Does amitriptyline cause brain fog? (+3 factors)

In this article, we will explore whether amitriptyline can cause brain fog or not, how amitriptyline causes brain fog, what factors contribute to amitriptyline-induced brain fog and what to do if amitriptyline causes brain fog.

Does amitriptyline cause brain fog?

Yes, amitriptyline can cause brain fog in some individuals. It is a commonly reported side effect of amitriptyline (1). Brain fog is a cluster of symptoms that affect cognitive functions such as difficulty in concentration, Memory problems, reduced mental clarity, lack of focus and mental fatigue. Several factors contribute to brain fog caused by amitriptyline.

Amitriptyline is a tricyclic antidepressant (TCA) that affects the neurotransmitters in the brain such as serotonin and norepinephrine, additionally, it also affects certain other receptors such as histamine receptors and muscarinic receptors (2). 

If you are taking amitriptyline and experience brain of then you need to consult your healthcare provider as it can significantly affect your normal routine. Your doctor will determine the cause of these side effects and treat you accordingly.

How does amitriptyline cause brain fog?

The exact mechanism that relates amitriptyline to brain fog is not yet fully understood and is quite complicated. However, various researches exist that show the link between amitriptyline and brain fog.

Amitriptyline is found to inhibit the action of acetylcholine, a neurotransmitter found in the brain (3). It is responsible for cognitive functions. Due to the blockage of acetylcholine caused by amitriptyline, various cognitive functions can be compromised such as memory problems, concentration problems and confusion (4).

Amitriptyline also causes a strong sedative effect (5). The sedation caused by amitriptyline may also disrupt the normal cognitive functions of the brain and may result in brain fog. 

What factors influence amitriptyline-induced brain fog?

Amitriptyline-induced brain fog can be influenced by several factors. Here are a few:

  • Higher doses are linked to increased side effects. Increased doses of amitriptyline may cause an increased risk of brain fog.


  • Prolonged use of a medication may also cause certain side effects to appear or become more persistent. 


  • Individual sensitivity is also an important factor. Variations in the effect of amitriptyline in different individuals might be attributed to genetic predisposition, metabolic rate, age and other individual factors.


  • Brain fog induced by amitriptyline might be more pronounced in starting the treatment with amitriptyline and it may subside with time. 


  • Inadequate sleep or poor quality of sleep can also act as a factor in brain fog while tracking amitriptyline.


  • Discontinuation of amitriptyline can also be a potential factor of brain fog. The dose of amitriptyline has to be tapered off. 

What to do if amitriptyline causes brain fog?

If you are taking amitriptyline and experience brain fog then it is crucial to contact your healthcare provider. They can help you determine the exact cause of brain fog and prescribe you a treatment plan accordingly. 

After taking your past medical history and analyzing your condition, your doctor will have to adjust your treatment plan, if amitriptyline is found to be the reason for brain fog. Your doctor will have to lower the dose of amitriptyline to help your body adjust better to its effects and then gradually increase the dose.

In order to manage your condition, your doctor will also advise you to make some lifestyle changes. 

  • Manage your sleep pattern
  • Regular exercise
  • Management of stress
  • Management of dietary nutrients

What are the alternatives to amitriptyline if it causes brain fog?

If, after all the adjustments and management your condition does not get better then you will have to switch your medication. After a thorough discussion with your healthcare provider, you might have been prescribed one of the following alternatives to amitriptyline. 

Other treatments Examples
Pharmacological treatment
  • Fluoxetine
  • Sertraline
  • Escitalopram
  • Venlafaxine
  • Duloxetine
Non-pharmacological treatment
  • Cognitive behavioural therapy CBT
  • Exercise
  • Physical activity
Symptomatic treatment
  • For neuropathic pain: Gabapentin, Pregabalin
  • For migraine prophylaxis: Topiramate, Propranolol  
Lifestyle adjustment
  • Sleep hygiene
  • Balanced diet
  • Stress management

In my opinion, amitriptyline can cause brain fog and it is a frequently reported side effect of this medication. Due to brain fog, cognitive functions of the patients are compromised which can be dangerous for the individuals. Hence, a proper clinical treatment or modification of the current treatment strategy is needed. 

You need to have an open communication with your doctor to manage your condition and get the best possible treatment with maximum effectiveness and reduced side effects. 

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Knegtering H, Eijck M, Huijsman A. Effects of antidepressants on cognitive functioning of elderly patients. A review. Drugs Aging. 1994 Sep;5(3):192-9. doi: 10.2165/00002512-199405030-00005. PMID: 7803947.


Thour, A. (2023, July 18). Amitriptyline. StatPearls – NCBI Bookshelf.


Richardson JS, Mattio TG, Giacobini E. Amitriptyline and imipramine inhibit the release of acetylcholine from parasympathetic nerve terminals in the rat iris. Can J Physiol Pharmacol. 1984 Jul;62(7):857-9. doi: 10.1139/y84-143. PMID: 6498615.


Newman, E. L., Gupta, K., Climer, J. R., Monaghan, C. K., & Hasselmo, M. E. (2012, January 1). Cholinergic modulation of cognitive processing: insights drawn from computational models. Frontiers in Behavioral Neuroscience.


Levesque, P.R., Lindsley, O.R. & Etsten, B.E. Amitriptyline (elavil) a sedating antidepressant with pressor activity for preoperative medication. Can Anaes Soc J 12, 129–136 (1965).

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