Understanding Amitriptyline Withdrawal

Amitriptyline hydrochloride was initially manufactured as Elavil and was one of the most popular early antidepressant drugs. Although the brand Elavil is no longer sold, the generic amitriptyline hydrochloride is still available today. In addition to treating depression, physicians often prescribe a tricyclic antidepressant to treat neuropathic pain. It is also used to treat some anxiety disorders, and it even has uses in treating nocturnal bedwetting for children. As it is with other prescription drugs, withdrawal can occur with Elavil. It is essential to know what causes withdrawal, how to recognize it, and what to do.

What Causes Amitriptyline Withdrawal?

The main reason for withdrawal is stopping the use of amitriptyline. A person may stop using it altogether and suddenly. More severe side effects may be associated with suddenly stopping amitriptyline after using it for a long time or taking a larger dose. When stopping the medication, whether to discontinue treatment or switch to a different antidepressant, it is crucial to taper off to minimize withdrawal symptoms properly. A professional can guide how to taper off, offering specific dosing recommendations based on the current dose.

Signs of Amitriptyline Withdrawal

The signs of withdrawal may vary from one person to another. While some people may experience a broad spectrum of symptoms, others may only notice a few. The effects of withdrawal are not as severe as with medications that have a much higher potential for abuse. Withdrawal from the drug is often called antidepressant discontinuation syndrome, or ADS. These are some of the most common symptoms that people experience when they stop taking amitriptyline. 

Flu-Like Feelings

Especially when a person takes a larger dose of amitriptyline, it is common to feel like the flu hits after discontinuing the drug. People often feel like their muscles are achy, weak, or tired. They may have chills, and some people may develop a low-grade fever. Sweating is also common with or without chills. It is also common to feel exhausted and have achy joints.

Headaches and Pain

Because amitriptyline effectively treats several types of pain, discontinuing it can bring a swift return of the original pain. Headaches are common after stopping the drug, and this is incredibly uncomfortable for people who use amitriptyline to treat frequent migraines.

Mood Changes

As it is with discontinuing an antidepressant, stopping the use of amitriptyline can come with a variety of mood-related shifts. Although withdrawal can be more uncomfortable for people who take the drug for depression or anxiety, mood changes, and psychological effects may also happen to people who take it for pain and then discontinue it. These are some of the possible psychological or mood-related symptoms:

• Irritability
• Strange dreams
• Memory changes
• Restlessness
• Insomnia
• Hallucinations
• Crying
• Difficulty concentrating
• Depression or anxiety
• Panic attacks
• Suicidal thoughts

Hypersensitivity

Amitriptyline affects multiple neurotransmitters in the brain and blocks some of them. Because it alters how the brain functions, stopping the drug suddenly can cause a flurry of changes as the brain tries to adjust. As this happens, it is common to feel hypersensitivity to light, sound, or other stimulants in the environment. That hypersensitivity can be distressing, leading to crying spells, mood swings, and a rollercoaster of different feelings. 

How Long Do Withdrawal Symptoms Last?

The short answer is one to three weeks. However, the most noticeable symptoms will usually occur within a few days of stopping the medication. This may not be the case for all people. For example, some people may notice more severe symptoms after a week. While many people experience mild symptoms, others may have more severe ones. The good news is that most discomfort, especially flu-like symptoms, will resolve quickly. People who experience lasting psychological symptoms may need additional treatment. Because of the risks of psychological changes, it is vital to have professional supervision during withdrawal. 

Treating Withdrawal From Amitriptyline

Although many people can work with a professional to taper off and remain at home while doing so, people who have known mental health conditions that came with severe problems in the past may need more intensive treatment while tapering off. There is no specific tapering regimen that applies to all people because amitriptyline doses can vary. 

For example, a person who is highly sensitive to prescription drugs and has mild pain or anxiety may only take the minimum 10-milligram dose every day. Someone who requires a more potent amount may take a total of 75 to 150 milligrams every day. The tapering schedule and quantity would vary for the two patients. Professionals know how long to recommend tapering at each reduced dose to prevent withdrawal and limit psychological discomfort. If a person is dependent on amitriptyline, a detox program may be helpful.

Risks of Amitriptyline Dependence

Although amitriptyline has a lower abuse potential than some other prescription drugs prescribed to treat pain, such as opioids, people can still misuse it. For instance, someone with depression or anxiety may take amitriptyline and start taking a larger-than-recommended dose after experiencing a traumatic event. As the brain and body adjust to the larger quantity, the person may become dependent on the drug over time. A person who takes amitriptyline for pain may take larger doses over time to treat additional or increasing pain.

Taking large doses of amitriptyline over time can lead to cardiac changes and signs of toxicity. These are some of the potential side effects of taking too much amitriptyline: 

• Irregular heartbeat or rapid heart rate
• Low blood pressure
• Labored or slowed respiration
• Dry mouth
• Difficulty urinating
• Constipation
• Nausea or vomiting
• Vision changes

An overdose may also lead to unconsciousness or other severe, adverse effects. Anyone who suspects an amitriptyline overdose should call 911 immediately.

Detox for Amitriptyline Dependence or Misuse

Detox is a process where the body rids itself of a substance. Amitriptyline has a half-life of 10 to 28 hours, which means it takes between 10 and 28 hours for half a dose of the drug to leave the body. As a rule, the drug will not altogether leave the body for about two to six days. 

Despite the drug leaving the system during this time frame, traces of it can remain in the hair and urine longer. For example, it may be detectable in urine for up to a month after stopping the drug, and it may be noticeable in hair up to three months after stopping the drug. Amitriptyline is usually detectable in saliva for a couple of days after discontinuing it.

A person who becomes dependent on amitriptyline, who has taken it for a considerable amount of time or taken a significant dose, should consider detoxing to stop the drug. During a detox program, a person has medical supervision. Health care providers consider all past and present needs, including mental, physical, and spiritual health. Having medical management means that uncomfortable symptoms can be managed or minimized. As the brain adjusts to lower doses or no amitriptyline, it is essential to have a professional monitor behavioral and physical changes.

Finding Help for Amitriptyline Detox and Withdrawal in New Jersey

If you or someone you know is planning to stop using amitriptyline, we are here to help. We especially encourage anyone who has a history of substance misuse or mental health struggles to work with us to safely detox from amitriptyline or any other prescription drug that affects brain function. Detoxing can come with a wide range of emotions, which may lead to unsafe thoughts or behavior. When discontinuing amitriptyline after misuse, the temptation to relapse and take a large dose exists for people who experience physical or psychological discomfort.

At Garden State Treatment Center, we take a customized approach to substance misuse and mental health treatment. Since many substance misuse problems stem from mental health conditions, we simultaneously use dual diagnosis treatment to address all co-occurring issues. We offer multiple therapy structures at our Sparta facility, utilizing various practical approaches that help people learn behavior causes or triggers and develop strategies to overcome or cope with life’s issues. To learn more about amitriptyline withdrawal and detox in New Jersey, don’t hesitate to get in touch with us.

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