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How Effective Is Amitriptyline for Depression?

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  • Written By: Jennifer Voight
  • Edited By: O. Wallace
  • Last Modified Date: 06 May 2020
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The use of amitriptyline for depression has been common since the drug was developed and marketed in 1961. Over the years, many studies have shown amitriptyline to be at least as effective for depression as other tricyclic antidepressants and newer selective serotonin re-uptake inhibitors (SSRIs). Amitriptyline works by decreasing the reabsorption by the nerve cells of serotonin and norepinephrine, neurotransmitters that play a role in regulating moods. This increases the duration and concentration of the neurotransmitters in the brain and alleviates depression by extending the duration of positive moods. It may take several weeks of taking the medication before maximum results are seen.

Tricyclic antidepressants like amitriptyline were the first drugs on the market for treatment of depression. Initially it was widely believed that the use of amitriptyline for depression was ineffective for most types of depression. Throughout the 1950s, sales were poor until more research revealed the effectiveness of amitriptyline for depression, especially in cases where depression is very severe or has lasted a long time.

While using amitriptyline for depression, many patients noticed that other conditions improved, such as migraine, anxiety disorders and insomnia. The medication also helps with childhood bedwetting, attention deficit hyperactivity disorder, and schizophrenic symptoms. This discovery led to the usage of amitriptyline for treatment of many other conditions. It continues to be the most widely used tricyclic antidepressant due to its efficacy, low cost, and ability to help improve concurrent conditions.

Although the efficacy of amitriptyline for depression has been well-known, some people cannot tolerate the drug’s unpleasant side effects, like drowsiness, weight gain, and a fuzzy-headed feeling. Side effects, especially daytime drowsiness, generally diminish over time and for many people become tolerable. Others who suffer not only from depression but insomnia, migraine, or other conditions, enjoy the fact that amitriptyline can help those conditions, too. This is especially true since people who suffer from depression tend to have problems with insomnia and anxiety.

The newer classes of antidepressants, like SSRIs and SNRIs, have become commonly prescribed and are perhaps more well-known than tricyclic antidepressants like amitriptyline because of fewer and less severe side effects. Doctors also believe these classes of drugs to be more effective than amitriptyline, despite research that suggests they are equally effective. Some doctors believe this could be the result of drug company marketing efforts, since these newer classes of drugs are frequently more expensive than older tricyclics.

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turquoise
Post 3

I don't think that amitriptyline is the best medication for someone who just has depression or anxiety. But it is a good drug for someone who has insomnia or pain in addition to depression. So rather than saying that amitriptyline works for depression or it doesn't work, let's say that it works in some cases.

ddljohn
Post 2

@ZipLine-- I think that people reach wrong conclusions about the effectiveness of amitriptyline because of the side effects. Most people who have tried amitriptyline have also tried newer class of anti-depressants like SSRIs which have less side effects. So they compare the side effects of amitriptyline to side effects of SSRIs and end their treatment too soon to get benefits.

Amitriptyline is not ineffective. It needs some time to work and the body needs time to adjust to the drug. So it's normal to have side effects in the beginning. In fact, depression can seem worse during the first couple of weeks, but it will improve soon after.

SSRIs have side effects too and most of them require six months or more to show their effects. Amitriptyline works much more quickly and once the side effects settle down, it's more helpful in the long run. At least this has been my experience with the medication.

ZipLine
Post 1

I was on amitriptyline for close to a month. It did nothing for my depression and I couldn't bear the side effects. I felt drowsy and tired constantly. I also ate more and gained weight in that short time frame.

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