Amitriptyline — what it does and who it helps

Amitriptyline is a tricyclic antidepressant (TCA) that’s still useful today for more than just depression. Doctors prescribe it for nerve pain, migraine prevention, certain types of chronic pain, and sleep problems at low doses. It works by changing brain chemicals that affect mood and pain signals. This quick guide tells you how it’s used, typical doses, common side effects, and safe ways to take it.

How amitriptyline is used and dosed

For depression, adults often start low and increase slowly. Typical ranges are 75–150 mg per day, usually split into two doses or given at night because it makes many people sleepy. Some people need up to 200–300 mg, but higher doses raise the risk of side effects and must be monitored by a doctor.

For nerve pain or migraine prevention, much lower doses often work: 10–50 mg at night is common. For insomnia related to pain or depression, a single low dose at bedtime (10–25 mg) is sometimes used. Always follow your prescriber's directions—dosing depends on the condition, age, other meds, and medical history.

Safety, interactions, and practical tips

Common side effects are dry mouth, drowsiness, constipation, blurred vision, weight gain, and difficulty urinating. Amitriptyline can also cause low blood pressure when standing (you might feel dizzy) and slow the heart rate or affect heart rhythm—so older adults or people with heart disease need extra monitoring. Overdose can be dangerous, so never take more than prescribed.

Watch for drug interactions. Do not combine amitriptyline with MAO inhibitors (this is dangerous). Some antidepressants, strong antibiotics, antifungals, and heart medicines can raise amitriptyline levels or increase side effects. Alcohol and other sedatives increase drowsiness. If you take multiple drugs, ask your pharmacist to check interactions.

If you miss a dose, take it when you remember unless it’s almost time for the next dose—then skip the missed one. Don’t double up. Don’t stop suddenly: TCAs can cause withdrawal symptoms and mood relapse. Your doctor will advise a gradual taper.

Before starting, tell your doctor if you have heart disease, glaucoma, an enlarged prostate, a history of seizures, or are pregnant or breastfeeding. Pregnant or nursing people should discuss risks and alternatives. For older adults, lower doses and ECG monitoring are often recommended.

Practical tips: take amitriptyline at night if it makes you sleepy; avoid heavy machinery until you know how it affects you; keep follow-up visits to check symptoms and side effects. If you notice fast heartbeat, fainting, severe confusion, or seizures—seek emergency care.

Amitriptyline can help a lot when used correctly. Keep an open line with your prescriber, report side effects, and ask about safer alternatives if needed.