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When levels are chronically low, the shift tends to be gradual rather than dramatic
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10 Amitriptyline side effects, each category lists adverse effects that are very severe and some less severe 1,2,6,7 (please note, this is not a complete list) Black box warning: for increased suicidality and clinical worsening of depression 6,7 Birth Defects Cardiac events: heart attacks, stroke, hypertension, tachycardia, palpitations CNS and Neuromuscular: coma, seizures, hallucinations, delusions, mania, hypomania, confusion, disorientation, loss of muscle coordination or control, tremors, neuropathy (nerve pain), numbness, tingling, involuntary movement disorders, excitement, anxiety, insomnia, restlessness, drowsiness, nightmares, weakness, headache, dizziness, tinnitus, and others Anticholinergic: blocked (paralyzed) intestines, urinary retention, constipation, blurred or other vision disturbances and changes in the eyes, dry mouth Hematologic: decreased red blood cells and loss of bone marrow function, decreased white blood cells (leukopenia), decreased platelet count resulting in unusual bleeding, bursting blood vessels (purpura), abnormal increase in certain white blood cells which are associated with inflammation, allergies, infection, asthma, rashes, trouble breathing, swelling, and certain cancers Gastrointestinal: liver damage, hepatitis, nausea, vomiting, anorexia, peculiar taste in the mouth, diarrhea, black tongue Endocrine: enlarged breasts and testicles in males, secretion of breast milk and enlarged breasts in females, increased or decreased libido, impotence, blood sugar dysregulation Other: weight gain or weight loss, increased urinary frequency, excessive perspiring, hair loss (alopecia), swelling in the feet, ankles, or other body parts
Toxicon 194:1722
4 A study of two participants cannot establish: The frequency of uncommon adverse events Safety across different ages or health conditions Safety with other medicines or substances Long-term safety Safety through other routes Clinical effectiveness The authors themselves stated that further studies were needed
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