Different types of pharmaceutical drugs are being prescribed to fibromyalgia patients. They include non-steroidal anti-inflammatory medications, muscle relaxants, sedatives, as well as antidepressants. Amitriptyline, belonging to the oldest type of antidepressants, is a common drug administered by fibromyalgia patients.
What Is Amitriptyline?
Amitriptyline is a type of tricyclic antidepressant (TCA ), mainly used in treating clinical depression. This class of antidepressants has some of the oldest antidepressants still in use. Amitriptyline, sold under the brand Elavil, is believed to be one of the most efficient antidepressants. However, in spite of its effectiveness, newer antidepressants are favored over Amitriptyline due to its side effects and toxicity when over-consumed.
Although approved by the FDA for treating major depressive disorders, Amitriptyline has not been approved by FDA as a fibromyalgia medication. However, it can also help in anxiety disorders and nerve-related pain conditions such as fibromyalgia.
How Does Amitriptyline Work For Fibromyalgia
Amitriptyline works by enhancing the levels of the brain chemicals or the neurotransmitters, norepinephrine and serotonin. This in turn prevents malfunctions in the brain and nervous system. Chronic pain patients, known to show low levels of norepinephrine and serotonin, generally see improvement after administering the drug.
In addition, amitriptyline also acts as muscle relaxant and has effects in increasing endorphins, the body’s natural painkiller. Although it can help treat fibromyalgia symptoms, the side effects of amitriptyline can prevent patients from taking the drug consistently.
Side effects of Amitriptyline for Fibromyalgia
Side effects of Amitriptyline can vary between individuals and are dependent on the dosage. Generally, amitriptyline are more likely to cause weight gain and drowsiness as compared to other tricyclic antidepressants. The other common side effects are:
- blurred vision
- constipation or diarrhea
- dry mouth
- skin rash
- swelling of face
- urine retention
Usually, the side effects are mild and would subside in a few weeks. If they are unbearable and persist, talk to your doctor and consider switching medications.
Usage of Amitriptyline for Fibromyalgia
In general, dosage of amitriptyline for fibromyalgia is much lower as compared to the usual dosage used for treating depression. The dosage can start to as low as 10 mg each day and administered at least three hours before sleep. This provides the patient with appropriate sedative effects from the medication without feeling the same effects when they wake up.
Studies On Amitriptyline For Fibromyalgia
In one clinical study, participants administered either 25 mg of amitriptyline or 20 mg of fluoxetine or both. Participants on the combination of both drugs found that its “twice as effective” as compared to taking 1 type of drug alone.
Another study investigated the effectiveness of regular consumption of 50 mg of amitriptyline for fibromyalgia. Participants reported better sleep, morning stiffness and pain threshold. However, tender points remained unchanged.
Later studies suggest that amitriptyline may be administered for neuropathic pain, however, patients may not attain sufficient pain relief.
As mentioned, FDA has not approved amitriptyline as a fibromyalgia medication. However, FDA approved two newer serotonin–norepinephrine reuptake inhibitor (SNRI) antidepressants, duloxetine and milnacipran, for fibromyalgia treatment. Nonetheless, research are still ongoing to substantiate amitriptyline as an effective fibromyalgia treatment.
Have you tried amitriptyline for fibromyalgia? Leave a comment to share your experience below.