How Effective Is Amitriptyline for Fibromyalgia?

The effectiveness of amitriptyline for fibromyalgia varies by patient, but often depends on factors like side effects and adverse reactions. For some patients, the tricyclic antidepressant amitriptyline manages depression and other fibromyalgia symptoms, like pain, with minimal or manageable side effects. For others, the side effects are too severe, or the medicine triggers extreme reactions that either impair their ability to function or are dangerous.

One of the original uses of amitriptyline was as a tricyclic antidepressant. Since it helps increase the brain chemicals that can improve depression, anxiety, and other symptoms of mental and emotional health problems, doctors prescribed it as an antidepressant for patients. These days, amitriptyline is one of several, though perhaps the most common of all, antidepressants used to treat fibromyalgia.

Amitriptyline can help improve several fibromyalgia symptoms including depression and anxiety, insomnia, and pain. Of course, doctors typically base the amitriptyline dosage on the predominant symptoms. For example, doctors often prescribe lower dosages of amitriptyline for fibromyalgia if the predominant symptom they’re trying to treat is pain, and not depression.

Some side effects of amitriptyline are mild and include dry mouth, constipation, and weight gain or weight loss. Others can impair a patient’s ability to carry on with normal daily activities, such as blurred vision, confusion, and a feeling of unsteadiness. When determining the effectiveness of using amitriptyline for fibromyalgia, a doctor and patient will consider these side effects, how intensely the patient experiences them, and whether the patient is willing or able to cope with them in order to obtain fibromyalgia relief.

Patients do vary in that willingness and ability to cope with certain side effects. For example, many fibromyalgia patients suffer from insomnia, or have trouble falling and staying asleep due to fibromyalgia pain. Some of these patients welcome the common side effects of drowsiness and sleepiness. Others, however, find the medicine makes them too drowsy and causes them to sleep too long to manage day-to-day activities. For these patients, amitriptyline for fibromyalgia might be an effective treatment, but it might also be impractical.

Certain severe side effects render amitriptyline an ineffective treatment for fibromyalgia. Such side effects include hallucinations, seizures, and fainting. Some patients who take amitriptyline for fibromyalgia experience hives and skin rashes, tongue and facial swelling, and bruises or bleeding that they can’t explain. Others develop chest pains, rapid or irregular heartbeats, and difficulty speaking. Sometimes, adjusting the amitriptyline dosage can help stop these side effects. Since they’re so severe, though, doctors and patients usually opt to try another medication instead.