In 2000, Elavil was discontinued by the Food and Drug Administration (FDA) due to the severe side effects people experienced while using the medication. The reasons why the brand name form of the drug was discontinued remain unclear. It’s thought that Elavil was discontinued because of the risk it posed of developing a heart condition while using the medicine. However, in 2017 the FDA put out a notice stating that the reason for discontinuing the drug was unrelated to its safety or effectiveness. This article breaks down the uses and side effects of Elavil. It also covers how to cope with these side effects, common dosages, and any potential risks of taking the drug.

Uses for Elavil

Amitriptyline has been found to be effective in treating depression. It is also prescribed off-label to treat: For more mental health resources, see our National Helpline Database.

BulimiaChronic painDiabetic neuropathyInsomniaIrritable bowel syndrome (IBS)MigraineMuscle pain or stiffnessPost-traumatic stress disorder (PTSD)Trigeminal neuralgia

When taken for depression and other mood problems, people usually begin experiencing some improvements in mood within one to two weeks of taking Elavil. It usually takes several weeks to experience the full effects.

Side Effects of Elavil 

Even in its generic form, the side effects you might experience when using Elavil can be split broadly into two categories: mild or severe. In other words, there are common side effects that typically go away with time and are usually nothing to worry about. On the other hand, there are more severe side effects that might require you to speak to your doctor about possibly lowering your dose or discontinuing the medication. 

Common Side Effects 

Although Elavil was discontinued, the generic form of the drug is still available and prescribed by doctors. It’s safe to take, and most people who use the medication will only experience a few mild side effects. The most common side effects of Elavil include: 

Drowsiness Weight gain Dizziness Weight fluctuation Blurred vision Constipation HeadachesDry mouth Lightheadedness Difficulty urinating

Severe Side Effects

Experiencing severe side effects while using Elavil is uncommon. However, there have been reports of the following side effects sometimes occurring while using this medication:

Changes in your vision Seizures Being unable to urinate Bruising or bleeding Severe stomach painMuscle spasms Difficulty having sex Developing a mask-like face Hallucinations Tremors FaintingDifficulty speaking Numbness in the arms or legs

If your doctor intends to have you discontinue Elavil, they will most likely gradually reduce your dose to wean you off of the medication. Neuroleptic Malignant Syndrome In sporadic cases, Elavil could cause a condition called neuroleptic malignant syndrome (NMS). NMS is a reaction to antipsychotic drugs that causes muscle stiffness, fever, or an altered mental state. Symptoms of NMS include:

Irregular heartbeatMuscle stiffnessExcessive sweatingSevere confusion

If you develop any of the above symptoms while taking this medication, you should get medical help immediately.  While there are very few reports of people developing an allergic reaction to Elavil or amitriptyline, it is possible. Symptoms of an allergic reaction to a medication typically include a swollen face, tongue, or throat, itching, dizziness, or trouble breathing. 

Coping With the Side Effects of Elavil 

While the more common side effects of this medication are not deadly, they can be bothersome. While using this medication, there are some safe ways to cope with the common side effects. For instance, if you are constantly constipated, you should increase your fiber intake and drink a lot of water. People who experience dry mouth could also increase their water intake or chew on some ice chips for relief.  If you experience headaches while taking Elavil, it’s safe to take over-the-counter pain medications like acetaminophen (e.g., Tylenol). But, if the headaches persist or increase in severity, you should speak to your doctor about them.  Elavil has sedative effects and could cause you to become a little dizzy or drowsy. So, it’s advisable to take this medication in the evening and avoid driving or operating any heavy machinery after taking this medication.

Elavil Dosages

The dosage your doctor prescribes can vary depending on your needs, what it is treating, and the strength of the medication. For the treatment of depression in adults, the starting dose is usually 75 mg divided between two doses taken in the morning and at bedtime. The maximum dose is 150 mg per day. Teens and older adults are prescribed lower dosages, which are usually taken in 10 mg doses three times a day with a 20 mg dose taken at bedtime. Dosages for the treatment of other health conditions can vary. For example, the dosage used to treat sleeping problems often ranges from between 10 and 50 mg per day.  If you miss a dose of your medication, take it as soon as you remember. However, if it is close to the time for your next dose, simply skip your missed dose. Never take two doses at once to make up for missing a dose.

Warnings and Interactions 

Before prescribing Elavil, a doctor will take a thorough look into your medical history and find out if you are taking any other medications. It’s essential to make a list of all medications you are on, including those you might have discontinued recently. Certain drugs interact dangerously with Elavil and, in some cases, could cause fatal results.  Let’s take a look at some of the drugs that can interfere with Elavil and discuss who should not take Elavil.

Drugs That May Interfere With Elavil

Here are some drugs or substances that may negatively impact the efficacy of Elavil. MAOIs People who are already taking monoamine oxidase inhibitors (MAOIs) or have just recently stopped using MAOIs are typically not prescribed Elavil. This is because it can cause very high fevers, convulsions, and death in the most extreme cases. There’s some evidence to suggest that when Elavil is used with epinephrine, it could cause high blood pressure. Alcohol Like with most medications, you shouldn’t consume alcohol when using Elavil. Alcohol could heighten its sedative effects and cause the medicine to be ineffective in treating symptoms of depression.

Who Should Not Take Elavil

Here are some populations that Elavil is not recommended for. People With Heart Problems One of the more uncommon side effects of using Elavil is an irregular heartbeat. This is why people with heart problems might be discouraged from taking this medication. In severe cases, Elavil has been linked to a condition called QT prolongation, which could cause seizures, fainting, and in fatal cases, death.  Younger People Research has linked the use of antidepressants to an increased risk of suicidal thoughts and ideation. If you or someone you know who’s on this medication notice any changes in mood or behavior, it’s crucial to speak to a doctor about it immediately. This is typically more common with younger people who are on the medication.  Elavil is typically prescribed for people who are over 18. It might be prescribed for children with nerve pain in some instances, but this is done with caution. Other Populations
In almost no scenario should Elavil ever be prescribed to the following people: 

People with liver or kidney conditions Pregnant people or people who are breastfeeding People with epilepsy or any disease which causes seizures People with glaucoma People who have allergic reactions to tricyclic antidepressants People with certain heart conditions like angina, for instance People who are already taking another type of antidepressant 

Alternatives to Elavil

Today, tricyclic antidepressants like Elavil are typically not the first option for doctors when prescribing antidepressants to people living with depression. Selective serotonin reuptake inhibitors (SSRIs) like Prozac, Celexa, and Cipramil, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, Effexor, and Fetzima are typically tried first. Research shows that they tend to have fewer side effects than tricyclic antidepressants.

A Word From Verywell

Elavil is an effective drug for treating depression. Unfortunately, you might experience some side effects while using this drug that will range in severity. If you experience mild side effects like dry mouth, constipation, drowsiness, and headaches, they are typically nothing to worry about. However, more severe side effects like tremors, seizures, and fainting should be reported to your doctor immediately. It’s essential to pay close attention to changes in your body and mood while using this drug and tell your doctor of any uncomfortable changes.