Elavil (Amitriptyline) 10mg

Antidepressant, Tricyclic 

“ALERT: US Boxed Warning

Suicidality and antidepressant drugs:

Antidepressants increased the risk compared with placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of amitriptyline in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults older than 24 years; there was a reduction in risk with antidepressants compared with placebo in adults 65 years and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Amitriptyline is not approved for use in paediatric patients.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Amitriptyline/Elavil inhibits reuptake of serotonin and/or norepinephrine in the presynaptic neuronal membrane pump in the central nervous system.

Amitriptyline/Elavil is officially indicated for major depressive disorder as an alternate agent.  It is also prescribed off-label for chronic fatigue syndrome, fibromyalgia, chronic tension headache prevention, interstitial cystitis, migraine prevention, postherpetic neuralgia, and qsialorrhea. (may be used for conditions not listed)

Before starting Amitriptyline/Elavil make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, if you have bipolar disorder, kidney disease, a seizure disorder, diabetes, cardiovascular disease or are pregnant or breastfeeding.  This medication also has risk of causing serotonin syndrome especially if combined with other serotonergic drugs.

10mg-150mg divided into one or two daily dosages

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, store at room temperature. Generally taken 1-3 hour prior to bed to minimize daytime drowsiness.

You Need to Avoid: Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness, tingling in extremities). Tolerance to sedation may develop however caution operating heavy machinery or driving if feeling impaired. May increase the central nervous system depressant effects of alcohol so caution if alcohol is to be consumed.

Drowsiness, dizziness, headache, anxiety, dry mouth, urinary retention, nausea, vomiting, blurred vision, orthostatic hypotension

Note this is not a complete list of side effects, only common ones

1. What do I do if side effects are intolerable?
   If you are just starting this medication or just had a dosage increase, then it is common to have more prominent side effects for 2 weeks or so and if any remain at that point they will likely remain.  If the symptoms are causing a lot of distress speak to your physician as soon as possible to discuss how to manage the side effects or to consider therapy modification.
2. What do I do if my mood worsens on this medication and I feel much worse?
   Contact your physician immediately, it is rare however antidepressant medications can cause suicidal ideation, generally in those under the age of 24.
3. What is serotonin syndrome?
   Serotonin syndrome is a rare, but potentially life-threatening condition of serotonin toxicity from too much of it in your system generally from the use of certain medications and supplements.  Usually multiple agents are at play or high doses are involved.  The signs and symptoms include agitation, hallucinations, delirium, coma, tachycardia (rapid heart rate), diaphoresis (excessive sweating), tremor, muscle rigidity, nausea, vomiting, diarrhea, and/or seizures.  If serotonin syndrome is suspected, discontinue any serotonergic medications, and seek immediate medical attention.