Side Effects and Long-Term Effects of Amitriptyline
As with many other antidepressants, for some the side effects of the medication can be mild. For others, the adverse reactions can be moderate or severe, and sometimes requiring medical attention. Long-term effects of amitriptyline such as sexual dysfunction, tinnitus, and others may persist for a very long time even after withdrawal of the drug.4-7
The most commonly reported amitriptyline side effects include:
- Sexual dysfunction
- Irritability
- Aggressiveness
- Hostility
- Impulsivity
- Panic attacks
- Weight gain
- Constipation
- Digestive issues
- Dizziness
- Headache
- Somnolence
- Unusual changes in behavior
Other adverse effects including serious and long-term effects that can worsen over time:
- Increased risk of suicide, suicidal ideation
- Worsening depression
- PSSD (persisting sexual dysfunction that can persist even after the drug is withdrawn)
- Persistent genital arousal disorder (can persist even after withdrawal from antidepressants including amitriptyline)
- Orthostatic hypotension (low blood pressure)
- Blurred vision
- Tachycardia
- Acute angle glaucoma
- Increased risk of seizure, risk increases with increased dosage
- Liver damage
- Risk of bone fracture
- Suppressed bone marrow
- Mania
- Persistent tinnitus
- Akathisia
- Panic attacks
What is Amitriptyline-Induced PSSD?
PSSD is a long-term effect of amitriptyline and many other antidepressants that interferes with serotonin/dopamine transmission. The term stands for Post-SSRI Sexual Dysfunction. A description of PSSD was first reported by the inventor of amitriptyline, Dr. Ayd, a psychiatrist, in 1960. The term PSSD emerged much later, in the 1990s.7
Studies show that an exceptionally large percentage — 50% to 73% — of people taking antidepressants experience PSSD symptoms during or after their drug treatment. Amitriptyline is one of many types of antidepressants associated with PSSD. The condition has been reported as early as within the first weeks of taking antidepressant medication, as well as persisting for years, well after the drug is withdrawn.8,9
Many doctors prescribing serotonergic antidepressants and other drugs that interfere with hormones and natural neurotransmitters may have never heard of this adverse event. Treatment for PSSD has been elusive but some reports suggest ginkgo biloba, or switching to bupropion has reversed or to a degree, lessened the negative effects of PSSD in small studies.
Amitriptyline Drug Interactions to Avoid
Many, many drug combinations should be avoided if taking amitriptyline. Always let your prescriber know exactly what else you are taking if you are prescribed any antidepressant, including amitriptyline.2
Examples of drug interactions that can occur with amitriptyline:
- Certain serious reactions have occurred in persons taking amitriptyline at the same time as MAOI type antidepressants. Severe convulsions and death may result with this combination of drugs.
- An anti-convulsive drug called Topiramate can cause amitriptyline levels to dramatically increase, necessitating a reduction in amitriptyline dosage to compensate. But whenever possible, avoid combining these drugs.
- Alcohol is also recommended to avoid while taking amitriptyline due to the cumulative effects on the CNS
Overdose Deaths and Amitriptyline
Amitriptyline has been associated with death by overdose. In an overdose of amitriptyline, the symptoms come on quickly, and are usually fatal without intervention in as soon as 30 minutes.
Overdose symptoms include tachycardia, cardiac dysrhythmias, CNS shutdown, coma, and death.2
Amitriptyline and Pregnancy
Amitriptyline crosses the placenta and is associated with birth defects such as deformed limbs in infants born to mothers taking amitriptyline. This long-term effect of amitriptyline can be avoided if the mother can be withdrawn from the drug before becoming pregnant, or very early in the pregnancy. Amitriptyline is known to pass through to the breast milk, thus breast feeding should be avoided by nursing mothers taking this drug.2,11
How to Avoid the Long-Term Effects of Antidepressants
Your symptoms are real. But their root cause(s) may not have been found, or even looked for. Depression is not a deficiency of amitriptyline. However, other deficiencies could well have been overlooked contributors to your symptoms. It is unfortunately uncommon in our modern times for a prescriber to actively search for root causes for symptoms before writing a prescription.12
Alternative to Meds Center has spent nearly 20 years treating clients with safer, effective, non-toxic alternatives to antidepressants. You can find out more about what alternatives might be useful for you or for your loved one by visiting the links below. Always seek medical guidance before changing medication or introducing anything that might interact adversely with amitriptyline. And never abruptly stop taking your antidepressant medication. Always seek informed professional help for amitriptyline withdrawal.
After more than 6 decades, the FDA states that it is still unknown how it works in the human body. What is known is that it has sedative effects, and it is not a CNS stimulant.
