Amitriptyline is a tricyclic antidepressant medication and many physicians use it in low-dose in patients with amplified pain such as fibromyalgia. They speculate that it can help restore a more normal sleep pattern. However, studies specifically looking at whether or not it changes sleep (α-δ non-rapid eye movement sleep) show that it does not. An open label study of 175 adults with fibromyalgia showed that amitriptyline was equally effective as routine physical therapy over 6 months. In multicenter placebo-controlled trial of amitriptyline in 90 children with irritable bowel syndrome there was no difference between it and the placebo. A recent Cochrane systematic review of these medications in patients with fibromyalgia were disappointed that they found no supportive, unbiased evidence to substantiate its use. They conclude it will satisfactorily relieve pain in only a minority of patients.
Before starting amitriptyline, it is important that a cardiologist review an EKG on all patients to make sure there are no underlying heart problems. If these are present amitriptyline and tricyclic antidepressants can lead to serious heart problems.
Young people (up to age 24 years) taking amitriptyline are at an increased risk of suicide in the first few months and need to be monitored closely.
Other common side effects include:
- upset stomach
- weight gain
- blurred vision
- dry mouth
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