Back & Neck Pain Treatment Elavil (Amitriptyline) Side Effects By Anne Asher, CPT Anne Asher, CPT Facebook LinkedIn Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial process Updated on July 23, 2022 Medically reviewed by Laura Campedelli, PT, DPT Medically reviewed by Laura Campedelli, PT, DPT LinkedIn Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Expert Board Print 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. Jose Luis Pelaez Inc / Getty Images 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. HivesSwelling in your face or throatDifficulty 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 changesPanic attacksYou have trouble sleepingYour speech becomes slow or difficultYou feel dizzy and/or faintCrushing chest painRapid, pounding, or irregular heartbeatSevere skin rash or hivesSwelling of the face and tongueYellowing of the skin or eyesSpasms in your jaw, neck, and/or back musclesOne or more body parts start shaking uncontrollablyFaintingYou experience weakness or numbness down an arm or legUnusual bleeding or bruisingSeizuresHallucinating (seeing things or hearing voices that do not exist)Extreme thirst, general ill feelingUrinating 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. Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database. BMJ. 2015;350:h517. doi:10.1136/bmj.h517 Rajgadhi H, Gupta S, Malhotra SD, Thakor A, Patel P. Antidepressants triggering suicidal ideation: An area of concern. Indian J Pharmacol. 2016;48(6):733–735. doi:10.4103/0253-7613.194842 Pary R, Matuschka PR, Lewis S, Lippmann S. Managing bipolar depression. Psychiatry (Edgmont). 2006;3(2):30–41. PMID: 21103153 Riediger C, Schuster T, Barlinn K, Maier S, Weitz J, Siepmann T. Adverse Effects of Antidepressants for Chronic Pain: A Systematic Review and Meta-analysis. Front Neurol. 2017;8:307. doi:10.3389/fneur.2017.00307 Thour A. Amitriptyline. StatPearls [Internet]. Yekehtaz H, Farokhnia M, Akhondzadeh S. Cardiovascular considerations in antidepressant therapy: an evidence-based review. J Tehran Heart Cent. 2013;8(4):169–176. PMID: 26005484 Gn S, Nag A. Management of Oromandibular Dystonia: A Case Report and Literature Update. Case Rep Dent. 2017;2017:3514393. doi:10.1155/2017/3514393 Cummings JL, Miller BL. Visual hallucinations. Clinical occurrence and use in differential diagnosis. West J Med. 1987;146(1):46–51. PMID: 3825109 Marken PA, Munro JS. Selecting a Selective Serotonin Reuptake Inhibitor: Clinically Important Distinguishing Features. Prim Care Companion J Clin Psychiatry. 2000;2(6):205–210. doi:10.4088/pcc.v02n0602 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. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit