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Amitriptyline Withdrawal

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Amitriptyline enjoys the title of being one of the earliest antidepressant medications to be introduced into the market around 60 years ago. Despite decades of use, very little research has been dedicated to its potential to cause addiction. For a long time, amitriptyline was considered a non-addictive drug that could be quickly started and stopped as and when convenient. Recent research, however, has shed more light on its tolerance-inducing properties and strong addiction potential.

Though uncommon, amitriptyline addiction is real and capable of inducing a withdrawal. This withdrawal can be so intense that it may force individuals to keep using amitriptyline even when they no longer require it. However, due to the dangerous consequences associated with its prolonged use, such a practice is not recommended.

If you or a loved one have been using amitriptyline for some time and wish to let go without undergoing an amitriptyline withdrawal, give this article a read.

Amitriptyline is a prescription antidepressant medication for managing severe depressive disorder. Additionally, some experts prescribe it off-label to manage children’s migraines, fibromyalgia, arthritis, and nighttime bedwetting. Being a psychiatric medication, amitriptyline targets the brain to alter the balance of certain neurotransmitters. It mainly targets serotonin and norepinephrine, two major mood-regulating and pain-relieving hormones. Activating these chemicals’ release and preventing their reabsorption makes them readily available to the brain and spinal cord to fight signs of depression.

Today, most tricycle antidepressants, including amitriptyline, have been replaced by other more advanced antidepressant medications. This is mainly due to the long list of side effects and withdrawal risks associated with their use. Even so, amitriptyline continues to be used and abused in different parts of the world, triggering addictions and consequent withdrawals in many.

The amitriptyline withdrawal symptoms generally vary from one user to another. While some individuals report experiencing a broad spectrum of symptoms, others may develop only a few o of them. The effects of withdrawal from amitriptyline are generally not as severe as with other medications with higher abuse liability. Nevertheless, it can be uncomfortable and risky if not managed adequately.

Collectively known as antidepressant discontinuation syndrome (ADS), the most common amitriptyline withdrawal symptoms include the following:

Flu-like symptoms

Individuals consuming higher doses of amitriptyline may develop flu-like symptoms shortly after discontinuing the medication. They may feel like their muscles have become weak, achy, and tired and may experience low-grade fever, with or without chills. Sweating is another common symptom of amitriptyline withdrawal that is often accompanied by severe physical exhaustion.

Headaches and pain

Because amitriptyline is also used to manage several types of pain, discontinuing it may bring many users a swift return of the original pain. They may also develop intense headaches, especially if they have a history of migraines.

Mood irregularities

One of the significant withdrawal symptoms associated with quitting amitriptyline is mood shifts. Although this side effect is more pronounced in people who are taking this antidepressant for depression or anxiety, it can also hit those consuming it for pain management. Some of the common psychological and mood-related withdrawal symptoms that a user may experience shortly after quitting amitriptyline include:

Irritability
Panic attacks
nightmares
Memory changes
Sleeping difficulties
Restlessness
Rebound depression or anxiety
Crying spells
Hallucinations
Poor concentration
Suicidal thoughts

Hypersensitivity

Inside the brain, amitriptyline can affect various neurotransmitters, possibly blocking some of them. Because of its ability to alter brain function, its sudden cessation can lead to a flurry of changes as the brain attempts to readjust its working in the absence of amitriptyline. As this happens, some users may develop hypersensitivity to the common stimulants in the environment, including sound and light. This hypersensitivity can be highly distressing, sometimes leading to intense mood swings and crying spells.

Amitriptyline can easily stay in an individual’s body between 4 to 21 days after the last dose. Depending on personal factors, some people may take much longer to eliminate it from their systems. In simpler words, withdrawal duration for amitriptyline varies widely, with some symptoms appearing much later than others and some continuing for longer. As a general rule, amitriptyline should be out of the body within three weeks of its last dose. Consulting a doctor is recommended if the withdrawal symptoms persist beyond this limit.

The criteria to determine how long does amitriptyline withdrawal last depends on:

The dose of amitriptyline being consumed
The duration of consumption
Indication of using amitriptyline
Any co-existing medical or psychiatric issues

If someone has been using this drug for a long time (one year or above) or in very high doses (up to 300 mg), they will take longer to feel normal again. In contrast, those taking it for a few weeks or months in a mild dose (75 mg or less) can quickly get through the withdrawal in 2 to 3 weeks.

