What Is Amitriptyline? Abuse & Addiction Of Elavil

Last Updated: February 7, 2020

Authored by Sharon Levy, MD, MPH

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.

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.

safety of Elavil

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.

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.

Amitriptyline 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.

Elavil abuse

Amitriptyline Abuse

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.

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 alternative medications

Amitriptyline Alternatives

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.

Other Alternatives

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.

price of Elavil

Purchasing Amitriptyline

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
10mg $11-$30 $13-$39 $37-$49
25mg $13-$26 $13-$42 $14-$57
50mg $11-$51 $37-$91 $55-$132
75mg $27-$66 $39-$129 $49-$143
100mg $21-$102 $39-$183 $57-$263
150mg $33-$102 $64-$258 $94-$358

Insurance Coverage

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.

Page Sources

  1. 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.
  2. Amitriptyline Hydrochloride Tablets, USP. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/085966s095,085969s084,085968s096,085971s075,085967s076,085970s072lbl.pdf.
  3. 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.
  4. Amitriptyline - for depression. NHS. 2018. https://www.nhs.uk/medicines/amitriptyline-for-depression/.

Published on: February 7th, 2020

Updated on: February 7th, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


Leave a comment