Does amitriptyline withdrawal cause stomach pain? (+3 tips)

In this article, we will explore whether amitriptyline withdrawal can cause stomach pain or not, how amitriptyline withdrawal causes stomach pain, how to treat stomach pain caused by amitriptyline withdrawal and how to safely discontinue amitriptyline. 

Does amitriptyline withdrawal cause stomach pain?

Yes, amitriptyline withdrawal can cause stomach pain. It is a very commonly observed effect of discontinuing amitriptyline. Amitriptyline is an antidepressant that needs to be tapered off gradually rather than abruptly discontinued. Stomach pain might not be as common as anxiety or insomnia but still is commonly reported as a withdrawal effect of amitriptyline. 

Amitriptyline is a tricyclic antidepressant or a TCA. It is primarily used to treat depression and related disorders along with nerve pains (1). Amitriptyline modulates the levels of serotonin and norepinephrine in the brain to control the mood and pain perceptions associated with the nervous system only (2).

Amitriptyline is a prescription drug that should only be used under the careful guidance and advice of an experienced healthcare provider. You need to consult your healthcare provider in order to taper off your medication with minimal side effects. 

How does amitriptyline withdrawal cause stomach pain?

Amitriptyline’s sudden withdrawal makes you susceptible to certain adverse effects that can be dangerous. Stomach pain can be one of these. 

Amitriptyline causes an increase in the serotonin levels. Once you stop taking amitriptyline, it causes the serotonin levels in the brain to plummet. This sudden decrease can affect the centres of the brain responsible for digestion. This sudden reduction in serotonin levels can cause (3):

• Increased gut motility
• Increased muscle spasms causing cramps and abdominal pain

All these effects can lead to stomach pain. In some cases, amitriptyline can increase your pain perception which causes even minor pain stimuli to affect you greatly. The gut-brain axis is also an important factor to consider here. Sudden withdrawal of amitriptyline can cause:

• Increased stress may cause increased acid production causing heartburn (4).
• Stress hormones can also trigger inflammation in the gut lining (5). 

How to treat amitriptyline withdrawal-induced stomach pain?

If you have stopped taking amitriptyline without proper guidance from your healthcare provider, you might experience stomach pain. In this case, you need to consult your healthcare provider. Your doctor will have to carefully analyze your condition.

• They might have to restart your medication if stopped recently and then you will be made to discontinue amitriptyline through proper tapering of the dose. 

• Your doctor might suggest you take some over-the-counter medications such as Pepto-Bismol, Tums or Imodium for your stomach condition. 

• You need to avoid pain relievers like ibuprofen, they can irritate your stomach lining and make the pain worse. 

How to safely discontinue amitriptyline?

If you need to discontinue amitriptyline then it is recommended to inform your doctor first and seek guidance from them. Your doctor will have to determine your rate of metabolism and the condition of your body to determine your course of action to taper off amitriptyline. 

Tapering off dose

The right regimen is to taper by 25% of your daily dose of amitriptyline every 1-4 weeks (6). Further adjustments will depend on how your body responds to this action. During this time period, your doctor will have to carefully examine your condition and observe any side effects that may appear. 

If, after reducing this dose every 1-4 weeks in the same pattern does not cause any withdrawal symptoms to appear then your doctor may continue reducing your dose at the same pace until it can be completely stopped. 

During this process, you need to keep an eye on any symptoms or side effects or any withdrawal effects that may appear and you need to inform your healthcare provider to seek guidance. 

In my opinion, Amitriptyline is not to be discontinued as per choice. This is a prescription medication and needs to be taken or managed through proper medical advice. Sudden discontinuation of amitriptyline causes stomach pain and related effects. 

If you wish to start or stop any medication including amitriptyline then you need to consult your healthcare provider to get safe advice. 

References