Common questions about amitriptyline for depression

Amitriptyline is from a group of medicines called tricyclic antidepressants. They're thought to work by increasing levels of a chemical called serotonin in your brain. This can improve your mood.

You may find you're feeling better after a couple of weeks. But it usually takes between 4 and 6 weeks for you to feel the full benefit of the medicine.

Do not stop taking amitriptyline just because you feel it is not helping your symptoms. Allow at least 6 weeks to see if it works for you.

Antidepressants like amitriptyline help to gradually improve your mood so you feel better. You may notice that you sleep better and get on with people more easily because you're less anxious. You'll hopefully be more relaxed about things that used to worry you.

Amitriptyline will not change your personality. It will simply help you feel like yourself again.

Do not expect to feel better straight away though. Some people feel worse during the first few weeks of treatment before they begin to feel better.

Although there's a lot of information on the short-term effects of taking amitriptyline, less is known about the long-term effects.

There may be an increased risk of confusion and possibly dementia in people taking medicines like amitriptyline, but more research needs to be done. If you're worried about this, talk to your doctor.

Your doctor will check with you regularly to make sure your treatment is still working and that you're not having problems with side effects.

Amitriptyline is not addictive but you can get withdrawal side effects if you stop taking it suddenly. These symptoms can include headache, feeling anxious and tired, and difficulty falling asleep.

Do not stop taking it without talking to your doctor first.

If you've been feeling better for 6 months or more, your doctor may suggest coming off amitriptyline.

If you stop taking amitriptyline suddenly, you may get withdrawal side effects.

These side effects are a physical reaction as the medicine leaves your body and can include headache, feeling anxious and tired, and difficulty falling asleep.

Your doctor may recommend reducing your dose gradually over several weeks, or longer if you've been taking amitriptyline for a long time. Reducing your dose gradually will help to help prevent any withdrawal side effects caused by stopping the medicine.

Amitriptyline does not work any better or worse than other antidepressants. However, for some people, the side effects are a problem and they may have fewer side effects with another antidepressant. Sometimes people respond better to one antidepressant than to another.

Talk to your doctor if you are not feeling any better after taking amitriptyline for 6 weeks, or sooner if the side effects are still a problem.

Antidepressants, including amitriptyline, are just one of several approaches to treating depression. Other potential treatments include:

• talking therapy such as cognitive behavioural therapy (CBT)
• exercise programmes
• joining a self-help group
• using relaxation techniques
• help to get a good night's sleep

Choosing a treatment that's most suitable for you depends on:

• how long you've had depression
• your symptoms
• whether you've had depression before
• whether previous treatment has worked
• how likely you are to stick with your treatment
• the potential side effects
• your preferences and priorities

Amitriptyline can change how hungry you feel. Some people feel more hungry when they're taking it, while others feel less hungry. So your weight may change when you first start taking it.

If you start to have problems with your weight while taking amitriptyline, talk to your doctor or a pharmacist.

Amitriptyline may, after a while, improve your sex life as your mood improves.

Taking amitriptyline can occasionally cause problems getting an erection and problems ejaculating.

Sexual side effects are not common and should go away after the first couple of weeks. If they do not get better, and this is a problem for you, speak to your doctor to see if there's another antidepressant you can try.

Amitriptyline does not affect any type of contraception, including the combined pill and emergency contraception.

Some people feel sleepy and dizzy while they're taking amitriptyline. It's best to stop driving and cycling, and avoid using machinery or tools, for the first few days of treatment until you know how this medicine makes you feel.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking amitriptyline.

GOV.UK has more information on the law on drugs and driving.

You can drink alcohol while taking amitriptyline, but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel.

You can eat and drink normally while taking amitriptyline. However, it might be best to stop drinking alcohol until you see how the medicine makes you feel.

Taking cannabis with amitriptyline can give you a fast heartbeat. Cannabis can also make you more drowsy, especially if you've just started taking amitriptyline.

Methadone and other opiates (for example, heroin) can increase the risk of severe drowsiness if you're taking amitriptyline.

It can be dangerous to take amitriptyline with:

• stimulants like MDMA (ecstasy) or cocaine
• hallucinogens like LSD
• novel psychoactive substances (which used to be known as legal highs) like mephedrone

Find out more about the side effects of recreational drugs on the Frank website.