Elavil (Amitriptyline) Side Effects

Elavil (amitriptyline) and other drugs with amitriptyline as the active ingredient are usually given for depression and other mental disorders. It is also prescribed off-label for chronic back pain after conservative treatment has been tried.

African man holding daily pill box with pills in hand
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Possible Side Effects

Because Elavil is an antidepressant, side effects may include unanticipated changes in your mental status. During clinical trial testing of the drug, for example, some of the participants (20 to 60 years old) started to have suicidal thoughts. If problems with your mental status related to taking Elavil do develop, their occurrence may correspond to times when your dosage is adjusted, or when you first start taking the medication.

If you’ve been diagnosed with depression or mental illness, your risk for becoming suicidal is increased upon taking Elavil. If anyone in your family has bipolar disorder (extreme mood changes from depressed to excited), mania (frenzied or abnormally excited mood) or has considered suicide, your risk for suicidal behavior increases even more.

The two most frequent side effects of taking Elavil are drowsiness and dry mouth, but the medication can affect a number of body systems. These systems include (but are not limited to) cardiovascular, nervous, gastrointestinal, hematological (blood) and more. Drug interactions between Elavil and other medications may prevent you from taking it safely, called a contraindication. Elavil has two such contraindications. So it’s important to tell your healthcare provider about all other medications you are taking before starting this medication.

When prescribed for chronic spine pain, amitriptyline is given in lower doses than for depression, and this may reduce the degree to which you experience side effects.

Elavil and other amitriptyline medications are not commonly given to seniors and the elderly. Heart-related side effects are more common in people over 60 who take amitriptyline. This is because arrhythmia is more common in this age group.

Side Effects Requiring Immediate Medical Attention

As with any medication, some side effects associated with taking Elavil require immediate attention.

  • Hives
  • Swelling in your face or throat
  • Difficulty breathing

If you have any of these, go to the emergency room as soon as possible.

Side Effects for Which You Should Call Your Healthcare Provider ASAP

If you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself, you should call your healthcare provider immediately. Also, call your healthcare provider if you have any of the side effects listed on IMPORTANT WARNING section of the label or listed below:

  • Mood or behavior changes
  • Panic attacks
  • You have trouble sleeping
  • Your speech becomes slow or difficult
  • You feel dizzy and/or faint
  • Crushing chest pain
  • Rapid, pounding, or irregular heartbeat
  • Severe skin rash or hives
  • Swelling of the face and tongue
  • Yellowing of the skin or eyes
  • Spasms in your jaw, neck, and/or back muscles
  • One or more body parts start shaking uncontrollably
  • Fainting
  • You experience weakness or numbness down an arm or leg
  • Unusual bleeding or bruising
  • Seizures
  • Hallucinating (seeing things or hearing voices that do not exist)
  • Extreme thirst, general ill feeling
  • Urinating less frequently or not at all

Less Serious Side Effects

Along with the serious potential side effects listed above, a number of less serious ones still need to be brought to your healthcare provider's attention should you experience them. They include:

  • Drowsiness
  • Dry mouth
  • Nausea
  • Vomiting
  • Weakness or tiredness
  • Nightmares
  • Headaches
  • Constipation
  • Difficulty urinating
  • Blurred vision
  • Pain, burning or tingling in the hands or feet
  • Changes in sex drive or ability
  • Excessive sweating
  • Changes in appetite or weight
  • Confusion
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Fink, K., MD, Director Pain Services. National Rehabilitation Hospital, Washington, DC. Telephone Interview.

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.