Elavil (amitriptyline) (a-mə-trip-tə-lēn) is a tricyclic antidepressant. It may be used to treat chronic pain associated with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Anti-depressives such as Elavil contain a black box warning such as the following:
Suicidality and Anti-depressant Drugs
Anti-depressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of ELAVIL or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. ELAVIL is not approved for use in pediatric patients.
Studies have shown a small amount of people who take antidepressants (particularly young people under 25) may experience depression that worsens, even if taking the medication for something other than depression. A small number of people may experience adverse mental and mood symptoms, even suicidal thoughts or attempts.
Discuss the dangers and benefits of Elavil with your physician.
While taking Elavil, if you experience worsening depression or other psychiatric conditions, suicidal thoughts or attempts, anxiety/panic attacks, insomnia, hostile feelings, reckless actions, severe agitation, or rapid speech, please notify your doctor immediately. Particularly watch for symptoms when beginning an Elavil regimen or changing the dose.
Why Is Elavil Prescribed for Prostatitis?
Elavil is used to improve pain in cases of CP/CPPS. It has been shown to improve neuropathic pain in a central manner with moderate success.
How Should Elavil Be Used?
Elavil is supplied as 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg tablets, as well as a sterile solution for intramuscular use.
The adult recommended dose is 40 to 150 mg each day divided into separate doses. The lowest effective dose is recommended.
Elavil may be taken with or without food.
Other Uses for Elavil
Elavil works to balance chemicals in the brain. It is primarily used to treat symptoms of depression. It can be used to treat anxiety disorders; migraines, ADHD, bipolar disorder, anorexia or bulimia, insomnia, PTSD, cyclic vomiting syndrome, tinnitus, nerve pain, fibromyalgia, chronic fatigue syndrome, and other uses.
Do I Need to Follow Special Precautions?
Your doctor should check your progress at regular intervals while you’re taking Elavil. Your physician may need to change the dose and should monitor for any side effects.
This medication may cause agitation, irritability, or other unusual behaviors. It may also cause suicidal inclinations or worsening depression. If you experience any adverse effects, tell your doctor immediately.
Do not take Elavil if you have taken a monoamine oxidase inhibitor (MAOI) within the past two weeks. Do not begin taking an MAOI within five days of stopping an Elavil regimen. If Elavil is combined with an MAOI, you may experience confusion, nervousness, restlessness, stomach or intestinal problems, escalating body temperature, high blood pressure, or convulsions. (See below for more information about MAOIs.)
Discuss other medications you take with your doctor.
Using this medication with Propulsid (cisapride) may augment the likelihood of severe side effects.
Unless you inform your physician, do not stop taking this medicine abruptly. Your doctor may suggest slowly reducing the dose before stopping Elavil completely. Withdrawal symptoms may include headache, nausea, or a general feeling of sickness.
Elavil will increase the effects of alcohol and other central nervous system depressants, including antihistamines or other allergy medicines; cold medicine; sedatives, tranquilizers, or sleep aids; prescription pain medicine or narcotics; barbiturates; seizure medications; muscle relaxants; or anesthetics.
Before having any surgeries, inform the surgeon if you are taking Elavil.
Elavil may affect blood sugar levels.
Be sure to know how you respond to Elavil before driving or performing any dangerous activity, as it may cause drowsiness.
Do I Need to Follow a Special Diet When Taking Elavil?
Unless your doctor provides any dietary restrictions or guidelines, continue your normal diet.
What If I Forget a Dose?
If a dose is missed, take the medication as soon as you remember. However, if nearing the time when you are supposed to take the next dose, skip the missed dose and resume your regular schedule. If a dose is missed, do not double the dose.
Are There Side Effects When Taking Elavil?
Side effects of this medication may include:
- Nausea or vomiting
- Rapid heart rate
- Blurred vision
- Pain or tingling in extremities
- Difficulty urinating
- Dry mouth
- Changes in weight or appetite
- Changes in sex drive or ability
- Profuse sweating
- Low blood pressure on standing
Rare or other serious side effects include:
- Severe chest pain
- Yellowing of skin or eyes
- Muscle spasms
- Unusual bleeding or bruising
Elavil is used cautiously with patients who have a seizure disorder.
This medication is also used with caution when a patient has an enlarged prostate because of the risk of difficulty urinating.
Elavil may cause increased pressure in the eyes with patients who have glaucoma.
Inform your physician of any side effects you experience.
Does Elavil Have Special Storage Instructions
This medication should be stored at room temperature in a tight container away from light.
Avoid storing Elavil at temperatures above 86°F (30°C).
What Do I Do in the Case of an Accidental Overdose?
In case of a suspected overdose, contact an emergency room or poison control center immediately. For a local control center in the United States, call 1-800-222-1222. Canada residents: call a poison control center within your province.
Overdose symptoms may include heightened drowsiness, hallucinations, fast/irregular heartbeat, fainting, labored/depleted breathing, dilated pupils, or seizures.
An adult overdose consists of ingestion of up to 750 mg of this medication.
What Else Should I Know About Elavil for Prostatitis?
Elavil should not be used with MAOI medications, including Nardil (phenelzine), Emsam/Eldepryl/Zelapar (selegiline), Parnate (tranylcypromine), Marplan (isocarboxazid), and Azilect (rasagiline). If Elavil is combined with an MAOI, high fever, convulsions, and possibly death may occur.
Do not use EpiPen (epinephrine) with Elavil because when combined they may cause severe high blood pressure.
Drinking alcohol hinders the antidepressant action of Elavil while escalating its sedative effect.
Tagamet (cimetidine) may cause blood levels of Elavil to rise, as well as its side effects.