How Long Does Amitriptyline Take To Work For Headaches?

Hello and thank you for your question! In regard to preventing tension-type headaches, drugs like amitriptyline, which belongs to the 'tricyclic antidepressant' class of drugs, have the most evidence for benefit.

Several studies have reported a statistically significant decrease in headache frequency on the drug (one study reported an average decrease of around 5 headaches per month).

However, amitriptyline doesn't start working immediately after taking your first dose. It takes time.

How Long does Amitriptyline Take To Work?

Drugs like amitriptyline generally do not provide immediate results in regard to reducing the frequency and severity of headaches. Additionally, it is not effective for acute attacks (i.e. it won't have the same effect as taking an analgesic, like Tylenol or Advil). It is a preventative medication.

Most studies show that, on average, it takes at least 3 to 6 weeks of consistent use to notice an effect.

One study, published in The Journal International Association for the Study of Pain, reported the following:

In the amitriptyline group, a significant reduction in daily headache duration was already found in the 3rd week of treatment, while in the placebo group no significant changes in headache duration were to be seen. In week 6 the amitriptyline group had a significantly shorter daily duration of headache than did the placebo group.

One of the largest review studies on the matter (largest in terms of literature/studies included in review) found that amitriptyline is effective in preventing chronic tension-type headaches, and, on average, it took 2 to 3 weeks of consistent use to realize a benefit.

Exactly how long it takes to work will vary by individual, but with consistent use, you should notice positive effects by the end of your first month or two of therapy.

Drawbacks

While studies consistently show that amitriptyline is effective in preventing tension-type headaches (additional studies report it is also effective for other types of headaches, like migraines), it does have some drawbacks.

For one, among tricyclic antidepressants, it is likely the most sedating. It also tends to cause dry mouth, constipation and can even cause weight gain.

Most importantly, it carries the risk of causing cardiac arrhythmias.

Although the risk varies by individual, and recommendations vary by source, many recommend that anyone over 40 years of age should have a baseline electrocardiogram (ECG), especially if you have a history of heart problems.

Other Options

If amitriptyline isn't the best choice for you to treat your headaches, or you are experiencing side effects on it, there are other options.

Staying within the tricyclic antidepressant class, others, such as nortriptyline and protriptyline, are less sedating, and cause less weight gain. Weight loss has been reported to occur with protriptyline in some individuals.

Moving away from tricyclics, but staying with antidepressants, mirtazapine and venlafaxine have shown some benefit.

Other drugs that have reported positive effects for the prevention of headaches include:

• Gabapentin
• Levetiracetam
• Topiramate
• Tizanidine

It would be prudent to look into non-drug therapies as well, such as behavioral modification, physical therapy, or even acupuncture, which has some evidence behind it. Be sure to talk to your doctor regarding the best options for you.

Final Words And Video Summary

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