What does the research show about amitriptyline?

Amitriptyline

Meta-analyses found amitriptyline raised response in depression against placebo and ranked it among the strongest antidepressants, with more dropouts for side effects. Evidence for nerve pain and fibromyalgia was low quality. One trial found a benefit in irritable bowel syndrome. Dry mouth, drowsiness and weight gain were common. The Beers Criteria list it for older adults to avoid.

Add to Bio HackChecked 2026-11-13

Status: Prescription drugs in the US. Amitriptyline and nortriptyline are FDA-approved for the relief of symptoms of depression, and both labels carry a boxed warning on suicidal thoughts in children, teenagers and young adults. Their use for nerve pain, migraine and headache prevention, irritable bowel syndrome, sleep and quitting smoking is off-label.
Also called: amitriptyline, Elavil, nortriptyline, Pamelor, tricyclic antidepressant, TCA, low-dose amitriptyline
Taken for: depression, nerve pain, fibromyalgia, migraine prevention, tension headache, irritable bowel syndrome, sleep, insomnia, back pain, quitting smoking

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help6

StrongShown to raise response in depression against placebo, with about 2.7 times the odds, and had the highest odds of response of 21 antidepressants, with higher dropout rates.
ModerateShown in very low quality evidence to make at least 50% pain relief about three times as likely as placebo, with about 4 treated for one extra responder.
ModerateShown to reduce migraine frequency against placebo in adults in a network meta-analysis, which ranked it above several other preventive drugs on weak evidence.
ModerateShown to cut chronic tension-type headaches by about 4.8 a month against placebo with tricyclic antidepressants, which also reduced headaches more than SSRIs.
ModerateShown to about double quit rates against placebo with nortriptyline in a Cochrane review of six trials.
LimitedOne trial found low-dose amitriptyline improved irritable bowel syndrome symptoms more than placebo over 6 months in primary care.

Reported risks15

StrongShown to raise side effects such as dry mouth, drowsiness and dizziness, with any adverse event in 55% to 78% on amitriptyline against 36% to 47% on placebo.Very common
ModerateFDA states antidepressants raised suicidal thoughts and behaviors in children, teenagers and young adults in short-term trials, 14 more cases per 1,000 under age 18.Common
StrongShown to raise weight gain against placebo in two meta-analyses, one of which grouped it with mirtazapine and paroxetine as the antidepressants most tied to weight gain.How often is not known
ModerateThe 2023 Beers Criteria list amitriptyline and nortriptyline as drugs for older adults to avoid, because they are highly anticholinergic, sedating and cause low blood pressure on standing.How often is not known
LimitedThe label reports arrhythmias, fast heart rate and slowed heart conduction, especially at high doses, and lists use after a recent heart attack and with cisapride as contraindications.How often is not known
LimitedLinked to more deaths per overdose than other antidepressants: tricyclics had a case fatality rate ratio of 13.8 against 0.5 for SSRIs in England and Wales.How often is not known
LimitedThe label warns of serotonin syndrome with other serotonergic drugs and lists MAOIs as a contraindication, after hyperpyretic crises, convulsions and deaths with the combination.How often is not known
LimitedThe label states that SSRIs, quinidine, cimetidine and other drugs that block the liver enzyme CYP2D6 can raise tricyclic levels, and topiramate raised them sharply in some people.How often is not known
LimitedThe label warns that amitriptyline may enhance the effects of alcohol, barbiturates and other sedating drugs, which raises the danger of an overdose.How often is not known
LimitedThe label names thyroid medication, guanethidine, anticholinergic drugs and epinephrine with local anesthetics as combinations that need close supervision. It gives no rates.How often is not known
LimitedThe label reports low blood sodium on amitriptyline, often from inappropriate antidiuretic hormone release, with older adults and people on diuretics at greater risk. It gives no rate.How often is not known
LimitedThe label warns that amitriptyline's atropine-like action can trigger angle-closure glaucoma and urinary retention, and lists caution in people with seizures. It gives no rates.How often is not known
LimitedThe label warns that depressed people with bipolar disorder may shift to mania or hypomania, and that amitriptyline is not approved for bipolar depression.How often is not known
LimitedThe label reports nausea, headache and malaise after abrupt stopping, and irritability, restlessness and sleep disturbance during gradual reduction. It gives no rate.How often is not known
LimitedCase reports: the label notes a few reports of nervous system effects, limb deformities or developmental delay in infants exposed in pregnancy, with no causal link established.How often is not known

What people take it for, and what was found

Shown to help6

Strong

Depression in adults

Shown to raise response in depression against placebo, with about 2.7 times the odds, and had the highest odds of response of 21 antidepressants, with higher dropout rates.

