Amitriptyline: The Benefits – and Risks – of This Antidepressant

Ever feel like you have the blues? Most people experience periods of depression and sadness during their lives. It's an unpleasant fact, but it's true: the things that make us sad, like loss, disappointment, and grief, are all normal parts of life.

For a person with depression, though, the blues don't end. Depression sucks the joy, value, and meaning out of a person's life. It's why many people take antidepressant drugs like amitriptyline.

Depression is a serious mental illness that affects millions of people worldwide. It can interfere with daily activities, relationships, and overall quality of life. While there are various treatment options for depression, including therapy and lifestyle changes, antidepressant medications like amitriptyline are often prescribed to help manage symptoms.

Amitriptyline is a common antidepressant medication that belongs to the drug class of tricyclic antidepressants (TCA). TCAs are some of the oldest and earliest antidepressants developed by pharmaceutical scientists.

Amitriptyline is prescribed to treat mental health disorders like MDD or major depressive disorder and anxiety. The brand name for amitriptyline is Elavil.

It is vital to note that Elavil is not a first-line medication for these conditions. In fact, it is considered second-line therapy for managing such disorders. Today, there are various other advanced antidepressant tablets available with fewer side effects.

So, amitriptyline is recommended in cases where people suffer from chronic pain originating from issues like damaged nerve cells, fibromyalgia, back & neck pain, and arthritis.  

Earlier, when there were few options, this antidepressant was commonly prescribed by doctors and medical professionals. At that time, the prescribed dosage tended to be high, resulting in significant side effects. This is not the case today, as it's given in lower amounts for pain management purposes. Now the doctors stick with 75 mg to 150 mg so that the patients do not experience severe side effects or withdrawal symptoms.

Amitriptyline is an oral medication dispensed in varying strengths like 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. It is recommended that amitriptyline be taken only once a day and during the nighttime since it makes the user tired. 

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Elavil was discovered in the 1950s at an American pharmaceutical company known as Merck. In 1961, it was approved by the United States Food and Drug Administration (FDA). It is not a controlled substance and is available in only one generic form. Even though it's not a classified medication, the user must procure a prescription from a qualified medical professional. Let's now talk about how and why amitriptyline is addictive. 

It is interesting to note that TCAs like amitriptyline have been phased out from the markets as more advanced selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are more common today.

SSRIs and SNRIs have fewer and milder side effects than TCAs. This does not mean it is no longer prescribed. Amitriptyline is an antidepressant drug that works by rebalancing our central nervous system. Among the various amitriptyline uses, the primary one is to provide pain relief. For that, it affects certain neurotransmitter chemicals in our brains.

Amitriptyline drugs work by rebalancing the chemicals like serotonin and norepinephrine in our bodies to assist people with chronic pain. If we talk about the addictive nature of amitriptyline, there have been many anecdotal reports. 

There are some unofficial accounts and evidence where people have claimed that amitriptyline leads to feelings of high or experience hallucinations. However, there has been no official research or study done on this. Some people argue that antidepressant medications like amitriptyline do not cause euphoria, and it's a misconception. They claim this misconception came into the picture because people think of antidepressant medications to induce euphoria or make people happy.

According to them, these people are unaware of the workings of such drugs and how they assist in treating mental health conditions. 

Despite this, there is significant evidence to prove that at higher doses, amitriptyline drugs can cause severe side effects like organ damage and overdose.

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An overdose of this medication can be fatal. Most antidepressants have a low potential for abuse; some people believe they cannot cause addiction. However, continuous and frequent use of Elavil for more than six to eight weeks can lead to physical dependence.

When the user tries to reduce the dosage or abruptly stop its use, they will experience uncomfortable withdrawal symptoms. We will learn more about this in the below sections. 

Medical professionals consider antidepressants like amitriptyline non-addictive with no potential for abuse. However, it is essential to know the possible signs and symptoms since there has been evidence of abuse and addiction.

Elavil works by depressing the central nervous system. Like most antidepressants, amitriptyline also comes with a black box warning. This means there is a risk of developing suicidal thoughts. There is also a case for developing a physical dependency on the drug. The body can become accustomed to its presence, and overdose can happen over time. A few signs of amitriptyline overdose are dizziness, drowsiness, convulsion, muscle stiffness, nausea, enlarged pupils, and uneven heartbeat.

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Some common and mild effects of amitriptyline are improving mood, energy levels, and motor skills. These can be experienced by those who are suffering from conditions such as chronic pain or depression. Unfortunately, the side effects are not limited to the types mentioned above.

