Table of ContentsView AllTable of ContentsHow Amitriptyline Works on MigrainesDosingSide Effects and ComplicationsInteractionsContraindications
Table of ContentsView All
View All
Table of Contents
How Amitriptyline Works on Migraines
Dosing
Side Effects and Complications
Interactions
Contraindications
This article discusses the use of amitriptyline to treat migraines. It covers its side effects, how the drug may interact with other medications, and reasons why you should talk to a healthcare provider about other underlying health conditions.
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The effects of amitriptyline on these two brain chemicals are thought to help prevent migraine headaches, as well aschronic tension-type headachesand some other chronic pain conditions. More research is needed, but some studies have found amitriptyline effective at preventing migraines, and others have found it may improve outcomes when used withother interventions.
Can Children Take Amitriptyline for Migraines?Amitriptyline can be used to treat both children and adults, but the AHS and AAN recommend other drugs (like topiramate) that are more likely to be effective in treating kids. Children who take amitriptyline for migraines while also receivingcognitive behavioral therapymay be more likely to benefit from the combined treatment.
Can Children Take Amitriptyline for Migraines?
Amitriptyline can be used to treat both children and adults, but the AHS and AAN recommend other drugs (like topiramate) that are more likely to be effective in treating kids. Children who take amitriptyline for migraines while also receivingcognitive behavioral therapymay be more likely to benefit from the combined treatment.
Amitriptyline for Depression, Anxiety, and More
Amitriptyline comes as a tablet you swallow. The smallest dose is 10 milligrams (mg), although the drug is available in larger doses per tablet. The AHS/AAN Guidelines for Prevention of Episodic Migraines recommend between 25 and 150 mg of amitriptyline per day.
It will take some medication adjustment to figure out the best dosage for you. Your healthcare provider will likely start you on a very low dose, wait several weeks for the drug to become established in your system, and then determine if you need to try a higher dose or a different drug.
Amitriptyline is associated with a host of side effects—most relatively common and mild, others more serious.
You should see a healthcare provider or go to the nearest hospital emergency department right away if you develop any serious symptoms after taking amitriptyline. Similarly, if you experience mild side effects that become severe or don’t go away, let yourhealthcare providerknow.
Mild Side EffectsNauseaVomitingDrowsinessWeakness/fatigueNightmaresHeadachesDry mouthConstipationDifficulty urinatingBlurred visionPain or tingling in hands or feetChanges in sexual functionExcessive sweatingChanges in appetiteWeight loss/weight gainConfusionBalance problemsSerious Side EffectsTrouble speakingDizziness/faintnessWeakness/numbness in a limbCrushing chest painRapid, pounding, or irregular heartbeatSevere skin rash or hivesSwelling of the face and tongueYellowing of skin or eyesSpasms of the jaw, neck, and/or back musclesUncontrollable shakingFaintingUnusual bleeding or bruisingSeizuresHallucinating
Mild Side EffectsNauseaVomitingDrowsinessWeakness/fatigueNightmaresHeadachesDry mouthConstipationDifficulty urinatingBlurred visionPain or tingling in hands or feetChanges in sexual functionExcessive sweatingChanges in appetiteWeight loss/weight gainConfusionBalance problems
Nausea
Vomiting
Drowsiness
Weakness/fatigue
Nightmares
Headaches
Dry mouth
Constipation
Difficulty urinating
Blurred vision
Pain or tingling in hands or feet
Changes in sexual function
Excessive sweating
Changes in appetite
Weight loss/weight gain
Confusion
Balance problems
Serious Side EffectsTrouble speakingDizziness/faintnessWeakness/numbness in a limbCrushing chest painRapid, pounding, or irregular heartbeatSevere skin rash or hivesSwelling of the face and tongueYellowing of skin or eyesSpasms of the jaw, neck, and/or back musclesUncontrollable shakingFaintingUnusual bleeding or bruisingSeizuresHallucinating
Trouble speaking
Dizziness/faintness
Weakness/numbness in a limb
Crushing chest pain
Rapid, pounding, or irregular heartbeat
Severe skin rash or hives
Swelling of the face and tongue
Yellowing of skin or eyes
Spasms of the jaw, neck, and/or back muscles
Uncontrollable shaking
Fainting
Unusual bleeding or bruising
Seizures
Hallucinating
Why Is Amitriptyline a High-Risk Medication?
As with many antidepressants, amitriptyline has been found to cause some people to develop thoughts of self-harm or become suicidal when taking the drug for depression.The risk is greater for children, teenagers, and young adults under age 24.
A small risk of suicidal thoughts or other changes in mental health also exists for adults over 24, especially at the very beginning of treatment or whenever there is a change in dosage.
Amitriptyline for Migraines and Weight GainWeight gain is one of the most common side effects of taking amitriptyline. It affects between 7% and 19% of adults who take it.The dosages for off-label use to treat migraine may not be as high as those used to treat depression, so side effects may be more mild.