Compared with placebo [1][2]; other antidepressants in head-to-head trials [2]

The numbers and sources

Effect: Across 18 trials, response was more likely on amitriptyline than placebo (OR 2.67, 95% CI 2.21 to 3.23). Fewer people left for lack of effect (OR 0.20), and more left for side effects (OR 4.15, 95% CI 2.71 to 6.35) [1]. In a network meta-analysis of 21 antidepressants, amitriptyline had the highest odds of response against placebo (OR 2.13, 95% CrI 1.89 to 2.41), was among the drugs with higher response rates in head-to-head trials, and was among those with the highest dropout rates [2].
Population: 3,509 adults with major depression in 39 trials of 3 to 12 weeks [1]; 116,477 adults in 522 trials [2].
Sources: [1], [2]
Caveats: Randomization, allocation concealment and blinding were usually poorly reported, and funnel plots suggested possible publication bias [1]. Certainty in the network analysis ranged from moderate to very low [2].

Moderate

Fibromyalgia

Shown in very low quality evidence to make at least 50% pain relief about three times as likely as placebo, with about 4 treated for one extra responder.

Compared with placebo and other active treatments [6]

The numbers and sources

Effect: Using third-tier evidence, at least 50% pain relief was more likely on amitriptyline than placebo (RR 3.0, 95% CI 1.7 to 4.9), a number needed to treat of 4.1. Fatigue, sleep, quality of life and tender points showed no consistent differences. At least one adverse event occurred in 78% on amitriptyline and 47% on placebo [6].
Population: 649 adults in nine studies of 6 to 24 weeks at 25 to 50 mg a day [6].
Sources: [6]
Caveats: No study had 50 or more participants per arm, and the review found no first or second tier evidence [6].

Moderate

Migraine prevention in adults

Shown to reduce migraine frequency against placebo in adults in a network meta-analysis, which ranked it above several other preventive drugs on weak evidence.

Compared with placebo [7]; candesartan, fluoxetine, propranolol, topiramate and valproate, in network comparisons [7]

The numbers and sources

Effect: Amitriptyline reduced episodic migraine against placebo (SMD -1.2, 95% CI -1.7 to -0.82). The network analysis found it better than candesartan, fluoxetine, propranolol, topiramate and valproate, and no different from atenolol, flunarizine, clomipramine or metoprolol [7].
Population: Adults with migraine in randomized trials, including 11 tricyclic antidepressant trials against placebo [7].
Sources: [7]
Caveats: The authors describe the evidence for amitriptyline's superiority over other drugs as weak [7].

Moderate

Tension-type headache

Shown to cut chronic tension-type headaches by about 4.8 a month against placebo with tricyclic antidepressants, which also reduced headaches more than SSRIs.

Compared with placebo, SSRIs and behavioral therapy [9]

The numbers and sources

Effect: Tricyclic antidepressants reduced headache frequency against placebo (WMD -4.8 headaches a month, 95% CI -6.63 to -2.95) and painkiller use (WMD -21.0 doses a month). They reduced headaches more than SSRIs and were similar to behavioral therapy in a few trials [9].
Population: Adults in 22 randomized trials, 8 comparing a tricyclic with placebo [9].
Sources: [9]
Caveats: The pooled result is for tricyclics as a group, and the abstract does not separate amitriptyline [9].

Limited

Irritable bowel syndrome

One trial found low-dose amitriptyline improved irritable bowel syndrome symptoms more than placebo over 6 months in primary care.

Compared with placebo [10]

The numbers and sources

Effect: At 6 months, symptom severity scores improved by 27.0 points more on amitriptyline than placebo (95% CI -46.9 to -7.10). 20% stopped amitriptyline, 13% for adverse events, against 26% and 9% on placebo [10].
Population: 463 adults with irritable bowel syndrome still symptomatic after first-line treatments, in 55 English general practices [10].
Sources: [10]
Caveats: One trial. The difference was below the trial's 35-point threshold for a clinically important change [10].

Moderate

Nortriptyline for quitting smoking

Shown to about double quit rates against placebo with nortriptyline in a Cochrane review of six trials.

