- Last edited on March 6, 2021
Amitriptyline (Elavil)
Primer
Pharmacokinetics
- Tmax = 4-8 hours
- Half-life = 15-20 hours
- Nortriptyline is a metabolite of amitriptyline
Pharmacodynamics
- The noradrenergic effects from amitriptyline are thought to modulate pain pathways.
- This is also why duloxetine (an SNRI) is used for neuropathic pain too.
Indications
- Major depressive disorder
- Neuropathic pain
Alternatives
Often times patients may come in having been on amitriptyline for decades, it can be helpful to consider a switch to melatonin or doxepin 3-5mg qHS.