Amitriptyline, also known as Elavil, is a tricyclic antidepressant used to treat a wide variety of mental health conditions. While it has legitimate medical applications, amitriptyline hydrochloride can also be abused, in some cases resulting in addiction. Anyone considering taking Elavil must understand the medication.
Learn About Elavil Abuse & Addiction:
What Is Elavil (Amitriptyline)?
Elavil is a medication that has been approved for use in the United States since 1961. Generically known as amitriptyline, this medication is not widely prescribed but is relatively easy to access. The amitriptyline drug class is a tricyclic antidepressant.
Amitriptyline HCL is FDA approved for treating depression, so long as that depression is not associated with bipolar disorder. It also has numerous off label uses, and amitriptyline for pain is the most common off them.
Is Amitriptyline Safe?
Numerous studies have found Elavil to be safe, or at least as safe as other antidepressants, in most cases. With that said, amitriptyline HCL does come with certain risks. Like all antidepressants, it can cause suicidal thoughts in the user, and the side effects of the medication are numerous. There are also amitriptyline interactions to consider. Elavil abuse is also a concern, with amitriptyline overdose being uncommon, but certainly possible.
Due to the risks associated with the medication, it is available by prescription only. Although someone might be able to access it without a prescription online or by purchasing it on the street, this should be avoided. Only take Elavil if being supervised by a trained medical professional.
Generic And Brand Names Of Amitriptyline
Elavil is the most well-known amitriptyline brand name. It is made by AstraZeneca. Because the medication is decades old, there are also many companies that market it under other names, as well as generics that are simply called amitriptyline HCL. Endep and Vanatrip are two common generic names, with there being others for combination versions of the drug.
When taking Elavil generic, the effects of the drug should essentially be the same as with the brand-name version. Amitriptyline dosage does not vary between versions unless looking at combination drugs, and the active ingredients remain the same. However, amitriptyline side effects might be different between versions of the drug due to the inactive ingredients.
The exact ingredients used in a formulation can vary between manufacturers. However, the active ingredient will always be amitriptyline HCL. Inactive ingredients may vary, but most formulas will include the following:
- Colloidal silicon dioxide, to allow the powder to flow freely once processed
- Hypromellose, a controlled release agent
- Lactose monohydrate, a filler
- Magnesium stearate, to prevent ingredients from sticking together
- Microcrystalline cellulose, a texturizer and anti-caking agent
- Polyethylene glycol, a solvent
- Polysorbate, a stabilizer and emulsifier
- Sodium starch glycolate, a dissolution excipient
- Titanium dioxide, a white pigment
- Various other pigments to give the medication color based on the dose
Most people think of the active ingredient in medication as being the only risk. While amitriptyline is the ingredient most likely to be problematic for a user, it is also possible for someone to have a reaction to inactive ingredients. Users with known allergies must carefully examine all ingredients in medication before taking it.
The majority of individuals taking Elavil use is as directed by their doctor. However, there will be those who attempt to abuse it. Amitriptyline abuse is not very common for a variety of reasons, including its limited availability and few people being aware of the drug. The greatest reason is not often abused is that the amitriptyline high is not very powerful. At best, users describe it as a feeling of relaxation, while most fail to note any sense of euphoria at all.
In most cases, when Elavil is abused, it is done in conjunction with other medications, street drugs, and alcohol. This is extremely dangerous as it increases the risk of interactions and overdose. At best, abusing the drug will result in exasperated side effects, such as extreme amitriptyline weight gain. At worst, it can result in death.
Is Amitriptyline Addictive?
When looking at addiction from a medical standpoint, Elavil is not considered to be addictive. However, many users consider themselves to have an amitriptyline addiction. Some may find this to be physical dependence, experiencing bodily symptoms when missing a dose or taking less than normal. Others consider this a mental addiction because they feel afraid to go without their medication or as if they depend on it to live. There is also the fact that if someone stops taking it cold turkey, they can experience amitriptyline withdrawal.
Essentially, while the medical community does not feel all of this meets the standard of addiction, patients often feel differently, especially those who have abused the medication. If someone feels like they are dependent upon Elavil, the best thing to do is to seek treatment for addiction.