There can be negative side effects, which can be potentially irreversible and fatal. These side effects vary from mild to severe. These include:

• Headache

• Weakness

• Blurred vision

• Dizziness

• Dry mouth

• Nausea

• Diarrhea

Stomach cramps, lethargy, sleepiness, difficulty in urination, tingling in hands and feet, weight gain or loss, rashes, confusion, chest pain, difficulty in speaking, lost sex drive, muscle spasms, fainting spells, unusual bleeding, hallucination, and seizures. 

One of the biggest side effects that can potentially happen due to amitriptyline misuse is overdose. This will occur when a person takes a heavy quantity of drugs. This will cause a person to experience sedating and euphoric effects. People sometimes take too much amitriptyline, thinking it will amplify the effect or work more effectively. What they don't realize is that they are exceeding the tolerance level of their body.

Overdosing on antidepressants like Elavil can lead to life-threatening effects like cardiac arrest, fatally low blood pressure, and seizures. In rare cases, people can experience dangerous central nervous system depression and even death. The risk of overdose can also be high if the user combines other drugs and substances, especially alcohol.  

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Once the user's system has become physically dependent on a drug like amitriptyline, quitting can be risky. Users who try to stop the usual dose might experience withdrawal symptoms. The intensity of withdrawal symptoms is determined by individual factors. These factors can include the type of drug, dosage amount, physiology, and body type of the user.

Several withdrawal symptoms are commonly experienced by the users. These are:

• Depression

• Vomiting

• Body aches

• Anxiety

• Appetite change

• Nausea

• Diarrhea

• Insomnia

• Hypersensitivity

• Fatigues

• Dizziness

• Headache

• Suicidal thoughts

First, it is almost impossible to find the exact length of amitriptyline stays. This is because every person has a different physiology. It can change from one individual to another. However, the half-life of any drug can help estimate the duration. The half-life of amitriptyline is 20 hours.

Half-life is the duration any drug takes to be eliminated by half. If a person takes 20 mg of amitriptyline, half of it, 10mg, will be eliminated in 20 hours. Even after being fully eliminated from the system, a medication like this can take a few weeks to be flushed out from the body after the last use. 

Amitriptyline is an antidepressant medication whose addiction must be handled with care. Since it's a medication, one must carefully approach it to discontinue it. There would always be a risk of relapsing and resuming the substance if not handled cautiously.

The first and foremost thing to note is do not go cold turkey. It is absolutely not recommended to suddenly go off the amitriptyline dosage as it can throw off the balance of our body. Like other drugs, amitriptyline gets built up in the user's system, and it will take time to flush out its presence.

There had to be a strategic approach with medications and behavioral counseling involved. 

Drug Detox

The best and most secure way of discontinuing and safely withdrawing from the drugs is to have a medical drug detox. Medical detox is a procedure conducted in a secure drug rehab facility. So even when the withdrawal symptoms are severe, or emergency services are needed, the person can safely access it from the rehab.

This first phase of rehabilitation treatment is about eliminating amitriptyline from the user's system while managing withdrawal symptoms. Besides medical detox, the recovery treatment for amitriptyline requires therapy too. This helps the patients to understand the origin and causes of this problem. The primary reason for having rehabilitation programs is to learn how to deal with stress and trigger factors without relapsing. 

Inpatient Drug Rehab

The inpatient rehab programs are specialized care where the patients are under medical watch throughout the treatment. Round-the-clock medical care is provided by the qualified rehab team. This is especially helpful in severe cases with a relapse risk. Since the patient has to reside in the facility, they are removed from the tempting environment.

The length of these programs can vary from five weeks to several months. This is dependent on individual addiction cases.

Outpatient Drug Rehab

Outpatient rehab programs, on the other hand, assist patients in treating addiction without intervening or disrupting their personal and professional life. The medical services provided here are suitable for people with less intensity of addiction and a low risk of relapse. 

A family-owned drug rehab, The Edge Treatment Center has a deep understanding of depression disorders. Guided by a trauma-informed philosophy, we use evidence-based, effective methods to treat depression, including transcranial magnetic stimulation (TMS).

At The Edge, we are committed to helping individuals find long-lasting relief from depression and regain control of their lives. Our experienced team of therapists and medical professionals work together to create personalized treatment plans for each individual, addressing not just the symptoms, but the underlying causes of depression.

Whether you are struggling with amitriptyline or looking for alternative treatments for depression, The Edge Treatment Center offers a supportive and nurturing environment where you can find hope and healing. Don't struggle alone – reach out to us today and begin your journey towards a happier, healthier life.

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If you or a loved one is struggling with addiction, there is hope. Our team can guide you on your journey to recovery. Call us today.

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