{"id":629732,"date":"2024-09-11T08:56:22","date_gmt":"2024-09-11T12:56:22","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=629732"},"modified":"2026-06-05T15:43:41","modified_gmt":"2026-06-05T19:43:41","slug":"amitriptyline-migraine","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/amitriptyline-migraine\/","title":{"rendered":"Amitriptyline for migraines and headaches"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Affecting over <\/span><a href=\"https:\/\/americanmigrainefoundation.org\/resource-library\/migraine-facts\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">37 million people<\/span><\/a><span style=\"font-weight: 400;\"> in the United States, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/migraine-types\/\"><span style=\"font-weight: 400;\">migraines<\/span><\/a><span style=\"font-weight: 400;\"> are a disabling type of headache that causes intense pain. Unfortunately, migraines are often a recurrent condition, and preventive therapy is key to improving the quality of life for many. A wide range of medications are used for migraine prevention, with amitriptyline being one of them. But is amitriptyline good for migraines? As a tricyclic antidepressant (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/tricyclic-antidepressants\"><span style=\"font-weight: 400;\">TCA<\/span><\/a><span style=\"font-weight: 400;\">), amitriptyline is a prescription drug that\u2019s approved by the U.S. Food and Drug Administration (<\/span><a href=\"https:\/\/nctr-crs.fda.gov\/fdalabel\/services\/spl\/set-ids\/76d3f4fd-4603-4cfc-94ab-2e62c0bdae75\/spl-doc\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">FDA<\/span><\/a><span style=\"font-weight: 400;\">) to treat depression. However, it\u2019s also used off-label for migraine prevention.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Read on to learn more about amitriptyline and migraines.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"does-amitriptyline-treat-migraines\"><span style=\"font-weight: 400;\">Does amitriptyline treat migraines?<\/span><\/h2>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/amitriptyline-hcl\/what-is\"><span style=\"font-weight: 400;\">Amitriptyline<\/span><\/a><span style=\"font-weight: 400;\"> is an <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antidepressants\"><span style=\"font-weight: 400;\">antidepressant<\/span><\/a><span style=\"font-weight: 400;\">, but it has many additional off-label uses, including migraine prevention. While <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/off-label-prescription-drugs\/\"><span style=\"font-weight: 400;\">off-label<\/span><\/a><span style=\"font-weight: 400;\"> use means the FDA hasn\u2019t approved the drug for this particular use, there is <\/span><a href=\"https:\/\/www.aafp.org\/pubs\/afp\/issues\/2019\/0101\/p17.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">substantial evidence<\/span><\/a><span style=\"font-weight: 400;\"> from 12 studies that amitriptyline can be effective. However, because amitriptyline has a considerable risk of side effects, the American Headache Society and American Academy of Neurology only classify amitriptyline as \u201c<\/span><a href=\"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14153\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">probably effective<\/span><\/a><span style=\"font-weight: 400;\">\u201d for migraine prevention. Examples of studies supporting its use are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/www.bmj.com\/content\/341\/bmj.c5222\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">2010 review<\/span><\/a><span style=\"font-weight: 400;\"> and meta-analysis evaluated the safety and effectiveness of TCAs, including amitriptyline, for treating migraines, tension-type headaches, and mixed headaches. Researchers found that TCAs were effective for migraine and tension-type headache prophylaxis (prevention).\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30895388\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">2019 review<\/span><\/a><span style=\"font-weight: 400;\"> found amitriptyline has the best evidence among antidepressants for use in migraine prevention. However, they note that the side effect profile of antidepressants is a concern.\u00a0<\/span><\/li>\n<\/ul>\n<h2 id=\"how-does-amitriptyline-work-for-migraine-headaches\"><span style=\"font-weight: 400;\">How does amitriptyline work for migraine headaches?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">According to amitriptyline\u2019s prescribing information, the drug works by increasing the levels of certain neurotransmitters, or chemicals, in the brain. These include serotonin and norepinephrine.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Migraine headaches occur for various reasons, and researchers believe <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4117050\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">low serotonin <\/span><\/a><span style=\"font-weight: 400;\">levels may be one of the causes. Serotonin acts on nerve endings and blood vessels during a migraine attack. By doing so, it affects how the body perceives pain. More research is needed to fully understand how amitriptyline works for migraine headaches, but this may explain why amitriptyline is considered an <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamaneurology\/article-abstract\/578009\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">effective antimigraine agent<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"how-long-does-it-take-for-amitriptyline-to-work-for-migraines\"><span style=\"font-weight: 400;\">How long does it take for amitriptyline to work for migraines?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In most cases, migraine prevention therapy takes time to work and doesn\u2019t occur immediately. According to the American Headache Society, prevention plans are usually followed for at least eight weeks before their effectiveness is determined. Response to amitriptyline, in particular, is typically seen within <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK507873\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">four weeks<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"amitriptyline-dosage-for-migraines\"><span style=\"font-weight: 400;\">Amitriptyline dosage for migraines<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">According to American Family Physician, the recommended starting <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/amitriptyline-hcl\/dosage\"><span style=\"font-weight: 400;\">dose of amitriptyline<\/span><\/a><span style=\"font-weight: 400;\"> is 10 mg once daily for migraine prevention. If this dosage isn\u2019t preventing your migraine headaches, your healthcare provider may increase your dose gradually until you reach a dose that works for you. The recommended daily dose is typically 25 mg to 150 mg once daily. The maximum recommended dose of amitriptyline in adults is 150 mg to 300 mg per day, according to StatPearls.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Amitriptyline is available as an oral tablet that should be swallowed whole. It comes in six strengths: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. Because amitriptyline can cause drowsiness, it\u2019s best to take your dose at night. It can be taken with or without food.