Doctors' Answers to "Frequently Asked Questions" - Amitriptyline

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Amitriptyline [posted 1/14/99]
Question: I am a court reporter working on a transcript, which discusses amitriptyline. I need to know what term is used for digested amitriptyline in the body. Nortriptyline? Narcotriptyline? I would truly appreciate help with this as quickly as possible.

Answer: Well, it is metabolized by the liver using the P450 system. I'm not aware of any specific names, but I suspect the scientific department of Zeneca would (brand name Elavil by the way): 302-886-8000.

Amitriptyline & Nortriptyline [posted 12/08/98]
Question: What is the difference between amitriptyline and nortriptyline? Is one better than the other for insomnia? Also, is it ok to drink taking either one of these tricyclic antidepressants?

Answer: They belong to the same class of antidepressants, the tricyclics. They have a somewhat different structure;but, similar side effects and toxicities. Amitriptyline tends to be somewhat more sedating and better as a sleep adjunct. Alcohol should be avoided due to boths ability to cause cardiac irregularity.

Amitriptyline & Blood Pressure Concerns [posted 12/02/98]
Question: My mom is 78 years old, she has High Blood Pressure she was taking Hyzaar 50-12.5 once a day also Lanoxin 0.25mgs a day, She was doing ok ,she is going to have eye surgery for a cateract removal and was nervous about this and her BP was rising , So we went in to see her DR. He changed her medicines to Verapamil 240mgs once a day and added Amitriptyline 25mgs to help her relax, its been just a few days. My mom BP when from 150/90 to 220/120 ..we are seeing the doctor this morning..would Amitriptyline have made her BP jump like this..Thanks

Answer:  Probably not.

Amitriptyline: Concerns about Longterm Side Effects [posted 10/23/98]
Question: I am a user of amitriptyline for the purpose of sleeping. I am 28 yrs old and have had insominia for about 6 yrs off and on. My doctor presribed amitriptyline for a way of me to sleep, so what I would like to know is what the long term effects are? What I really want to know is who can my doctor refer to me to..Eg sleep clinic, psychiatrist, etc., thanks.

Answer: The long term side effects are the same as the short, drowsiness, constipation and irregular heart beats. If you wish to continue to explore this area, see a sleep specialist not a psychiatrist.

Amitriptyline: Concerns about Addictiveness [posted 10/23/98]
Question: I recently lost my husband after an agonizing death of lung cancer. He died at home with no help from his hospice. I am having trouble sleeping and my primary physician has prescribed 10mg. amitriptyline for the restlessness and inability to get a good nights sleep. Is this a safe drug to take for this problem?

Answer: Yes. Non-addictive and a mild antidepressant to boot.

Amitriptyline [posted 8/13/98]
Question: I have had a serious virus enter my shoulder and damage a large area of nerves and some muscle tissue breakdown. Even though the virus is gone, the recovery period has been over six months. The chronic pain (mostly nerve based) has been severe enough to inhibit me from regular everyday activities. I have been on 20 or so pain killers with no luck. The only drug that seemed to work a little was Ultram. The latest drug is Amitriptyline (3, 25 mg tablets per day). For the entire period of recovery, I haven't been able to gain back the 15 pounds that were lost due to the sickness. However, from a week or so after taking this new drug, I have blotted/gained more weight than ever before in my entire life. The only information on side effects of this drug that I have found is that it induces an increased appetite for sweets. What happens if I continue taking this drug for the next year or so for pain suppression? Will I continue to gain weight at this pace? I'm an athlete and am very concerned that this drug has produced something I've never dealt with before.

Answer: About 40-50% of patients on antidepressants will have a ongoing weight gain. I suspect it will continue as long as you take the medication, possibly plateau - possibly continue.

Question: I would like to know the medical uses and any side effects of Amitriptyline Tab (100 mg).

Answer: This is a drug used to treat depression, chronic pain and sleep disorders. Initially, it was used in depression and is moderately effective. It does produce somnolence in many patients, dry mouth, constipation, and in large does irregular heart beats (occasionally fatal in large doses). Consequently, it was found to be effective in sleep disorders, especially fibromyalgia, and also as an adjunct in chronic pain control.

Amitriptyline and Alcohol
Question: I realize that amitriptyline and alcohol, when taken together, have a compounding effect as to sleepiness. I am taking 75 mg per day to control pain. Will this drug effect the way alcohol is absorbed by the liver? Will it hold the alcohol in the system longer or intensify the effects other than sleepiness? The reason for the question is that I had three strong drinks in about one hour and became very drunk. I was a two to three drink a day person, but since starting on this drug, I seldom drink because of the feeling of tiredness. I did not expect the extra drunk feeling even though I hadn't drank anything for about two months previous to this occasion.

Answer: The combination of these two drugs magnifies the effect of both. It does not appear to work through the liver, but at a central acting site.

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Last modified January 14, 1999