• If you have epilepsy, diabetes, phaeochromocytoma or glaucoma, or suffer from heart, liver, thyroid, kidney or prostate trouble
• If you are taking any other medication
• If you are pregnant, breast feeding or wish to become pregnant.

 What if any one has taken an overdose of amitriptyline?
Immediate action must be sought after overdose (or suspected overdose). If palpitations are noticed or consciousness is lost then emergency action is necessary immediately!

What should I do if I miss a dose?
If you forget/miss a dose, take it as soon as you remember, as long as it is within a few hours of the usual time.

Is amitriptyline addictive?
Tricyclics are not addictive, but need to be treated carefully. Some people do get some “discontinuation” effects if they stop their tricyclics suddenly. These effects include anxiety, dizziness, feeling sick and not being able to sleep.

How will amitriptyline work?
All antidepressants work slowly. It works on brain cells and chemicals (neurotransmitters) to set their balance right. Some of the tricyclics also help people relax and sleep better, before their depression starts to lift.  

How long will it take before I can see it work?
People only tend to feel better over a period of weeks rather than days. Different symptoms may get better at different times. Most people find that they feel noticeably better after about 2-3 weeks. However the full effect of antidepressants is usually felt only after about four to six weeks. It is very important to continue to take antidepressants so that the full effects can be felt. 

Are there any side effects of taking amitriptyline?
These are some of the side effects people experience when they are taking amitriptyline. Please note that not all patients will get all the side effects listed. There may possibly be other side effects. Always consult your psychiatrist about the side effects. 

Symptom	Frequency	What to do
Drowsiness	Common	Avoid driving
Sweating	Common	If excessive, see your doctor
Dry mouth	Common	Sugar-free sweets, chewing gum can help
Constipation	Common	Eat more fibre, like vegetables, salad, drink plenty of water
Blurred vision	Common	If bad, consult
Dizziness	Common	Try not to stand suddenly
Difficulty passing urine	Rare	Consult now
Palpitations	Rare	Not usually dangerous, but can be treated if lasts long
Weight gain	Common	Avoid fatty food, increase physical exercise
Tremor	Rare	Consult

 

Will amitriptyline interact with any other medication I am taking?

Sedatives: All drugs that have sedative effects intensify those of amitriptyline.

Barbiturates: These reduce the antidepressant effect of amitriptyline and may increase its toxic effect in overdose.

Heavy smoking: This may reduce the antidepressant effect of amitriptyline.

Antihypertensive drugs: Amitriptyline may reduce the effectiveness of some of these drugs.

Monoamine oxidase inhibitors: In the rare cases where these drugs are given with amitriptyline serious interactions may occur such as fever, seizures and delirium.  Do not forget to tell your psychiatrist if

• You have heart problems
• You have had epileptic fits
• You have long-term liver or kidney problems
• You have had glaucoma
• You have had prostate trouble

You should also take note of the following:

Pregnancy: This drug's safety in pregnancy has not been established. You should discuss this with your doctor.

Breast feeding: This drug will pass into breast milk and may affect the baby so you should discuss this with your doctor.

Surgery & general anaesthetics: Amitriptyline treatment may need to be stopped before having a general anaesthetic. Discuss this with your doctor or dentist.

What about alcohol?
It is officially recommended that people taking amitriptyline should not drink alcohol. This is because both alcohol and amitriptyline can cause drowsiness, which can lead to falls or accidents. Alcohol can also make your depression worse. 

What about driving?
Because this drug can lead to blurred vision and reduced alertness you should avoid activities such as driving or hazardous work until you have learned how the drug affects you.  

When I feel better, can I stop the medication?
No. If you stop taking amitriptyline, your original symptoms may return. To reduce your chances of being depressed again, you may need to take your antidepressants for at least 6 months after you feel better, sometimes even longer. This is not thought to be harmful.  

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