Information last reviewed: May 2026 — for educational purposes only.
What Is Elavil (Amitriptyline)?
Amitriptyline, marketed under the brand name Elavil, is a tricyclic antidepressant (TCA) that inhibits neuronal reuptake of both serotonin and norepinephrine while also blocking multiple receptor types (muscarinic, histamine H1, alpha-1 adrenergic). Its broad receptor profile explains both its clinical versatility and its prominent side-effect profile (sedation, anticholinergic effects, cardiac conduction effects). Despite being an older drug, amitriptyline remains in frequent use at low doses for neuropathic pain, insomnia, migraine prevention, and fibromyalgia — indications where its non-antidepressant properties are therapeutically exploited.
Prescription (Rx) Status
Amitriptyline is prescription-only. Generic amitriptyline tablets are inexpensive. Due to its cardiac toxicity in overdose (QTc prolongation, arrhythmias), it is prescribed cautiously in patients with cardiovascular disease and those at suicide risk. An ECG is recommended before starting in elderly patients or those with cardiac concerns. It is on the Beers Criteria list of potentially inappropriate medications for older adults.
Uses of Amitriptyline
FDA-approved: major depressive disorder. Widely used off-label: neuropathic pain (diabetic neuropathy, post-herpetic neuralgia), migraine prevention (at low doses 10–25 mg nightly), insomnia (low-dose sedative effect), fibromyalgia, interstitial cystitis, and irritable bowel syndrome (IBS). At low doses (10–50 mg), side effects are generally well tolerated.
Tablet Strengths
Amitriptyline oral tablets: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. For depression: typically 75–150 mg/day in divided doses or as a single bedtime dose. For neuropathic pain or migraine prevention: 10–50 mg at bedtime. Maximum dose: 300 mg/day (inpatients under specialist care). A liquid formulation (10 mg/5 mL) is available for patients unable to swallow tablets.
Price
Generic amitriptyline is very inexpensive. A 30-day supply of 25 mg tablets typically costs $5–$15 at most pharmacies. The brand Elavil is no longer marketed in many countries; generic forms are the standard.
Frequently Asked Questions
Q: Does amitriptyline cause weight gain?
A: Yes — weight gain is a common side effect, partly due to H1 receptor blockade (increased appetite) and metabolic effects. This is more pronounced at higher antidepressant doses.
Q: Why is amitriptyline used for pain if it's an antidepressant?
A: In addition to its antidepressant mechanism, amitriptyline modulates pain signals in the spinal cord and peripheral nervous system independently of its effect on mood, making it effective for nerve pain at sub-antidepressant doses.
Q: Can I stop amitriptyline suddenly?
A: No — abrupt discontinuation can cause withdrawal symptoms (nausea, malaise, headache). Always taper under medical supervision.
Disclaimer: This page is for informational purposes only and does not constitute medical advice. Amitriptyline requires a valid prescription. Always consult a qualified healthcare professional. See our full disclaimer.