Elavil (Amitriptyline) Question

No, do not be worried.  Many people think that if they get prescribed an antidepressant, that either they are, or their doctors think they are depressed, nuts, or whatever.

Nooooo...many drugs can have more than one use.  The  initial use for amitriptyline was as an antidepressant, that's why it is 'in that class' of drugs.  But it can also be used for pain. http://www.mayoclinic.com/health/pain-medications/PN00044   

  It is certainly well established that it can be useful for pain. We definitely know more about pain than we did 10 years ago, but there are still mysteries.

Amitriptyline can cause some drowsiness, so that's another reason why they like to prescribe it to be given at bedtime. 

 Another, wilder example.  A drug, called prochlorperazine (Compazine) was originally developed in the ~1950s to be used as an anti-worm drug (like for  intestinal worms).  It was used for that purpose in mental institutions, and they found psychotic patients got better.  So it was used as an antipsychotic.  Then it was used in psychotics who were having nausea and vomiting, so they found out about that effect.  By the 1980s or 1990s, probably 95% of the post-operative patients at my hospital were getting prochlorperazine prescribed for post-op nausea and vomiting.  They stopped making it for a few years (probably because it was so cheap), so it isn't used nearly as much as it used to be.

Pain can be a very individual thing.  You are starting with a low dose of amitriptyline.  You can see if it helps, or not.  If you don't like it, you can stop.

 *Any* drug, (even water) can have side effects.  You might see a big long list of side effects.  Probably the most common are drowsiness (that's why you're taking it at night) and dry mouth, constipation are the most common side effects.  Just because a drug has a long list of side effects, that doesn't mean you will get them.  There are very few drugs where nearly all the people get a certain side effect. 

It is up to you whether you want to try it.  It really does help some people, but not everyone. 

 Leaf (who is a hospital pharmacist) 

With all you have gone through, its no wonder you are cautious.  After seeing what my friend is going through with pancreatic cancer (she is a postop nurse), it really changes my perspective.

I see it prescribed pretty frequently, but I don't usually know for what condition it is being used. But I would disagree that its never used for depression- sometimes one drug works well for one person and not another, or a person has allergies or side effects.

It is an old drug, but that doesn't mean it doesn't have its uses. Its really heartening when they find new uses for older drugs.  Older drugs are often much less expensive, and we often know a lot more about them. Of course, older drugs are less profitable for drug manufacturers, so this doesn't happen often.  Sometimes they come out with a new drug, and the only difference from the old drug is that it might have 5% less side effects.   Whether this is worth the (almost always) increased drug cost (often 10 fold more), well, that's a judgement call.

If you don't like it, or it doesn't work for you, you can always stop. 

Hi Anne!

I have been using .20 mg. of elavil for 7 years now at bedtime.  It works very gently, I have woken out of a sound sleep and tended to kids, been able to function in the AM (a tiny bit groggy for 10 mins or so) and no side effects at all.

I always list it on the list of drugs I am on, as when I went thru all the bc stuff I was concerned about anesthesia etc.  No problems.

I take it for fibromyalgia which has been completely under control with this.  I am considering taking only one, my dr. says fine, go for it.

One codicil which I am sure they mentioned but if they did not!  You can't just go off of it, you should wean yourself to one pill a night, or half a pill for a week or so first.

It's a good drug, works well, quite safe, no prob. even if you want a glass of wine at dinner now and then, just try to have the wine about 6 hours before taking the drug.  I don't drink anything anymore bec. of bc, but good to know.

good luck to you!

annie