Amitriptyline for Migraines and Weight Gain
Weight gain is one of the most common side effects of taking amitriptyline. It affects between 7% and 19% of adults who take it.The dosages for off-label use to treat migraine may not be as high as those used to treat depression, so side effects may be more mild.
Adverse Reaction to a Medication or Drug
There are quite a few medications, both prescription and over-the-counter (OTC), that may interact with amitriptyline. They’re not all listed here, but some medications that are known to interact with amitriptyline include:
Your healthcare provider will need to know about any other medications or supplements you are taking, including other anti-anxiety drugs, antidepressants, or sedatives. Alcohol use and opioids present a special risk to people who take amitriptyline. You also should use caution with herbalSt. John’s wort.
Amitriptyline and AlcoholAmitriptyline can increase the effects of alcohol.Even if you only have an occasional drink, be aware that you may feel the effects of it more strongly than usual. Drinking substantial amounts of alcohol while taking this drug is not advised.
Amitriptyline and Alcohol
Amitriptyline can increase the effects of alcohol.Even if you only have an occasional drink, be aware that you may feel the effects of it more strongly than usual. Drinking substantial amounts of alcohol while taking this drug is not advised.
Alcohol: A Trigger for Headaches and Migraines
Amitriptyline isn’t safe for everyone, so it’s important that the healthcare provider who prescribes it for you knows your complete medical history. People who should not take amitriptyline or who should use it with caution include those with:
People who are or plan to be pregnant or breastfeeding should not take amitriptyline. It’s not safe for people over 65, and also is likely to be less effective for them than other medications.
Amitriptyline and Mental Health MedicationPeople with aschizophreniadiagnosis should discuss using amitriptyline for migraines with their healthcare provider.And if you’re taking other medications for mental health issues, be sure to let them know due to potential side effects and drug interactions.
Amitriptyline and Mental Health Medication
People with aschizophreniadiagnosis should discuss using amitriptyline for migraines with their healthcare provider.And if you’re taking other medications for mental health issues, be sure to let them know due to potential side effects and drug interactions.
Summary
The FDA has not approved off-label use of amitriptyline for migraines, but some studies show it can be effective in preventing migraine headaches.
Your healthcare provider can discuss your options with you. Amitriptyline often has side effects, some of them serious, and it isn’t recommended for people with certain underlying health issues. If you do take amitriptyline, expect to take it for at least several weeks before your progress is evaluated.
How to Prevent Migraines
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lampl C, Versijpt J, Amin FM, Deligianni CI, Gil-Gouveia R, Jassal T,et al.European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptyline.J Headache Pain. 2023 Apr 11;24(1):39. doi:10.1186/s10194-023-01573-6National Health Service.Who can and cannot take amitriptyline for pain and migraine.Food and Drug Administration.Amitriptyline label.Kalita J, Kumar S, Singh VK, Misra UK.A Randomized Controlled Trial of High Rate rTMS Versus rTMS and Amitriptyline in Chronic Migraine.Pain Physician. 2021 Sep;24(6):E733-E741. PMID: 34554691.Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ.Amitriptyline for neuropathic pain in adults.Cochrane Database Syst Rev. 2015;2015(7):CD008242. doi:10.1002/14651858.CD008242.pub3Oskoui M, Pringsheim T, Billinghurst L, Potrebic S, Gersz EM, Gloss D,et al.Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2019 Sep 10;93(11):500-509. doi:10.1212/WNL.0000000000008105American Academy of Family Physicians.Migraine headache prophylaxis.National Health Service.Side effects of amitriptyline for pain and migraine.Sepúlveda-Lizcano L, Arenas-Villamizar VV, Jaimes-Duarte EB, García-Pacheco H, Paredes CS, Bermúdez V,et al.Metabolic adverse effects of psychotropic drug therapy: A systematic review.Eur J Investig Health Psychol Educ. 2023 Aug 12;13(8):1505-1520. doi:10.3390/ejihpe13080110MedlinePlus.Amitriptyline.National Health Service.Taking amitriptyline for pain and migraine with other medicines and herbal supplements.Kassim T, Mahfood Haddad T, Rakhra A, Kabach A, Qurie A, Selim M,et al.A case of amitriptyline-induced myocarditis.Cureus. 2018 Jun 19;10(6):e2840. doi:10.7759/cureus.2840
