Elavil (amitriptyline) for the treatment of migraine headaches: an introduction

Elavil is an antidepressant medication that is in the tricyclic antidepressant class. The generic name of the drug is amitriptyline. It is most often used to treat depression, but it has also been found to prevent migraines.

How Elavil works as a migraine medication

It is unclear exactly how migraine treatment with antidepressants such as Elavil works. It changes the balance of chemicals in the brain such as the neurotransmitter serotonin. Migraines and serotonin are believed to be closely related. This is thought to alter the way migraines attacks occur.

Forms of Elavil available to treat migraines

Elavil is available in tablet form. There is another product, Limbitrol, which contains amitriptyline, the active ingredient in Elavil, along with chlordiazepoxide.

Most common side effects of Elavil

  • Nausea and/or vomiting
  • Drowsiness
  • Weakness or tiredness
  • Nightmares
  • Headaches
  • Dry mouth
  • Increased sensitivity to the sun
  • Constipation
  • Difficulty urinating
  • Blurred vision
  • Pain, burning, or tingling in the hands or feet
  • Changes in sex drive or ability
  • Excessive sweating
  • Changes in appetite or weight
  • Confusion
  • Unsteadiness

Serious side effects

Antidepressants, including Elavil, come with the U.S. Food and Drug Administration’s strongest warning that the use of antidepressants has been associated with an increased risk of suicidal thoughts and behaviors in children, adolescents and young adults. Tricyclic antidepressants can be fatal in overdose. You should monitor your mental health and if you experience any changes notify your doctor immediately. You and a caregiver should monitor your behavior for new or worsening depression, any thoughts of hurting or killing yourself, any impulsive behavior, anxiety, restlessness, worry, agitation, panic attacks, changes in sleep or aggressive behavior.

Also contact your doctor right away if you notice any of the following symptoms:

  • 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 nusual bleeding or bruising
  • Seizures
  • Hallucinating (seeing things or hearing voices that do not exist)

Who should not take Elavil

Before taking Elavil, you should tell your doctor if you have or have had any of the following:

bleeding problems, breathing problems, liver problems, recent heart attack, any problems urinating, overactive thyroid, glaucoma, any history or family history of mental illness or mood disorders, family history of suicide, seizures or conditions that may increase your risk of seizures.

Several other medications and natural remedies may interact with Elavil, therefore you should always let your doctor know every treatment you take.

Antidepressants can have serious interactions with other drugs. Please let your doctor know all other medications you take including oral contraceptives, barbiturates, MAO inhibitors, sleep medicines, antihistamines, pain killers, blood pressure medicines and others.

Antidepressants should not be stopped abruptly. First consult your doctor who will advise you on how to gradually cut down your dose.

Tell your doctor if you have ever had seizures, urinary retention, glaucoma or other chronic eye conditions, a heart or circulatory system disorder, or liver problems.

You should also let your doctor know if you are on thyroid medication, if you drink large amounts of alcohol and about any other medical conditions you may have.

Your doctor should know about antidepressant use before having surgery, dental treatment, or any diagnostic procedure. Certain medications that may be used in surgery or other procedures may cause a serious reaction.

You should let your doctor know of any heart problems. Elavil may cause changes to the heart’s rhythm which may cause fast or irregular heartbeats. In rare cases this can be fatal.

If you suffer from diabetes, Elavil may make it difficult to control your blood sugar levels.

You should also tell your doctor if you are pregnant, breastfeeding or may become pregnant before taking Elavil.



As always, the best source for advice on treating your migraines is your own migraine specialist. These medication descriptions are provided only for informational purposes. You should begin no medication regimen without first checking with your physician. Again, this information should in no way substitute or be mistaken for medical advice.

Written by: Otesa Miles | Last review date: November 2010
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