Amitriptyline side effects

I’ve been prescribed amitriptyline, 10mg initially, and took my first dose last evening. Knowing that I can be a bit sensitive to many drugs these days, and have had some pretty extreme reactions in the past, it was suggested I cut them in half for the first 4 days, then increase upwards slowly past 10 to whatever worked best for me.

Within 20 mins of taking half a tablet my face was flushed and I felt jittery. Went to bed, really cold, nodded off but woke from a dream that someone was shaking me, my heart was racing (and i’m on betablockers) the shaking was that horrible internal shaking/vibrating, really strong. Also slightly ‘trippy’. I’ve had this with Tramadol and co-dydromal, which I used to be ok with, and last year had a dreadfull adverse reaction to citalopram. I was able to bring my heart rate down with breathing and meditation type exercises, but still had the ‘hyper’ feeling.

Resorted to a Zopiclone in the end, but still only got about 5 hours sleep, and am feeling hyper still, and teary, though the trembly feeling has quietened down.

GP said yesterday I’d probably be drowsy and groggy.

Any advice, or any similar experiences?

We all react differently to meds and a small % of people find that amitriptyline makes them more alert rather than drowsy, but given your history with meds I have to wonder if it could have been more of a placebo thing - your body was expecting to have a bad reaction so it produced it? Of course, the only way to test this is to try again :frowning:

I think, if I were you, I would try again but make sure that it was during the day and that there was someone there (to help if you have the same effect but also to take over whatever needs doing if it makes you drowsy this time). This could be very bad advice though so I’m sure it would be better to ask your GP what to do!

It’s not a disaster if it’s not for you - there are alternatives and hopefully one of them will help (without any nasty side effects!).

Karen x

Hi Hunny, Amitriptyline can make you feel a bit odd at first… yes trippy… and can also cause insomnia at first. After a few days it should settle down. I was on Ami for a couple of years and then spent a few years trying other drugs… in the end I went back to Ami.

For the first week I took one Paracetamol at night just to get me to sleep. I then went to half a Paracetamol for a couple of nights… and then cut it out altogether… by which time my body had adapted to the Ami and I was sleeping well.

Take the Ami early evening or you will feel like a zombie in the morning. I take 25mg at 6.30 pm (got my mobile alarm set).

Hope it works out for you but if not, as Karen says, there are alternatives.

Pat x

Hi Karen

I wondered about the placebo thing too. Had I subconciously made it happen? I’m not sure, but I think I will try it again later.

The neuro has given a whole list of things to try, but I assumed amitriptyline was the first line, the mildest if you like, and now I’m so worried that if I can’t cope with this, I’m not going to be able to tolerate anything at all! I’m in so much pain at the moment, my foot feels like there is a piece of glass or sharp stone lodged in it, and the only way I can walk is to screw my toes up and turn my foot inwards about 45 degrees. The neuro hoped the meds would help with the migraines too, which are becomming relentless, so I’m desperately hoping something will help here


Hi Pat,

Must have been typing whilst you were posting.

I’m seeing the nurse on Tuesday, so I think I will try to persevere on the half dose till then, take it around tea-time, and see how it goes. Unless it gets worse!



Hi Hunny, I started with amytriptiline but gave up on it as it gave me terrible insomnia. I then tried Gabapentin which helped me to sleep, so was much better. Hth, Teresa xx

Hi Hunny, I have been taking Amitriptyline for about three years now. Like you I was started on 10mg and felt awful to begin with which my GP warned me I might but to persevere. I am now up to 30mg without any problems. I also take Citalopram without any bad reactions. Anne x.

Sorry typo - amitriptyline! xx

We all react differently to meds and some people get terrible side effects to a med that almost everyone else swears by, so it’s impossible to tell what’s going to work for any one individual. I was started on amitriptyline and it zonked me out better than any sleeping pill. That wasn’t a problem for me, but then the skin on my mouth and throat started coming out in ulcers and literally sloughing off. Not nice! So I was switched to pregabalin. I found the side effects difficult (vertigo mainly), but not as bad as ulcers, so I persevered thanks to my MS nurse persuading me. It took me a month to get up to a very wimpish 100mg a day, but once I got over the side effects, it has proven to be a godsend for my sensory symptoms and electric shocks. But others may find that it does nothing for them, or that the side effects are impossible (like my ulcers) and that they do better on amitriptyline or gabapentin (eg). It’s all trial and error I’m afraid :frowning: First to find a med that suits, but then to find the right dose and continually monitor that dose vs symptoms so we are taking just enough and not too much (best to keep a bit of wriggle room if possible).

Re migraine. My headache specialist recommended upping my pregabalin to help prevent my migraine, but he also recommended that I first try vitamin B2, 400mg a day (take it all at once, with food). There have only been a couple of studies and it’s not approved as a treatment for migraine in the UK yet, but the results are really good - it can reduce migraine in about three in four people, me included :slight_smile: I built the dose up 100mg a week (so 100mg in the first week, 200mg in the second…) and noticed a difference at 300mg. When I’d been on 400mg for a short time, the difference was amazing - my several times a week migraine has become a couple of times a month and that’s perfectly manageable with migraine meds. It’s a water soluable vitamin so the excess leaves the body quickly (and turns urine a remarkable yellow colour!) so, as far as I know, it’s harmless, and definitely worth a try.

I hope the second half pill isn’t too bad!


Thanks Teresa and Anne

Its not much bl**dy fun is it?! I’ve got one heck of a headache now (not migraine) and feel like I did many years ago after a heavy night out. If only…

Thanks everyone for your support


I cut my tablet in quarters and took this for 2 weeks. I’m now having half a tablet and have felt OK. If you worried take a small amount and build up slowly. My doctor knows I’m sensitive to tablets and this was her advice. I definetly felt more comfortable doing it this way. I took my first 1/4 in the morning to check I wasn’t going to have any adverse effects and then after that about 7 in the evening. Hope this helps

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