From the Guidelines
Amitriptyline is primarily used to treat depression, certain types of chronic pain, and irritable bowel syndrome with diarrhea, typically prescribed at doses of 10-150 mg per day, taken orally, usually as a single dose at bedtime. For depression, treatment usually starts at 25-50 mg daily, increasing gradually if needed 1. For chronic pain conditions like fibromyalgia or neuropathic pain, lower doses of 10-50 mg daily are often effective 1. It's essential to start at a low dose and increase gradually to minimize side effects, which can include drowsiness, dry mouth, and constipation. Amitriptyline should be taken consistently for several weeks to achieve full effect. Some key points to consider when prescribing amitriptyline include:
- Its sedating effects make it particularly useful for patients with depression who also have sleep disturbances 1.
- Patients should be aware that abrupt discontinuation can cause withdrawal symptoms, so dosage should be tapered under medical supervision when stopping treatment.
- Amitriptyline works by increasing levels of serotonin and norepinephrine in the brain, which helps regulate mood and pain perception.
- The most recent and highest quality study on the use of amitriptyline for irritable bowel syndrome with diarrhea found that it was associated with global symptom relief and abdominal pain relief, although the quality of evidence was rated as low due to indirectness, risk of bias, and imprecision 1. Some potential uses of amitriptyline include:
- Treating depression and certain types of chronic pain
- Managing irritable bowel syndrome with diarrhea
- Helping with sleep disturbances, such as insomnia
- Relieving symptoms of fibromyalgia and neuropathic pain It's crucial to weigh the potential benefits and risks of amitriptyline, considering its side effects and interactions with other medications, to ensure the best possible outcome for patients.
From the FDA Drug Label
Amitriptyline HCl is an antidepressant with sedative effects.
Amitriptyline hydrochloride is not approved for use in treating bipolar depression.
The primary use of Amitriptyline is as an antidepressant.
From the Research
Uses of Amitriptyline
Amitriptyline is a tricyclic antidepressant agent with various uses, including:
- Treatment of chronic pain conditions, such as post-herpetic neuralgia and painful diabetic neuropathy 3
- Treatment of depression, with efficacy comparable to other tricyclics and selective serotonin reuptake inhibitors 4
- Treatment of fibromyalgia and as an adjuvant for uncontrolled cancer pain, although evidence for these applications is limited 3
- Treatment of major depression, with intravenous and oral administration routes showing similar efficacy 5
Therapeutic Applications
The therapeutic applications of amitriptyline include:
- Chronic non-malignant pain management 3
- Depression treatment, including depressive neurosis, involutional melancholia, and manic-depressive illness 4, 6
- Maintenance treatment of depression, with a relatively safe profile 7
Administration Routes
Amitriptyline can be administered through: