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Pros and Cons of Using Elavil or Amitriptyline for Sleep Problems

Elavil or amitriptyline is a drug prescribed for depression, nocturnal enuresis and nerve pains. However, since it causes drowsiness some take it to help sleep better.

Elavil is a medication prescribed for depression, painful conditions due to nerve problems (e.g. fibromyalgia), nocturnal enuresis in children and migraine. It is in the Tricyclic antidepressant class and its generic name is amitriptyline. However, Elavil is not licensed to use for insomnia (lack of satisfactory sleep).

But this medication causes sedation and drowsiness as a side effect (BNF, 59). Therefore, people can argue that it can be used to improve sleep. However, Elavil can cause many other side effects and it does not improve quality of sleep. In addition, Elavil’s effect on sleep decays over time.

How Elavil acts?

Elavil or amitriptyline causes drowsiness by inhibiting histamine 1, alpha 1 adrenergic receptors and muscarinic cholinergic receptors (Stahl, 3rd). In addition, it increases norepinephrine and serotonin levels in certain brain areas, which causes reduction in clinical depression and effectiveness in neuropathic pain.

How insomnia or sleep problems are treated?

Insomnia is effectively treated by making certain life style modifications, which are aimed at improving sleep hygiene. Pharmaceutical drugs do not produce quality sleep (makes the person refreshed after getting up). In addition, they cause various side effects. Therefore, it is very important, not to rely on drugs to improve your sleep.

Why Elavil can be used to improve sleep?

Unlike benzodiazepines like Dalmane ®, Elavil does not make you addicted to it. In addition, it does not produce any significant withdrawal reactions after stopping it.

Elavil improves sleep in the patients with fibromyalgia and neuropathic pain. This medication is also effective when the patient is having clinical depression associated with lack of sleep (sleep problems are frequently seen in clinical depression).

In addition, Elavil has long half-life (12 – 24 hrs.), compared to other prescription sleep medications (AHFS, 2010). Therefore, it may have a place for people who suffer from late insomnia, or getting up too early in the morning.

What are the problems associated with Elavil?

Elavil has many side effects. Some problematic side effects are dry mouth, blurred vision, increased heart rate and urinary retention. In addition, it can precipitate sudden drop in blood pressure that can make you dizzy. Improvement of sleep seen in Elavil goes down over time. Elavil is also known to cause cardiac conduction problems that can precipitate heart failure (BNF, 59).

Summary

Elavil or amitriptyline is a tricyclic antidepressant medication that causes sedation and drowsiness. It is known to cause many side effects. However, it is effective for treating pain associated with fibromyalgia and neuropathic pain. Therefore, it can be used for sleep problems associated with clinical depression and pain. However, use of Elavil is not justified for isolated sleep problems.

Sources

British National formulary 59th edition

AHFS drug information 2010

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