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lampl C, Versijpt J, Amin FM, Deligianni CI, Gil-Gouveia R, Jassal T,et al.European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptyline.J Headache Pain. 2023 Apr 11;24(1):39. doi:10.1186/s10194-023-01573-6National Health Service.Who can and cannot take amitriptyline for pain and migraine.Food and Drug Administration.Amitriptyline label.Kalita J, Kumar S, Singh VK, Misra UK.A Randomized Controlled Trial of High Rate rTMS Versus rTMS and Amitriptyline in Chronic Migraine.Pain Physician. 2021 Sep;24(6):E733-E741. PMID: 34554691.Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ.Amitriptyline for neuropathic pain in adults.Cochrane Database Syst Rev. 2015;2015(7):CD008242. doi:10.1002/14651858.CD008242.pub3Oskoui M, Pringsheim T, Billinghurst L, Potrebic S, Gersz EM, Gloss D,et al.Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2019 Sep 10;93(11):500-509. doi:10.1212/WNL.0000000000008105American Academy of Family Physicians.Migraine headache prophylaxis.National Health Service.Side effects of amitriptyline for pain and migraine.Sepúlveda-Lizcano L, Arenas-Villamizar VV, Jaimes-Duarte EB, García-Pacheco H, Paredes CS, Bermúdez V,et al.Metabolic adverse effects of psychotropic drug therapy: A systematic review.Eur J Investig Health Psychol Educ. 2023 Aug 12;13(8):1505-1520. doi:10.3390/ejihpe13080110MedlinePlus.Amitriptyline.National Health Service.Taking amitriptyline for pain and migraine with other medicines and herbal supplements.Kassim T, Mahfood Haddad T, Rakhra A, Kabach A, Qurie A, Selim M,et al.A case of amitriptyline-induced myocarditis.Cureus. 2018 Jun 19;10(6):e2840. doi:10.7759/cureus.2840
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lampl C, Versijpt J, Amin FM, Deligianni CI, Gil-Gouveia R, Jassal T,et al.European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptyline.J Headache Pain. 2023 Apr 11;24(1):39. doi:10.1186/s10194-023-01573-6National Health Service.Who can and cannot take amitriptyline for pain and migraine.Food and Drug Administration.Amitriptyline label.Kalita J, Kumar S, Singh VK, Misra UK.A Randomized Controlled Trial of High Rate rTMS Versus rTMS and Amitriptyline in Chronic Migraine.Pain Physician. 2021 Sep;24(6):E733-E741. PMID: 34554691.Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ.Amitriptyline for neuropathic pain in adults.Cochrane Database Syst Rev. 2015;2015(7):CD008242. doi:10.1002/14651858.CD008242.pub3Oskoui M, Pringsheim T, Billinghurst L, Potrebic S, Gersz EM, Gloss D,et al.Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2019 Sep 10;93(11):500-509. doi:10.1212/WNL.0000000000008105American Academy of Family Physicians.Migraine headache prophylaxis.National Health Service.Side effects of amitriptyline for pain and migraine.Sepúlveda-Lizcano L, Arenas-Villamizar VV, Jaimes-Duarte EB, García-Pacheco H, Paredes CS, Bermúdez V,et al.Metabolic adverse effects of psychotropic drug therapy: A systematic review.Eur J Investig Health Psychol Educ. 2023 Aug 12;13(8):1505-1520. doi:10.3390/ejihpe13080110MedlinePlus.Amitriptyline.National Health Service.Taking amitriptyline for pain and migraine with other medicines and herbal supplements.Kassim T, Mahfood Haddad T, Rakhra A, Kabach A, Qurie A, Selim M,et al.A case of amitriptyline-induced myocarditis.Cureus. 2018 Jun 19;10(6):e2840. doi:10.7759/cureus.2840
Lampl C, Versijpt J, Amin FM, Deligianni CI, Gil-Gouveia R, Jassal T,et al.European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptyline.J Headache Pain. 2023 Apr 11;24(1):39. doi:10.1186/s10194-023-01573-6
National Health Service.Who can and cannot take amitriptyline for pain and migraine.
Food and Drug Administration.Amitriptyline label.
Kalita J, Kumar S, Singh VK, Misra UK.A Randomized Controlled Trial of High Rate rTMS Versus rTMS and Amitriptyline in Chronic Migraine.Pain Physician. 2021 Sep;24(6):E733-E741. PMID: 34554691.
Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ.Amitriptyline for neuropathic pain in adults.Cochrane Database Syst Rev. 2015;2015(7):CD008242. doi:10.1002/14651858.CD008242.pub3
Oskoui M, Pringsheim T, Billinghurst L, Potrebic S, Gersz EM, Gloss D,et al.Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2019 Sep 10;93(11):500-509. doi:10.1212/WNL.0000000000008105
American Academy of Family Physicians.Migraine headache prophylaxis.
National Health Service.Side effects of amitriptyline for pain and migraine.
Sepúlveda-Lizcano L, Arenas-Villamizar VV, Jaimes-Duarte EB, García-Pacheco H, Paredes CS, Bermúdez V,et al.Metabolic adverse effects of psychotropic drug therapy: A systematic review.Eur J Investig Health Psychol Educ. 2023 Aug 12;13(8):1505-1520. doi:10.3390/ejihpe13080110
MedlinePlus.Amitriptyline.
National Health Service.Taking amitriptyline for pain and migraine with other medicines and herbal supplements.
Kassim T, Mahfood Haddad T, Rakhra A, Kabach A, Qurie A, Selim M,et al.A case of amitriptyline-induced myocarditis.Cureus. 2018 Jun 19;10(6):e2840. doi:10.7759/cureus.2840
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