriptyline, talk with your doctor. They may be able to help determine ways to manage your weight. If the weight gain bothers you, your doctor may be able to recommend a different treatment option.

Headache

It’s possible for amitriptyline to cause headache. This side effect was reported in studies of amitriptyline.

It’s important to note that headache can be a symptom of stroke, which is a serious side effect of amitriptyline. Other symptoms of stroke can include:

  • numbness or weakness on one side of your body, face, leg, or arm
  • slurred speech
  • changes in vision
  • trouble walking

What might help

If you experience headache during your amitriptyline treatment, talk with your doctor. They may recommend an over-the-counter medication, such as acetaminophen (Tylenol), to relieve your headache.

Call 911 or a local emergency number right away if you have a headache along with other symptoms of stroke.

Cardiac (heart-related) side effects

Some people may experience heart-related side effects while taking amitriptyline.

Examples of heart-related side effects that could occur with amitriptyline may include:

What might help

Your doctor may monitor your heart more often while you’re taking amitriptyline. If there are any changes in your heart rate, heart rhythm, or blood pressure, they may recommend a different treatment option for you.

Sexual side effects

Amitriptyline can cause sexual side effects in some people. It’s unknown how often these side effects occurred in studies of the drug. But sexual side effects that were reported in amitriptyline studies include:

What might help

If you’re concerned about sexual side effects from amitriptyline, talk with your doctor. In some cases, they may be able to adjust your dosage to relieve your side effects. Be sure to take amitriptyline exactly as your doctor prescribes it. You should not change your dose unless your doctor recommends it.

Allergic reaction

Like most drugs, amitriptyline can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to amitriptyline, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to amitriptyline, they may have you switch to a different treatment.

Keeping track of side effects

During your amitriptyline treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how amitriptyline affects you. They can then use this information to adjust your treatment plan if needed.

Get answers to some frequently asked questions about amitriptyline’s side effects.

Do the side effects of amitriptyline vary depending on the dose I’m prescribed (such as 25 mg or 50 mg)?

Yes, taking a higher dose of amitriptyline could raise your risk of side effects. When you take a higher dose, your body is exposed to more of the drug. This could raise your risk of side effects.

For example, people taking an amitriptyline dose of 50 milligram (mg) may be more likely to have side effects (or may have worse side effects) than those taking a 25 mg-dose.

If you experience bothersome side effects during your treatment, talk with your doctor.

Can stopping amitriptyline suddenly cause withdrawal symptoms?

Yes, suddenly stopping amitriptyline may cause withdrawal symptoms. (These are side effects that can occur when you stop taking a drug that your body has become dependent on.) Withdrawal symptoms may be more likely if you’ve taken amitriptyline for a long time.

Withdrawal symptoms that can occur if you suddenly stop taking amitriptyline include:

  • nausea
  • headache
  • irritability
  • restlessness
  • sleep problems

Due to the risk of withdrawal symptoms, you should not stop taking amitriptyline without first talking with your doctor. In some cases, if your doctor recommends stopping treatment, they may slowly decrease your dose over time. This can help prevent withdrawal symptoms.

If you have questions about how to end your amitriptyline treatment safely, talk with your doctor or pharmacist.

Does amitriptyline cause long-term side effects?

Yes, amitriptyline can cause long-term side effects in some people. Although long-term side effects aren’t very common, they can occur.

Examples of long-term side effects from amitriptyline may include:

If you’re concerned about long-term side effects with amitriptyline, talk with your doctor.

* In this article, we use the terms “male” and female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Do older adults have a higher risk of amitriptyline’s side effects than younger people?

Yes, it’s possible that older adults (ages 65 years and older) have a higher risk of side effects from amitriptyline. This is because adults in this age group:

  • may break down amitriptyline more slowly, which could cause the drug to build up in the body
  • are more likely to have other conditions that may affect how amitriptyline works
  • may take other medications that can interact with amitriptyline

Due to these possible risks, if you are 65 years or older and require amitriptyline, your doctor may prescribe a lower starting dose of the medication. Your doctor may also want to monitor you more closely for side effects during your treatment.

What are some of the overdose symptoms that taking too much amitriptyline can cause?

You should not take more amitriptyline than your doctor recommends. This can increase your risk of an overdose. In some cases, an overdose can be severe or even life threatening.

Symptoms of overdose may include:

  • heart rhythm problems
  • seizures
  • slowed brain activity, which may lead to coma
  • confusion
  • agitation
  • vomiting
  • changes in body temperature
  • very low blood pressure
  • hallucinations (seeing or hearing things that aren’t really there)
  • twitching
  • sleepiness
  • problems with eye movement
  • muscle stiffness

If you take too much amitriptyline, go to the hospital right away. Overdose symptoms may occur very quickly and require monitoring in the hospital.

Before starting amitriptyline, tell your doctor about any other medical conditions that you have. They can help determine if amitriptyline may be safe for you to take.