Compared with placebo [14]; bupropion [14]

The numbers and sources

Effect: Nortriptyline raised smoking cessation against placebo (RR 2.03, 95% CI 1.48 to 2.78, I² 16%). Against bupropion, quit rates did not clearly differ (RR 1.30 favoring bupropion, 95% CI 0.93 to 1.82) [14].
Population: 975 smokers in six nortriptyline trials, within a review of 124 studies [14].
Sources: [14]
Caveats: The evidence is for nortriptyline, not amitriptyline. Nortriptyline is not approved for quitting smoking.

Mixed results1

Moderate

Nerve pain

Mixed results: Cochrane reviews found no unbiased evidence for amitriptyline or nortriptyline in nerve pain, while a broader meta-analysis found tricyclics needed fewer treated per responder than other classes.

Compared with placebo [3][4][5]; gabapentin, morphine and other antidepressants [5]

The numbers and sources

Effect: Across 17 amitriptyline studies, only third-tier evidence existed, and amitriptyline beat placebo in two of seven studies reporting usable efficacy data. At least one adverse event occurred in 55% on amitriptyline and 36% on placebo (RR 1.5, 95% CI 1.3 to 1.8) [3]. In a meta-analysis of 229 studies of nerve pain drugs, numbers needed to treat were lower for tricyclic antidepressants than the 6.4 to 7.7 found for SNRIs, pregabalin and gabapentin [4]. Nortriptyline trials gave very low quality evidence of efficacy similar to gabapentin, morphine, chlorimipramine, amitriptyline and placebo [5].
Population: 1,342 adults in 17 studies across seven nerve pain conditions [3]; 229 studies of oral and topical drugs [4]; 310 adults in six nortriptyline studies [5].
Sources: [3], [4], [5]
Caveats: Most amitriptyline studies were small and at high risk of bias. The Cochrane authors write that the concern is overestimation of the effect, not proof of no effect [3].

Not shown to help2

LimitedStudied in children

Migraine prevention in children and teenagers

One trial in children and teenagers found amitriptyline no better than placebo for migraine, and it raised fatigue and dry mouth.

Compared with placebo and topiramate [8]

The numbers and sources

Effect: Headache days halved in 52% on amitriptyline, 55% on topiramate and 61% on placebo, with no differences in disability or headache days. The trial was stopped early for futility. Fatigue (30% against 14%) and dry mouth (25% against 12%) were more common on amitriptyline [8].
Population: 361 children and adolescents aged 8 to 17, 328 analyzed, over 24 weeks [8].
Sources: [8]
Caveats: One trial, with a high placebo response [8].

Limited

Chronic low back pain

One trial found low-dose amitriptyline did not reduce back pain more than an active placebo at 6 months, with less disability at 3 months only.

Compared with an active placebo, benztropine [11]

The numbers and sources

Effect: Pain did not differ at 6 months (adjusted difference -7.81, 95% CI -15.7 to 0.10) or 3 months. Disability was lower at 3 months (adjusted difference -1.62, 95% CI -2.88 to -0.36) but not at 6 months. Withdrawals for adverse events were 12% in each group [11].
Population: 146 adults with chronic nonspecific low back pain, 118 completing 6 months [11].
Sources: [11]
Caveats: One modest-sized trial at 25 mg a day [11].

Claimed, not studied in people1

Untested

Sleep and insomnia

Not studied in people with insomnia. A Cochrane review found no trials of amitriptyline for insomnia, though sedation is one of its side effects.

No study in people. This rests on how it acts in the body.

The numbers and sources

Effect: A Cochrane review of antidepressants for insomnia found no evidence for amitriptyline, despite its common use [12]. The label describes amitriptyline as an antidepressant with sedative effects [13], and depression trials found more sedation than on placebo [1].
Population: 23 trials with 2,806 participants of other antidepressants for insomnia [12].
Sources: [12], [13], [1]
Caveats: Sedation in depression trials does not show better sleep in people with insomnia.

Doses studied

The amitriptyline label lists 75 mg a day in divided doses for adult outpatients, up to 150 mg a day, with up to 300 mg in some hospitalized patients, and 50 to 100 mg a day for maintenance [13]. The nortriptyline label lists 25 mg three or four times a day, and sets 150 mg a day as its upper limit [15]. The pain and gut trials used lower doses: 25 to 50 mg a day for fibromyalgia [6], 25 mg a day for back pain [11], and 10 mg a day self-titrated up to 30 mg for irritable bowel syndrome [10]. The children's migraine trial used 1 mg/kg a day [8].

Risks

Reported risks15

StrongVery common

Dry mouth, drowsiness and other side effects

Shown to raise side effects such as dry mouth, drowsiness and dizziness, with any adverse event in 55% to 78% on amitriptyline against 36% to 47% on placebo.

