| Amitriptyline: Adverse Reactions
Many side-effects can be ascribed totally or in part to the anticholinergic effects. The usual therapeutic doses often cause fatigue, dry mouth (which could be accompanied by complications such as candidiasis or caries), tachycardia, and weight-gain. Orthostatic hypotension, constipation, blurred vision, urinary hesitancy, and various central nervous problems (e.g. memory disturbance, confusion) occur. Amitriptyline has a quinidine-like effect and can cause or suppress arrhythmias. Other side-effects are rare: convulsions, hyponatremia, impotence, galactorrhea, jaundice, etc. An overdose mainly represents cardiac hazards. Withdrawal symptoms have rarely been described in relation to amitriptyline.
Significant interactions with alcohol, barbiturates, cimetidine, neuroleptics (central sedation); other substances with anticholinergic effects; monoamine oxidase inhibitors, sympathomimetic agents (hypertensive crisis, general reaction); quinidine (cardiotoxicity).