Boxed warning: Risk of suicidal thoughts and behaviors

Amitriptyline has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

The risk of suicidal thoughts and behaviors may occur in children and young adults ages 24 years and younger. To learn more, see the “Side effects explained” section above.

Other warnings

Amitriptyline may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether amitriptyline is a good treatment option for you.

Talk with your doctor about your health history before starting amitriptyline. Factors to consider include those described below.

Certain mental health conditions. If you have any mental health conditions such as schizophrenia or bipolar disorder, tell your doctor before taking amitriptyline. Taking amitriptyline could worsen your condition. Your doctor may want to monitor you more closely during treatment to make sure your condition isn’t getting worse.

Electric shock therapy. If you get electric shock therapy, talk with your doctor before starting amitriptyline. This combination may raise your risk of side effects. Your doctor can determine if amitriptyline is safe to take if you’re having electric shock therapy.

Heart problems. If you have any heart problems, such as heart rhythm problems or a past heart attack, tell your doctor before taking amitriptyline. Amitriptyline may increase the risk of heart-related side effects. If you already have heart problems, taking amitriptyline may worsen your condition. Your doctor can determine if it’s safe for you to take this drug.

Seizures. Amitriptyline can raise the risk of seizures. If you have a condition that causes seizures, such as epilepsy, taking amitriptyline may make your condition worse. In this case, your doctor may monitor you more often or may recommend a different treatment option for you.

Allergic reaction. If you’ve had an allergic reaction to amitriptyline or any of its ingredients, your doctor will likely not prescribe amitriptyline. Ask them what other medications are better options for you.

Upcoming surgery. If you have an upcoming surgery while you’re taking amitriptyline, tell your doctor. In some cases, your doctor may have you stop taking amitriptyline for a few days before having surgery. But you should not stop taking this drug without first talking with your doctor.

Diabetes or high or low blood sugar levels. If you have diabetes or another condition that causes low or high blood sugar, talk with your doctor before taking amitriptyline. This drug can cause changes in blood sugar levels, including high or low blood sugar.

If you already have a condition that affects your blood sugar levels, taking amitriptyline may make your condition worse. Your doctor can determine if amitriptyline is safe for you to take with your condition. In some cases, they may recommend that you monitor your blood sugar levels more often.

Liver problems. If you have any liver problems, tell your doctor before taking amitriptyline. In rare cases, this drug can cause serious liver problems such as liver damage or hepatitis. If you already have a liver condition, taking amitriptyline may make it worse. Your doctor can determine if amitriptyline is safe for you to take with your condition.

Urinary retention. Amitriptyline may cause urinary problems, including urinary retention. If you already have this condition, taking amitriptyline could make it worse. If you have urinary retention, your doctor may monitor you closely for symptoms during your treatment. Or in some cases, they may prescribe a different drug for you.

Eye problems. Amitriptyline may cause an increase in eye pressure. If you have certain eye problems, such as glaucoma, you may already have increased eye pressure. In this case, taking amitriptyline may make your condition worse. Your doctor can determine if it’s safe for you to take amitriptyline.

Taking monoamine oxidase inhibitors (MAOIs). If you’re taking any MAOIs, such as selegiline (Emsam) or tranylcypromine (Parnate), tell your doctor before starting amitriptyline. You should not take amitriptyline while taking an MAOI and for at least 14 days after stopping the MAOI. Taking these drugs together (or within 14 days of each other) may cause serious side effects, such as seizures or a very high fever. These side effects may be life threatening.

Alcohol and amitriptyline

You should not drink alcohol during your amitriptyline treatment. Combining alcohol with this drug could raise your risk of side effects, such as dizziness, nausea or vomiting, and liver problems. In addition, you may have a higher risk of overdose symptoms if you drink large amounts of alcohol while taking amitriptyline. This is because both alcohol and amitriptyline can slow brain activity. This can lead to potentially life threatening symptoms of overdose, including coma.

If you’ve misused alcohol before, talk to your doctor before taking amitriptyline. This medication may also interact with disulfiram (Antabuse), which is a drug taken by certain people with alcohol use disorder.

If you’re concerned about avoiding alcohol while taking amitriptyline, talk with your doctor.

Pregnancy and breastfeeding while taking amitriptyline

It may not be safe to take amitriptyline during pregnancy or while breastfeeding.

If you’re pregnant or breastfeeding or planning to become pregnant or breastfeed, talk with your doctor before taking amitriptyline. They can help determine if it may be safe for you to take.

If you have any questions about side effects that amitriptyline can cause, talk with your doctor. Questions that you may want to ask include:

  • Is my risk of side effects higher if I take other medications along with amitriptyline?
  • Is my risk of side effects higher when I first start treatment?
  • Does my risk of side effects depend on the dosage I take?
  • How do the side effects of amitriptyline compare with other drugs used to treat depression?

To learn more about amitriptyline, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.