The numbers and sources

How common: Very common: more than 1 in 10 people.
Effect: In depression trials, amitriptyline caused more anticholinergic side effects, fast heart rate, dizziness, nervousness, sedation, tremor, indigestion and sexual dysfunction than placebo, and more people left for side effects (OR 4.15) [1]. In nerve pain trials, at least one adverse event occurred in 55% against 36% [3], and in fibromyalgia trials in 78% against 47% [6]. In the children's migraine trial, fatigue occurred in 30% against 14% and dry mouth in 25% against 12% [8].
Population: 3,509 adults in depression trials [1]; 1,342 adults with nerve pain [3]; 649 adults with fibromyalgia [6]; 361 children and adolescents [8].
Sources: [1], [3], [6], [8]
Caveats: The pain trials used lower doses than depression trials and were small.

ModerateCommon

FDA boxed warning: suicidal thoughts and behaviors in young people

FDA states antidepressants raised suicidal thoughts and behaviors in children, teenagers and young adults in short-term trials, 14 more cases per 1,000 under age 18.

The numbers and sources

How common: Common: between 1 in 100 and 1 in 10 people.
Effect: In FDA's pooled analyses of placebo-controlled antidepressant trials, the drug-placebo difference in suicidal thinking or behavior was 14 more cases per 1,000 under 18, 5 more at 18 to 24, 1 fewer at 25 to 64 and 6 fewer at 65 and older. No suicides occurred in the pediatric trials [13].
Population: Over 4,400 children and adolescents in 24 trials and over 77,000 adults in 295 trials of several antidepressants [13].
Sources: [13]
Caveats: The pooled trials cover many antidepressants, not amitriptyline alone. The band is the excess under age 18 [13].

ModerateHow often is not known

Older adults (Beers Criteria)

The 2023 Beers Criteria list amitriptyline and nortriptyline as drugs for older adults to avoid, because they are highly anticholinergic, sedating and cause low blood pressure on standing.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The American Geriatrics Society lists antidepressants with strong anticholinergic activity, including amitriptyline and nortriptyline, as ones to avoid in adults 65 and older, rating the evidence high quality and the recommendation strong. It also lists tertiary tricyclics such as amitriptyline among drugs to avoid in people with fainting, because they raise the risk of low blood pressure on standing [16]. The label states older adults are particularly sensitive to anticholinergic effects, including confusion, delirium and urinary retention, and may be at greater risk of falls [13].
Population: Adults aged 65 and older, in an expert panel review of the evidence [16]; labeling statement [13].
Sources: [16], [13]
Caveats: A guideline listing, not a measured rate.

StrongHow often is not known

Weight gain

Shown to raise weight gain against placebo in two meta-analyses, one of which grouped it with mirtazapine and paroxetine as the antidepressants most tied to weight gain.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: A meta-analysis of 116 studies found amitriptyline, mirtazapine and paroxetine associated with a greater risk of weight gain [17]. A Cochrane review of depression trials found more weight gain on amitriptyline than placebo [1].
Population: 116 studies reporting weight change on antidepressants [17]; 39 trials with 3,509 adults [1].
Sources: [17], [1]
Caveats: Neither abstract gives the amount of weight gained.

LimitedHow often is not known

Heart rhythm problems

The label reports arrhythmias, fast heart rate and slowed heart conduction, especially at high doses, and lists use after a recent heart attack and with cisapride as contraindications.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states tricyclic antidepressants, especially at high doses, have been reported to cause arrhythmias, sinus tachycardia and prolonged conduction time, and that heart attack and stroke have been reported with the class. It is contraindicated in the acute recovery phase after a heart attack and with cisapride, because of QT prolongation and arrhythmia [13].
Population: Reports summarized in the label [13].
Sources: [13]
Caveats: No rates are given.

LimitedHow often is not known

Overdose

Linked to more deaths per overdose than other antidepressants: tricyclics had a case fatality rate ratio of 13.8 against 0.5 for SSRIs in England and Wales.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Comparing deaths with non-fatal self-poisonings, tricyclic antidepressants had a case fatality rate ratio of 13.8 (95% CI 13.0 to 14.7), against 2.5 for venlafaxine, 1.9 for mirtazapine and 0.5 for SSRIs. Dosulepin and doxepin were more toxic than amitriptyline [18]. The label states that overdose can cause cardiac dysrhythmias, severe low blood pressure, convulsions and coma, and that deaths may occur [13].
Population: UK prescriptions, poisoning deaths in England and Wales, and non-fatal self-poisonings at six hospitals, 2000 to 2006 [18].
Sources: [18], [13]
Caveats: Observational. People prescribed tricyclics may differ from those prescribed other drugs [18].

