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Amitriptyline withdrawal — GPhC CRA MCQ

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EasyCNS TherapeuticsAmitriptyline withdrawalGPhC CRA

A 40-year-old woman has been taking amitriptyline 50 mg at night for neuropathic pain for two years. She presents wanting to stop the medication as she feels her pain is now well controlled. What is the most appropriate advice?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — She should reduce the dose gradually over several weeks to avoid withdrawal symptoms

Amitriptyline, a tricyclic antidepressant, should not be stopped abruptly after prolonged use as this can cause withdrawal symptoms including nausea, headache, malaise, and sleep disturbance. The BNF recommends gradual dose reduction over at least four weeks, ideally longer if the patient has been on treatment for a long period. The GP should be involved in planning the taper and monitoring for any return of symptoms.

Reference: BNF; NICE CKS Neuropathic Pain