Amitriptyline — what it treats and how to use it safely

Here’s a quick fact that surprises a lot of people: amitriptyline was developed as an antidepressant but is now often prescribed at low doses for nerve pain, migraines, and sleep issues. If your doctor mentioned amitriptyline, you’re not alone — it’s a common, well-studied drug with uses beyond mood disorders.

How amitriptyline is used

Amitriptyline treats several problems depending on the dose. For depression, doctors typically use higher doses (often 75–150 mg a day). For nerve pain, migraine prevention, or chronic headaches, much lower doses (10–50 mg at night) are common. Low doses help with sleep and reduce pain signals without the stronger antidepressant effects.

It usually takes 2–6 weeks to notice benefit for mood or chronic pain. For migraines, people often try a steady low dose for a few months to see if attacks drop in frequency. Your doctor will set the dose and plan a follow-up to check if it’s working or causing problems.

Safety, side effects and interactions

Common side effects are dry mouth, drowsiness, constipation, blurred vision, and feeling lightheaded when standing up. Because it can make you sleepy and lower blood pressure, many people take it at night. Older adults are more likely to fall or get confused, so doctors usually choose lower doses or different drugs for seniors.

There are some important drug interactions. Amitriptyline is broken down in the liver by enzymes like CYP2D6 and CYP2C19, so strong inhibitors (for example, some antidepressants and antifungals) can raise amitriptyline levels and increase side effects. Mixing it with MAO inhibitors or certain migraine medications can cause serious problems like serotonin syndrome. If you take heart medication or have a heart rhythm problem, your doctor may want an ECG because high doses can affect the heart’s rhythm.

Never stop amitriptyline suddenly after longer use — withdrawal can cause dizziness, irritability, sleep trouble, or flu-like symptoms. Your prescriber should give a plan to taper the drug slowly.

Practical tips: start low, take at night, avoid alcohol while adjusting, and tell your doctor about all other medicines and supplements. If you notice severe dizziness, fast heartbeat, fainting, or new mood changes, contact your provider right away.

Want to buy amitriptyline online? Only use reputable pharmacies that require a prescription and check their licensing. If you see unusually low prices without a prescription, that’s a red flag.

Questions about a dose, side effect, or interaction? Ask your pharmacist or prescriber — they can give guidance based on your health history and other meds. Amitriptyline helps a lot of people when used the right way, but safe use means clear communication with your healthcare team.