LimitedHow often is not known

Serotonin syndrome and MAOIs

The label warns of serotonin syndrome with other serotonergic drugs and lists MAOIs as a contraindication, after hyperpyretic crises, convulsions and deaths with the combination.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Serotonin syndrome has been reported with tricyclics alone and particularly with triptans, other tricyclics, SSRIs, SNRIs, fentanyl, lithium, tramadol, tryptophan, buspirone and St. John's Wort. Use with MAOIs for psychiatric disorders is contraindicated, as is starting amitriptyline during linezolid or intravenous methylene blue. Hyperpyretic crises, severe convulsions and deaths have occurred with tricyclics and MAOIs taken together [13].
Population: Reports summarized in the label [13].
Sources: [13]
Caveats: No rate is given.

LimitedHow often is not known

Drugs that raise amitriptyline levels

The label states that SSRIs, quinidine, cimetidine and other drugs that block the liver enzyme CYP2D6 can raise tricyclic levels, and topiramate raised them sharply in some people.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: CYP2D6 inhibitors include quinidine, cimetidine, many antidepressants, phenothiazines and the heart rhythm drugs propafenone and flecainide, and all SSRIs inhibit it to varying degrees. People who metabolize poorly through this enzyme, about 7% to 10% of Caucasians, can have up to 8-fold higher tricyclic exposure. Cimetidine raised tricyclic levels and side effects. Some people had a large rise in amitriptyline concentration with topiramate [13].
Population: Labeling statements drawn from drug interaction studies [13].
Sources: [13]
Caveats: Changes in blood levels, with no rate of harm given.

LimitedHow often is not known

Alcohol and sedating drugs

The label warns that amitriptyline may enhance the effects of alcohol, barbiturates and other sedating drugs, which raises the danger of an overdose.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states amitriptyline may enhance the response to alcohol and the effects of barbiturates and other central nervous system depressants, that this may raise the danger of a suicide attempt or overdose, and that delirium has been reported with disulfiram [13].
Population: Labeling statement [13].
Sources: [13]
Caveats: No rate is given.

LimitedHow often is not known

Other interactions on the label

The label names thyroid medication, guanethidine, anticholinergic drugs and epinephrine with local anesthetics as combinations that need close supervision. It gives no rates.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Amitriptyline may block the blood pressure effect of guanethidine. Close supervision is required in people taking thyroid medication. Combining it with anticholinergic or sympathomimetic drugs, including epinephrine with local anesthetics, requires dose adjustment. Hyperpyrexia has been reported with anticholinergic or neuroleptic drugs in hot weather, and paralytic ileus with anticholinergic drugs [13].
Population: Labeling statements [13].
Sources: [13]
Caveats: No rates are given.

LimitedHow often is not known

Low sodium

The label reports low blood sodium on amitriptyline, often from inappropriate antidiuretic hormone release, with older adults and people on diuretics at greater risk. It gives no rate.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Hyponatremia has occurred, in many cases from the syndrome of inappropriate antidiuretic hormone secretion, with headache, confusion and unsteadiness, and in severe cases seizures, coma and death. Older adults, people taking diuretics and people who are volume depleted may be at greater risk [13].
Population: Reports summarized in the label [13].
Sources: [13]
Caveats: No rate or measured sodium change is given.

LimitedHow often is not known

Glaucoma, urinary retention and seizures

The label warns that amitriptyline's atropine-like action can trigger angle-closure glaucoma and urinary retention, and lists caution in people with seizures. It gives no rates.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Pupil widening may trigger an angle-closure attack in people with narrow angles, and even average doses may precipitate an attack in people with angle-closure glaucoma. The label calls for caution in people with a history of seizures or urinary retention [13].
Population: Labeling statements [13].
Sources: [13]
Caveats: No rates are given.

LimitedHow often is not known

Mania in bipolar disorder

The label warns that depressed people with bipolar disorder may shift to mania or hypomania, and that amitriptyline is not approved for bipolar depression.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The label states that treating a depressive episode with an antidepressant alone may raise the chance of a mixed or manic episode in people at risk of bipolar disorder, that people with schizophrenia may have more psychotic symptoms, and that rare mania has occurred 2 to 7 days after stopping long-term treatment [13].
Population: Labeling statements [13].
Sources: [13]
Caveats: The label states the link is not established in controlled trials [13].