Although amitriptyline withdrawal is not significantly dangerous or life-threatening, it may induce suicidal ideations or hallucinations in some individuals. This is particularly true for those with a co-existing mental health disorder. Almost everyone who abuses this drug and now wishes to come off it is likely to suffer from memory, judgment, and concentration issues, all of which may put them in dangerous situations. Additionally, some people may develop dehydration due to excessive nausea and vomiting, which can become dangerous if not managed in time.

The best way to treat amitriptyline withdrawal with high chances of success is by placing patients on a tapering schedule where their daily doses are gradually reduced. This schedule can be easily obtained by working closely with an expert in an outpatient clinic. However, in cases where an individual has been intentionally misusing amitriptyline or mixing it with other substances, joining an addiction treatment centre may become necessary.

Multiple addiction treatment centres are actively working across the UK to help people manage the side effects of stopping amitriptyline and other drugs. These centres use evidence-based medical therapies and holistic interventions to make withdrawal as easy and comfortable as possible. In addition to supporting through withdrawal, clients are offered different inpatient and outpatient rehabilitation programmes for complete recovery from their underlying addiction.

Call us today if you or a loved one has fallen victim to amitriptyline addiction and the fear of withdrawal prevents you or them from overcoming it.

Withdrawal from any medication, including amitriptyline, can exert intense adverse effects on the mental, physical, and psychological health of the users. In addition to seeking help from a rehab, experts suggest practising the following self-care tips to make the process more comfortable and easier to get through.

Find a support system

It might be hard to reach out to someone and discuss your addiction. However, sharing what you are going through with a loved one can make a massive difference in treatment and likely make a recovery more manageable and more achievable. If you do not have a family member or a friend to back you, charity organisations provide necessary help and emotional support.

Maintain a mood diary

Keeping a record of how altering the dose of amitriptyline affects your mood can help you recognise patterns and early signs that things are becoming problematic. This can help you seek professional help in time.

Prepare a self-care box

Withdrawal can easily make you feel unwell, confused, and lost, and it may become tough to get through the day, especially when the symptoms peak. To make things easier during such difficult days, make a self-care box beforehand, and include different things that help you cheer up. These may include your favourite books, movies, music, a stress ball, a nice-smelling candle, a soft blanket, or pictures of something or someone that you find comforting.

Take care of your emotional wellbeing

To make the withdrawal process more comfortable, keep track of your stress levels and try different activities to manage them. Some relaxation activities include deep breathing, meditation, yoga, listening to a soothing piece of music, or drawing a hot bath with essential oils. Spending time in nature can also balance your emotions and calm down your mind.

Amitriptyline withdrawal can take a toll on your physical health, leading to difficulties in sleeping and eating. So, prioritise your sleep and invest in healthy eating patterns to overcome these problems and limit withdrawal symptoms. You can consider getting sleeping aids from your doctor if it is suitable in the given circumstances.

If your withdrawal symptoms continue to worsen beyond your level of tolerance despite the above-mentioned self-care tips, do not hesitate to get help from a rehabilitation centre. The experts in these rehabs are experienced in managing amitriptyline addiction and withdrawal professionally and with due diligence. They may prescribe different medications to control the symptoms, along with counselling and therapy to alleviate the psychological difficulties.

FAQs

Can I just stop taking amitriptyline?

Attempting to stop amitriptyline cold turkey is an extremely risky and potentially dangerous move. Coming off amitriptyline abruptly can induce severe withdrawal symptoms that may resemble the signs of acute toxicity. Some of these symptoms, such as seizures, airway compromise, convulsions, and respiratory depression, can eventually lead to admission to an intensive care unit and even death. Moreover, it can also cause symptoms of depression to reappear, further deteriorating the life quality.
Hence, it is imperative to withdraw from amitriptyline use under the supervision of a medical professional.

How long do amitriptyline symptoms last?

The short answer to this question is somewhere between one to three weeks. The more noticeable amitriptyline withdrawal symptoms usually appear within a few days of ceasing its use, but some people may delay it to a week or so. While most people can get through withdrawal with mild symptoms, others experience bouts of intense symptoms that may disturb their mental and physical health. However, the good news is that these uncomfortable symptoms usually resolve quickly in most people.

How to wean off amitriptyline?

How you choose to get off of amitriptyline depends on the dose of medication, duration of using it, and your own circumstances. Considering all these factors, a doctor can decide the best action to wean off amitriptyline safely. It is important to reduce the dose by taking progressively smaller doses gradually. This process is known as tapering and has been associated with significantly lesser withdrawal symptoms. This is because taking smaller doses of amitriptyline at regular intervals is much safer than consuming larger doses with longer waiting times. Leaving a long gap between two doses can cause chemical fluctuations, further worsening the withdrawal symptoms.

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