\u00a0<\/span><\/p>\n<h2 id=\"amitriptyline-interactions-and-side-effects\"><span style=\"font-weight: 400;\">Amitriptyline interactions and side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Like other drugs, amitriptyline has risks, including adverse effects and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/amitriptyline-interactions\/\"><span style=\"font-weight: 400;\">drug interactions<\/span><\/a><span style=\"font-weight: 400;\">. It can cause a wide variety of side effects. Fortunately, most of the common side effects are relatively mild. According to the prescribing information, these can include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dry mouth<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drowsiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight gain<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Serious side effects may also occur. However, they are less common. These may include:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Confusion<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mania<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stroke<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hallucinations<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heart problems, including heart attack or arrhythmias<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Changes in blood sugar levels<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eye problems<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It\u2019s important to note that, like other antidepressants, amitriptyline has a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">boxed warning<\/span><\/a><span style=\"font-weight: 400;\"> for the risk of suicidal thoughts and behaviors in children and young adults. Taking the drug can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults in the first few months of treatment. The risk is greater if you or your family have a risk of bipolar disorder or suicidal thoughts or actions. <\/span><span style=\"font-weight: 400;\">Due to this risk, doctors <\/span><span style=\"font-weight: 400;\">typically won\u2019t prescribe <\/span><span style=\"font-weight: 400;\">amitriptyline<\/span><span style=\"font-weight: 400;\"> for <\/span><span style=\"font-weight: 400;\">patients<\/span><span style=\"font-weight: 400;\"> 24 <\/span><span style=\"font-weight: 400;\">years of age<\/span><span style=\"font-weight: 400;\"> or younger unless the potential benefits outweigh the risks.<\/span><span style=\"font-weight: 400;\"> Talk to a healthcare professional immediately if you or your loved ones notice any changes i<\/span><span style=\"font-weight: 400;\">n mood, behaviors, thoughts, or feelings.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Several drug interactions can occur with amitriptyline. These include prescription medicines, over-the-counter (OTC) drugs, and supplements. Interactions can alter the effects of amitriptyline or cause side effects. Some examples of drugs that may interact with amitriptyline include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Opioids, such as Roxicodone (oxycodone) or MS Contin (morphine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Monoamine oxidase inhibitors (MAOIs), including Nardil (phenelzine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Selective serotonin reuptake inhibitors, such as Prozac (fluoxetine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Triptans, including Imitrex (sumatriptan)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Benzodiazepines, including Xanax (alprazolam)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sleep aids, such as Ambien (zolpidem)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Wellbutrin (bupropion)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Benadryl (diphenhydramine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Topamax (topiramate)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">St. John\u2019s wort<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Because amitriptyline can interact with quite a few drugs, it\u2019s important to provide your <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/talk-doctor-migraine-prescriptions\/\"><span style=\"font-weight: 400;\">healthcare provider<\/span><\/a><span style=\"font-weight: 400;\"> or pharmacist with an updated medication list so they can screen for drug interactions. Additionally, amitriptyline can interact with certain foods, such as grapefruit and alcohol.\u00a0<\/span><\/p>\n<h2 id=\"amitriptyline-alternatives\"><span style=\"font-weight: 400;\">Amitriptyline alternatives<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While amitriptyline has evidence supporting its effectiveness in migraine prevention, the drug isn\u2019t right for everyone. Luckily, a number of <\/span><a href=\"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14692\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">alternative medications<\/span><\/a><span style=\"font-weight: 400;\"> are available. The following table outlines alternative medications recommended for <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/new-migraine-medications\/\"><span style=\"font-weight: 400;\">migraine prevention<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<table class=\" singlecare-table\">\n<thead>\n<tr>\n<th>\n<h2 id=\"heading-7\"><span class=\"title\">Amitriptyline alternatives<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Drug<\/b><\/td>\n<td><b>SingleCare price<\/b><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Topamax<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">topiramate<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/topamax\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Depakote<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">divalproex sodium<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/depakote\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Lopressor<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">metoprolol<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/lopressor\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Inderal XL<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">propranolol<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/inderal-xl\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Atacand<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">candesartan<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/atacand\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Pamelor<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">nortriptyline<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/pamelor\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Effexor XR<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">venlafaxine<\/span><span style=\"font-weight: 400;\">)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/effexor-xr\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Aimovig<\/span><span style=\"font-weight: 400;\"> (erenumab)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/aimovig\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Emgality<\/span><span style=\"font-weight: 400;\"> (galcanezumab)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/emgality\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Qulipta<\/span><span style=\"font-weight: 400;\"> (atogepant)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/qulipta\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Nurtec<\/span><span style=\"font-weight: 400;\"> (rimegepant)<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/nurtec\"><span style=\"font-weight: 400;\">See latest prices<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-weight: 400;\">As with any medication, it\u2019s important to consider potential side effects and interactions and discuss them with your healthcare provider. If amitriptyline isn&#8217;t suitable, other alternatives may better fit your needs.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Affecting over 37 million people in the United States, migraines are a disabling type of headache that causes intense pain. Unfortunately, migraines are often a recurrent condition, and preventive therapy is key to improving the quality of life for many. A wide range of medications are used for migraine prevention, with amitriptyline being one of [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":629734,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[4316],"coauthors":[20969],"class_list":["post-629732","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-migraine","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Is amitriptyline good for migraines?<\/title>\n<meta name=\"description\" content=\"Amitriptyline has been proven effective for use in migraine prevention. 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