Amitriptyline side effects – NHS warns when to dial 999 over pain drug

The NHS has issued important guidance for patients prescribed amitriptyline for pain management or migraines. Chronic pain afflicts approximately 28 million adults across the UK, with roughly eight million experiencing moderate to severely disabling symptoms.

NHS statistics reveal that one in three adults live with chronic pain, a figure that climbs to more than half among those aged over 75. Whilst evidence suggests up to half of GP appointments concern this issue, treatment options are often limited beyond prescribing pain medication.

Amitriptyline is one medication frequently prescribed for chronic conditions. Although originally developed and licensed as an antidepressant, it is now more widely administered at lower doses to alleviate pain for patients suffering from various painful medical conditions.

Recent statistics indicate more than 15 million prescriptions for the medication were dispensed across the UK during 2022-23. Nevertheless, the NHS warns there are numerous side effects patients should be aware of, including one serious symptom that requires dialling 999 or heading directly to A&E, reports the Mirror.

The NHS has provided guidance for those taking the medication for pain and migraine relief. It cautions there are several “common side effects” impacting more than one in 100 individuals.

The advice states: “Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.” The common side effects include:

• Constipation

• Feeling sleepy or tired

• Difficulty peeing

• Headache

• Dry mouth

• Feeling dizzy

There are other uncommon but more severe side effects. The NHS advises calling a doctor or 111 now if:

• you get a fast or irregular heartbeat
• the whites of your eyes turn yellow, or your skin turns yellow, although this may be less obvious on brown or black skin – these can be signs of a liver problem
• you have a headache, you feel confused or weak, or you get muscle cramps – these can be signs of a low sodium level in your blood
• you have eye pain, a change in your eyesight, or swelling or redness in or around your eye

And there are some circumstances which all patients taking the medication need to be aware of. If you suffer any of these you should dial 999 immediately. These are if:

• you have weakness on one side of your body, trouble speaking or thinking, loss of balance or blurred eyesight – these can be signs of a stroke
• you have a seizure or fit
• you get severe chest pain – this can be a sign of a heart attack

There is one other essential time when you should call 999 or go to A&E. This is if you have thoughts about harming yourself or ending your life.

The NHS adds: “Many people sleep better while they’re taking amitriptyline. Although amitriptyline is an antidepressant, the doses are lower when used to treat pain. Taking amitriptyline as a painkiller will not have the same effects as taking it for depression.”