Elavil was a tricyclic antidepressant that was discontinued in 2000, though the generic amitriptyline is still used today. though mainly prescribed for mental health conditions such as depression, it is also occasionally used as a preventative treatment for migraines.

Why is Elavil used to treat migraines?

Elavil (amitriptyline) is a tricyclic antidepressant originally prescribed to those suffering from depression and other mental health disorders. Elavil works by interacting with certain neurotransmitters in the brain which regulate chemicals that affect mood and other sensations. 

The main neurotransmitter that is affected by Elavil is serotonin, which plays a large role in mood and happiness. Serotonin production is also believed to be closely linked to migraines, with people who produce less of the chemical naturally being more prone to suffering from intense headaches and migraines. 

By increasing serotonin levels to a regular amount, Elavil is able to prevent migraines from occurring for most people. A recent survey of people suffering from migraines that had taken Elavil as a preventative measure revealed that 44% of sufferers said the drug significantly reduced the symptoms of a migraine and 13% said it cut symptoms in half.[1]

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Side effects of Elavil for migraine

Like all forms of antidepressants, Elavil can have adverse effects on mental health and should be used under close supervision from a medical professional or psychologist. The Food and Drug Administration (FDA) puts their strongest warning label on antidepressants as studies have shown that they increase suicidal ideation in teens and young people. Tricyclic antidepressants can also cause fatal overdose if taken in high amounts. 

It is important to closely monitor mental health when taking antidepressants and you should consult with your doctor if you have worsening depression, anxiety, panic attacks, restlessness, changes in sleep patterns, or aggressive behavior. 

Common side effects of Elavil include:

  • Dry mouth
  • Constipation
  • Drowsiness
  • Insomnia
  • Orthostatic hypotension (low blood pressure)

Adverse side effects of Elavil can be more severe and potentially life-threatening. Seek medical attention if you are taking Elavil for migraines and experience any of the below symptoms. 

If you notice any of the following symptoms, seek immediate medical attention:

  • Slow or difficult speech, trouble speaking

  • Dizziness or faintness

  • Weakness or numbness of an arm or a leg

  • Crushing chest pain

  • Rapid, pounding, or irregular heartbeat

  • Severe skin rash or hives

  • Swelling of the face and/or tongue

  • Yellowing of the skin or eyes

  • Muscle spasms in the jaw, neck, and back

  • Uncontrollable shaking of a part of the body

  • Fainting

  • Any unusual bleeding or bruising

  • Seizures

  • Hallucinating (seeing things or hearing voices that do not exist)

Most people who use Elavil for migraine treatment report no or mild side effects (29% no effects, 34% mild side effects), and around 23% had noticeable side effects.[1]

Who shouldn’t take Elavil for migraines?

It is important to consult with your doctor about any preexisting health conditions before taking Elavil. This includes any history of mental health treatment and any antidepressant medication you are already on. Additionally, you should inform your doctor if you are taking antihypertensives (for high blood pressure), anticholinergic drugs, or neuroleptic drugs as these can have negative interactions with Elavil.

Additional health conditions to make your doctor aware of before taking Elavil for migraine treatment include:

  • Bleeding problems

  • Breathing problems

  • Liver problems

  • Recent heart attack or cardiovascular (heart) disease

  • Any problems urinating

  • Overactive thyroid

  • Glaucoma

Elavil should also not be taken by children under 12 and mothers who are breastfeeding.[1]