Amitriptyline as an Insomnia Treatment

Off-Label Use for an Anti-depressant

Amitriptyline is a drug approved for the treatment of depression. However, like other types of anti-depressants, it’s also commonly used as an off-label treatment for insomnia. Off-label drugs are not FDA approved for alternative uses, but because of relative effectiveness medications like amitriptyline gain new uses in popular medicine.

Besides its alternative use as sleep aid, amitriptyline is also used to treat pain associated with a wide array of medical conditions.

How Amitriptyline Works

Amitriptyline works as an anti-depressant by suppressing serotonin reuptake and norepinephrine uptake, as well. Both serotonin and norepinephrine are important neurotransmitters responsible for automatic mood and body responses. When both are in short supply the symptoms of depression, in tandem often with insomnia, can occur. Amitriptyline is known as a tricyclic antidepressant for its molecular structure.

As a Treatment for Insomnia

Remember, amitriptyline was not designed as a sleep aid, but as an anti-depressant and as such has many more popular anti-depressants ahead of it. But it’s usefulness as a sleep aid continues. Biggest benefit is the drug’s long half-life, 12-24 hours, which far exceeds that of most insomnia medications. This bioavailability makes the drug useful for patients with late waking insomnia—or the propensity for waking very early in the morning, at the end of the sleep cycle, unable to return to sleep.

But as drugs go one of the biggest controversies surrounding the use of amitriptyline is its use among physicians who prescribe it first for insomnia. Interestingly one of the common side effects IS insomnia, along with dry mouth, weight gain, dizziness, and confusion. But the challenge with some more common prescription sleep aids is their super short half-lives, making them totally useless for late insomnia sufferers.

Anti-Depressants Versus Sleep Aids and CBT

Real drugs created specifically to treat insomnia are safer and more effective, say sleep specialists. Especially concerned with the alternative uses for amitriptyline are those sleep doctors interested in pushing the effectiveness of cognitive behavior therapy. CBT is a non-pharmacological therapy that rolls together an assortment of therapies, including psychological, physiological and behavioral to address the habitual patterns of chronic insomnia.