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Amitriptyline Dosage Guide

Katelyn Hagerty FNP

Medically reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Last updated 5/20/2022

If there’s one thing we can say with certainty, it’s that amitriptyline did not win the “Catchy Names” lottery. This tricyclic antidepressant treatment’s name is hard to pronounce, and surprisingly, the only thing harder than the pronunciation might be the adverse effects.

If you’re reading this, we’re guessing you're probably pretty familiar with depression.

Depression is a common mental illness, and one of the most well-known mood disorders out there. There’s a reason so many people know about it: it affects a staggering number of people — millions in the U.S. alone.

Many medications have been created in hopes of curing us of depression over the years, and while not all of them have worked, some have indeed helped people with depression live a more normal life. 

Amitriptyline may be one of these, but the proper dosage of amitriptyline is going to be a deciding factor in that outcome. Unlike some other mental health medications, TCAs are known not so much for their benefits as their common side effects.

What Is Amitriptyline and What Does It Do?

Amitriptyline is a tricyclic antidepressant — a medication for depression that regulates mood by blocking the reuptake of both serotonin and norepinephrine neurotransmitters in the brain.

Essentially, amitriptyline keeps your brain from reducing the supply of these two neurotransmitters, and over time, that has the effect of regulation or balancing mood. This is especially beneficial to conditions like major depressive disorder (MDD), as amitriptyline works to stabilize the extremes of those highs and lows associated with the condition.

This medication is FDA approved for the treatment of depression, but amitriptyline has been used for the off-label treatment of a bevy of other conditions, from anxiety and PTSD (post-traumatic stress disorder), to insomnia and the neuropathic pain signals associated with chronic pain, to irritable bowel syndrome (IBS), bladder issues and more.


Typically, amitriptyline performs like other antidepressant medication in terms of how long it takes to work — you may see results as early as two weeks after you’ve begun taking this medication, though it may take a month or more to see significant results.

What’s the Correct Amitriptyline Dosage for Depression?

For depression, the National Library of Medicine (NLM) says that the initial recommended dose of amitriptyline is 25mg per day, to be taken at bedtime. This daily dose may change depending on its effectiveness in your individual case.

A healthcare professional may wish to increase your dosage, and if that’s the case, they’ll typically do so in windows of three to seven days, at a rate of about25 mg, until the desired effect is reached.

A maximum dose of about 300 mg a day is where you’ll likely cap out — anything beyond that might cause unnecessary and dangerous side effects of overdose.

This medication will likely be with you for three months or more to treat the condition, and if after some time you elect to go off the medication, a healthcare professional will slowly and gradually taper your dosage to avoid any withdrawal symptoms.

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What’s the Correct Amitriptyline Dosage for Anxiety?

While there’s no officially recognized amitriptyline dosage for anxiety, this off-label use of amitriptyline does have some standards according to the NLM. Off-label uses of amitriptyline typically start lower, at around 10mg per day, and will be gradually increased until the desired effect is reached.

Pediatric patients can sometimes use amitriptyline, although it is not FDA approved for use in children. In these cases, the dosage is usually on the lowest end of the spectrum.

It’s unlikely that your individual needs can be predicted by these general guidelines, so remember that, in all likelihood, your healthcare provider will set the appropriate dosage for your individual treatment needs, whether it’s starting at 10mg or higher.

Amitriptyline: Side Effects, Risks and Drug Interactions

There are some potentially serious side effects of amitriptyline and risks associated with amitriptyline treatment. Tell your healthcare provider if you experience any of the following adverse events:

  • Nausea or vomiting

  • Headaches

  • Sweating

  • Constipation

  • dry mouth

  • Unsteadiness

  • Confusion

  • Blurred vision

  • Changes in weight

  • Changes in sex drive

If you experience any of the following serious side effects, call your healthcare provider immediately:

  • Swelling of the face

  • Fainting

  • Slow or slurred speech

  • Increased Risk of Seizures

  • Yellowing of the eyes or skin

  • Muscle spasms or uncontrolled shaking

  • Hallucinations

  • Chest pain or weakness in limbs

  • Unusual bleeding or bruising

Amitriptyline should not be used by people who have previously experienced heart attacks or heart failure, and people on Monoamine Oxidase inhibitors (or MAOIs), suffering from glaucoma, dealing with seizures or taking seizure medications should talk to their healthcare provider about risks before taking this medication.

Also, talk with your healthcare provider about other medications that might affect your serotonin levels. These medications include things like sertraline and procarbazine — medications that might cause serotonin syndrome when mixed with amitriptyline.

What Happens If You Take Too Much Amitriptyline?

One thing you don’t want to do is take too much of this medication. Taking too little amitriptyline or skipping a dose is not necessarily dangerous, but taking too much can cause serious heart, brain and cognition problems.

Too much amitriptyline may result in some serious side effects. Overdose symptoms include irregular heartbeat, seizures, vomiting, fever, agitation, drowsiness, hallucinations, confusion, fever and coma. It’s possible that these side effects could potentially result in death.

If you’ve taken too much amitriptyline, call poison control immediately, and if symptoms have set in, call 911 immediately.

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Finding the Correct Amitriptyline Dosage: Next Steps

Amitriptyline is not a medication that you should take with disregard for its dangers, and that’s why getting the proper dosage (and taking that dosage on the proper schedule) is so important for your health.

There are many things that can affect your mental health for better or worse, and medication is not always the best solution to the problem. 

If you’re currently looking for help for depression or anxiety, talk to a healthcare professional about your concerns. They may indeed decide that TCAs like amitriptyline are right for you, but they may also suggest alternative drug or treatment options for depressive disorder and anxiety, like selective serotonin reuptake inhibitors or SSRIs, therapy, lifestyle changes and more. 

The best thing you can do for yourself is to talk to someone. Medical professionals and online mental help are available right now.

2 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. U.S. National Library of Medicine. (n.d.). Amitriptyline: Medlineplus drug information. MedlinePlus. Retrieved March 9, 2022, from https://medlineplus.gov/druginfo/meds/a682388.html.
  2. Thour A, Marwaha R. Amitriptyline. Updated 2022 Feb 7. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537225/.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.