Amitriptyline is a prescription-only medication that is commonly used for the management of nerve pain (also known as neuropathic pain). This type of pain occurs when a nerve becomes pinched, inflamed, or damaged in some way. Nerve pain can really cut to the core and gnaw away at you – people often describe intense burning, stinging, tingling, pins and needles, or a stabbing, shooting, or electric pain. Common conditions that can lead to nerve pain include shingles or after your shingles rash has cleared (post-herpetic neuralgia), sciatica, multiple sclerosis, fibromyalgia, a slipped disc pressing on a nerve, or diabetic neuropathy. Amitriptyline is also sometimes used to prevent migraines and chronic tension-type headaches. The medication is formulated as tablets or oral liquid, and it can take around four to six weeks before you feel its full effects.
Yes, amitriptyline is an antidepressant (specifically from the class of tricyclic antidepressants). In the past, amitriptyline was used to treat depression, but now it is rarely used for this purpose because SSRIs (selective serotonin reuptake inhibitors) like sertraline are considered to be the better treatment option. Amitriptyline doses for depression are typically a lot higher than doses for nerve pain.
It is not fully clear how amitriptyline relieves pain. However, it is thought to interfere with the transmission of pain signals in the brain and spinal cord. The antidepressant action of amitriptyline occurs via its action to prolong the effects of mood-elevating chemicals (serotonin and noradrenaline) that are regularly released in the brain. Depression is linked with people having low levels of these chemicals in their brain, so taking amitriptyline can help to raise their mood.
As with all medications, some people may experience side effects. Some common side effects can include constipation, headache, drowsiness, dizziness, and dry mouth. If you experience drowsiness, you should avoid driving or operating any machinery. Generally, it is best to avoid alcohol when taking amitriptyline as it can worsen your side effects. Amitriptyline can cause withdrawal effects if you suddenly stop taking the medication. To avoid this, your doctor will recommend a gradual dosage reduction for coming off the medication.
Amitriptyline can interact with other medications. Therefore, it is important that you check with your pharmacist before taking amitriptyline alongside any medications over the counter. For example, the sedating effect of amitriptyline can be enhanced by taking it alongside other medications that can cause drowsiness, such as drowsy antihistamines like chlorphenamine and opioid painkillers like codeine. Amitriptyline can also interact with some herbal medicines like St John’s wort, as this combination can cause you to have too much serotonin in your body, which can be dangerous.