LimitedHow often is not known

Symptoms after stopping

The label reports nausea, headache and malaise after abrupt stopping, and irritability, restlessness and sleep disturbance during gradual reduction. It gives no rate.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: After prolonged use, abrupt cessation may produce nausea, headache and malaise. Gradual dose reduction has been reported to produce transient irritability, restlessness and dream and sleep disturbance within two weeks. The label states these symptoms are not a sign of addiction [13].
Population: Labeling statement [13].
Sources: [13]
Caveats: No rate is given.

LimitedStudied in pregnancyHow often is not known

Pregnancy

Case reports: the label notes a few reports of nervous system effects, limb deformities or developmental delay in infants exposed in pregnancy, with no causal link established.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: Amitriptyline crosses the placenta. The label reports a few cases of central nervous system effects, limb deformities or developmental delay in infants whose mothers took it, states that a causal relationship has not been established, and that there are no adequate controlled studies in pregnant women. It was teratogenic in mice and hamsters at 9 to 33 times the maximum human dose [13].
Population: Case reports and animal studies described in the label [13].
Sources: [13]
Caveats: Case reports, with no denominator.

Claims tested and not found

That amitriptyline prevents migraine in children. In 361 children and adolescents, headache days halved in 52% on amitriptyline and 61% on placebo [8].
That low-dose amitriptyline relieves chronic back pain. In 146 adults, pain at 6 months did not differ from an active placebo [11].

SSRIs SNRIs Gabapentinoids Topiramate

Sources

Leucht C, Huhn M, Leucht S. Amitriptyline versus placebo for major depressive disorder. Cochrane Database of Systematic Reviews. 2012. https://doi.org/10.1002/14651858.CD009138.pub2
Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet. 2018. https://doi.org/10.1016/S0140-6736(17)32802-7
Moore RA, Derry S, Aldington D, et al. Amitriptyline for neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD008242.pub3
Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet Neurology. 2015. https://doi.org/10.1016/S1474-4422(14)70251-0
Derry S, Wiffen PJ, Aldington D, et al. Nortriptyline for neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD011209.pub2
Moore RA, Derry S, Aldington D, et al. Amitriptyline for fibromyalgia in adults. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD011824
Jackson JL, Cogbill E, Santana-Davila R, et al. A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache. PLOS ONE. 2015. https://doi.org/10.1371/journal.pone.0130733
Powers SW, Coffey CS, Chamberlin LA, et al. Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. New England Journal of Medicine. 2017. https://doi.org/10.1056/NEJMoa1610384
Jackson JL, Mancuso JM, Nickoloff S, et al. Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis. Journal of General Internal Medicine. 2017. https://doi.org/10.1007/s11606-017-4121-z
Ford AC, Wright-Hughes A, Alderson SL, et al. Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet. 2023. https://doi.org/10.1016/S0140-6736(23)01523-4
Urquhart DM, Wluka AE, van Tulder M, et al. Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Internal Medicine. 2018. https://doi.org/10.1001/jamainternmed.2018.4222
Everitt H, Baldwin DS, Stuart B, et al. Antidepressants for insomnia in adults. Cochrane Database of Systematic Reviews. 2018. https://doi.org/10.1002/14651858.CD010753.pub2
U.S. Food and Drug Administration. Amitriptyline hydrochloride tablets, prescribing information (Sun Pharmaceutical Industries). 2026. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4e520c63-1cf6-40f6-a51c-3f9b0e181342
Hajizadeh A, Howes S, Theodoulou A, et al. Antidepressants for smoking cessation. Cochrane Database of Systematic Reviews. 2023. https://doi.org/10.1002/14651858.CD000031.pub6
U.S. Food and Drug Administration. PAMELOR (nortriptyline hydrochloride) capsules, prescribing information. 2025. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e17dc299-f52d-414d-ab6e-e809bd6f8acb
2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2023. https://doi.org/10.1111/jgs.18372
Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. The Journal of Clinical Psychiatry. 2010. https://doi.org/10.4088/JCP.09r05346blu
Hawton K, Bergen H, Simkin S, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. The British Journal of Psychiatry. 2010. https://doi.org/10.1192/bjp.bp.109.070219

Everything in the library

Shown to help6

Reported risks15

What people take it for, and what was found

Shown to help6

Mixed results1

Not shown to help2

Claimed, not studied in people1

Doses studied

Risks

Reported risks15

Claims tested and not found

Related

Sources