Amitriptyline hydrochloride is an antidepressant drug. It is available as a generic (non-branded) product.

Low-dose amitriptyline can also be used to treat the pain caused by neuropathy (nerve damage), including neuropathy due to diabetes and herpes. Around two thirds of patients who try this treatment have at least moderate pain relief, although a fifth find the drug’s side-effects unacceptable^[1].

It is less certain whether low-dose amitriptyline is effective in alleviating neuropathy due to HIV or HIV treatment. In one placebo-controlled study of 250 patients with peripheral neuropathy caused by HIV, amitriptyline with or without acupuncture did not bring about a significant improvement in pain symptoms after 14 weeks of treatment^[2]. Similarly, a ten-week trial of 145 patients failed to show a benefit of amitriptyline over placebo^[3].

The main side-effects seen with amitriptyline treatment include sedation, perturbations of the heart rhythm, drowsiness, dry mouth, blurred vision, constipation, urinary retention and sweating.

Amitriptyline levels may be increased in patients taking protease inhibitors, with the possible exception of nelfinavir (Viracept). This may increase the risk of amitriptyline-related side-effects and may require the use of a reduced dose of amitriptyline.