Editing Amitriptyline (section)

==Side effects==
The most frequent side effects, occurring in 20% or more of users, are dry mouth, drowsiness, dizziness, constipation, and weight gain (on average 1.8&nbsp;kg<ref name="pmid25590213">{{cite journal | vauthors = Domecq JP, Prutsky G, Leppin A, Sonbol MB, Altayar O, Undavalli C, Wang Z, Elraiyah T, Brito JP, Mauck KF, Lababidi MH, Prokop LJ, Asi N, Wei J, Fidahussein S, Montori VM, Murad MH | title = Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 100 | issue = 2 | pages = 363–370 | date = February 2015 | pmid = 25590213 | pmc = 5393509 | doi = 10.1210/jc.2014-3421 }}</ref>).<ref name="pmid23235671">{{cite journal | vauthors = Leucht C, Huhn M, Leucht S | title = Amitriptyline versus placebo for major depressive disorder | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | issue =  12| pages = CD009138 | date = December 2012 | pmid = 23235671 | doi = 10.1002/14651858.CD009138.pub2 | pmc = 11299154 }}</ref> Other common side effects are headache problems ([[amblyopia]], blurred vision), [[tachycardia]], increased appetite, [[tremor]], fatigue/[[asthenia]]/feeling slowed down, and [[indigestion|dyspepsia]].<ref name="pmid23235671"/>

A less common side effect of amitriptyline is urination problems (8.7%).<ref name="pmid23235671"/>

Amitriptyline can increase suicidal thoughts and behavior in people under the age of 24 and the US FDA required a [[boxed warning]] to be added to the prescription label.<ref name=DailyMed /><ref>{{cite book |title=StatPearls |vauthors=Thour A, Marwaha R |date=18 July 2023 |publisher=StatPearls Publishing |location=Treasure Island, Florida |chapter=Amitriptyline |pmid=30725910 |access-date=18 March 2024 |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK537225/ |archive-date=22 April 2024 |archive-url=https://web.archive.org/web/20240422020545/https://ncbi.nlm.nih.gov/books/NBK537225/ |url-status=live }}</ref> Amitriptyline-associated [[sexual dysfunction]] (occurring at a frequency of 6.9%) seems to be mostly confined to males with depression and is expressed predominantly as [[erectile dysfunction]] and low [[libido]] disorder, with lesser frequency of ejaculatory and orgasmic problems. The rate of sexual dysfunction in males treated for indications other than depression and in females is not significantly different from placebo.<ref name="pmid29019272">{{cite journal | vauthors = Chen LW, Chen MY, Lian ZP, Lin HS, Chien CC, Yin HL, Chu YH, Chen KY | title = Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice | journal = American Journal of Men's Health | volume = 12 | issue = 2 | pages = 370–379 | date = March 2018 | pmid = 29019272 | pmc = 5818113 | doi = 10.1177/1557988317734519 }}</ref>

Liver test abnormalities occur in 10–12% of patients on amitriptyline, but are usually mild, asymptomatic, and transient,<ref name="LiverTox"/> with consistently elevated [[alanine transaminase]] in 3% of all patients.<ref name="pmid24362450">{{cite journal | vauthors = Voican CS, Corruble E, Naveau S, Perlemuter G | title = Antidepressant-induced liver injury: a review for clinicians | journal = The American Journal of Psychiatry | volume = 171 | issue = 4 | pages = 404–415 | date = April 2014 | pmid = 24362450 | doi = 10.1176/appi.ajp.2013.13050709 }}</ref><ref name="pmid13961401">{{cite journal | vauthors = Holmberg MB | title = A study of blood count and serum transaminase in prolonged treatment with amitriptyline | journal = The Journal of New Drugs | volume = 2 | issue = 6 | pages = 361–365 | date = 1962 | pmid = 13961401 | doi = 10.1177/009127006200200606 }}</ref> The increases of the enzymes above the 3-fold threshold of liver toxicity are uncommon, and cases of clinically apparent liver toxicity are rare;<ref name="LiverTox">{{cite book|url=http://www.ncbi.nlm.nih.gov/books/NBK548410/|title=Amitriptyline|date=6 January 2012|publisher=National Institute of Diabetes and Digestive and Kidney Diseases|access-date=6 January 2021|via=PubMed|pmid=31643729|archive-date=21 January 2022|archive-url=https://web.archive.org/web/20220121040521/https://www.ncbi.nlm.nih.gov/books/NBK548410/|url-status=live}}</ref> nevertheless, amitriptyline is placed in the group of antidepressants with greater risks of hepatic toxicity.<ref name="pmid24362450"/>

Amitriptyline [[QT-interval prolongation|prolongs the QT interval]].<ref name=AmitryptilineQT>{{cite journal | vauthors = Zemrak WR, Kenna GA | title = Association of antipsychotic and antidepressant drugs with Q-T interval prolongation | journal = American Journal of Health-System Pharmacy | volume = 65 | issue = 11 | pages = 1029–1038 | date = June 2008 | pmid = 18499875 | doi = 10.2146/ajhp070279 | url = http://www.medscape.com/viewarticle/575632_5 | url-status = live | archive-url = https://web.archive.org/web/20161221095718/http://www.medscape.com/viewarticle/575632_5 | archive-date = 21 December 2016 | url-access = subscription }}</ref> This prolongation is relatively small at therapeutic doses<ref name="pmid29466824">{{cite journal | vauthors = Hefner G, Hahn M, Hohner M, Roll SC, Klimke A, Hiemke C | title = QTc Time Correlates with Amitriptyline and Venlafaxine Serum Levels in Elderly Psychiatric Inpatients | journal = Pharmacopsychiatry | volume = 52 | issue = 1 | pages = 38–43 | date = January 2019 | pmid = 29466824 | doi = 10.1055/s-0044-102009 | s2cid = 3447931 }}</ref> but becomes severe in overdose.<ref name="pmid32252558">{{cite journal | vauthors = Campleman SL, Brent J, Pizon AF, Shulman J, Wax P, Manini AF | title = Drug-specific risk of severe QT prolongation following acute drug overdose | journal = Clinical Toxicology | volume = 58 | issue = 12 | pages = 1326–1334 | date = December 2020 | pmid = 32252558 | pmc = 7541562 | doi = 10.1080/15563650.2020.1746330 }}</ref>