Amitriptyline hydrochloride is not the only option people have when it comes to antidepressant medications. In fact, there are several dozen medications to choose from. If someone is struggling with Elavil but still needs treatment, alternatives could help.
Amitriptyline vs. Nortriptyline
Nortriptyline might work as an alternative for someone who is unhappy with Elavil but needs a medication as similar to it as possible. In fact, nortriptyline is what amitriptyline is metabolized into by the body. With that said, for many users, the two will be so similar that there isn’t enough of a difference to make the switch worth it.
Amitriptyline vs. Trazodone
Trazodone is a serotonin modulator, which means it treats depression in a radically different way from Elavil. It is less likely to cause side effects, which means that if negative symptoms of use are driving someone away from medicine, it could be a solid alternative. However, it has a roughly equal abuse potential, so if someone is looking to switch due to misuse, it may not offer a solution.
Amitriptyline vs. Topamax
If someone is taking Elavil for chronic pain, Topamax is generally a solid substitute. It is specifically used to prevent migraines and treat epilepsy, so if Elavil is being used for a different type of pain, it might not be as effective to switch. Additionally, Topamax is associated with numerous side effects, much like Elavil.
In addition to the medications above, there are a wide variety of medications and herbal supplements that can treat the same conditions as Elavil. However, patients should never stop taking the medicine or switch to something new on their own. Suddenly stopping an antidepressant can be incredibly dangerous and should only be done under the guidance of a medical professional.
Elavil can be purchased from most pharmacies, though smaller ones may not keep it in stock, given the infrequency of its use. The amitriptyline price will vary based on numerous factors. These include how many pills are ordered at one time, the dosage of the pills, and which manufacturer produces them. Below is a table showing the range of prices for generic amitriptyline based on dosage and the number of pills needed.
|Dose||30 tablets||60 tablets||90 tablets|
Keep in mind that the Elavil cost (brand name medication) will be higher than the generics of the drug, though insurance can help to make it more affordable. The exception to this is insurance coverage through Medicare. This government insurance only covers the generic version of the drug.
With Medicare, the patient pays the full price of the medication until they meet their deductible. Then, the copay must be paid. This copay decreases once the patient gets into the coverage gap but might be eliminated once they enter catastrophic coverage. Below is a chart explaining each.
Co-pay Depending On The Coverage Stage
|Deductible||Typical||Coverage Gap||Catastrophic Coverage|
|As high as $360 per year||Max $9 copay||Max $5 copay||Max $3 copay|
Illegally Purchased Medication
In addition to getting Elavil from a reputable pharmacy, it is possible to purchase it illegally. Keep in mind that amitriptyline street value always exceeds established retail prices, making it a poor financial choice for anyone who can get a prescription. Keep in mind that illegally purchasing prescription drugs is dangerous, posing severe health risks and the possibility of jail time.
Getting Help With Elavil Addiction
If someone is battling with Elavil misuse, they need to seek treatment. Drug rehab facilities know how to manage antidepressant misuse and addiction. With so many rehab centers available in the US, the most difficult step is just reaching out to find the right one.
- Determination That ELAVIL (Amitriptyline Hydrochloride) Oral Tablets, 10, 25, 50, 75, 100, and 150 Milligrams, Were Not Withdrawn From Sale for Reasons of Safety or Effectiveness. Food and Drug Administration. 2017. https://www.federalregister.gov/documents/2017/10/23/2017-22892/determination-that-elavil-amitriptyline-hydrochloride-oral-tablets-10-25-50-75-100-and-150.
- Amitriptyline Hydrochloride Tablets, USP. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/085966s095,085969s084,085968s096,085971s075,085967s076,085970s072lbl.pdf.
- Comparing the Safety and Effectiveness of Topiramate With the Safety and Effectiveness of Amitriptyline in Preventing Migraine Headaches. ClinicalTrials.gov. 2005. https://clinicaltrials.gov/ct2/show/NCT00210821.
- Amitriptyline - for depression. NHS. 2018. https://www.nhs.uk/medicines/amitriptyline-for-depression/.