Amitriptyline for Cats: One Medication Option to Manage Anxiety and Stress

Amitriptyline (Elavil) is a tricyclic antidepressant that is used in cats to treat a variety of behavioral issues, including: 

• Anxiety

• Excessive grooming

• Aggression

• Litter box problems 

• Urine spraying 

• Nerve pain 

Use of amitriptyline in cats, while common, is considered “extra-label” or “off-label” since it isn’t FDA approved for use in cats.

Amitriptyline for cats at a glance

What is amitriptyline for cats, and how does it work?

Amitriptyline is part of a drug class known as tricyclic antidepressants, or TCAs. TCAs are named for their chemical structure, which includes three carbon rings. Amitriptyline has been used since the early 1960s to treat mood disorders and nerve pain in humans. The medication can provide many of the same benefits to cats. 

Amitriptyline and most TCAs work in a few ways to treat behavioral disorders and nerve pain in cats. One major way TCAs function is by increasing the levels of dopamine and serotonin in the brain. By increasing the levels of these “feel-good” brain chemicals, it stabilizes a cat’s mood and reduces pain, thereby increasing a cat’s well-being. TCAs do this by blocking chemical receptors and transporters on the surface of brain cells. 

TCAs also function as an alpha-1 adrenergic receptor blocker, which can reduce fear.

What is amitriptyline used for in cats?

Amitriptyline has proven to be useful in managing various behavioral disorders in cats as well as treating nerve pain. Some feline conditions that may benefit from amitriptyline include:

• Anxiety and fear

•  Aggression toward other cats

• Urine spraying

• Urinating or defecating outside the litter box

• Lower urinary tract inflammation that is associated with stress, also known as feline lower urinary tract disease (FLUTD) stress cystitis, or interstitial cystitis

• Stress-related overgrooming 

• Pica (eating non-edible items)

Amitriptyline is most effective at treating stress and anxiety-related disorders in cats when combined with environmental modification and enrichment. For example, if amitriptyline is prescribed to a cat for stress-related urinary problems, it will be most effective when used alongside litter box best practices. 

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How is amitriptyline given for cats?

Amitriptyline comes in tablets ranging from 10 mg to 25 mg that can be split if necessary. Amitriptyline can also be compounded into an oral liquid, a chewable treat or tablet, or a transdermal lotion that can be rubbed into a cat’s ear. 

Unless your cat gets amitriptyline as a lotion, it is best to give this medication with food to increase absorption and minimize stomach upset. Wash your hands after handling the medication, and use gloves when applying a transdermal lotion.

The dosage of amitriptyline for cats varies depending on several factors, including: 

• The condition or issue your cat has

• Your cat’s weight and overall health

• Any other medications your cat takes 

Your veterinarian will determine the appropriate dosage for your cat. Often, the proper dosage for cats ranges between 2.5 mg to 12.5 mg once or twice each day. It is important to follow all dosing instructions exactly as amitriptyline is a potent medication that can be easily overdosed.

Typically, a veterinarian will start a cat at a lower dose to reduce negative side effects. If there is no improvement to the condition or if your cat experiences negative side effects, your vet will need to adjust the dosage of amitriptyline. This adjustment process may take several weeks. So be patient and communicate with your veterinary provider during this time period to get the best results. 

What are the common side effects of amitriptyline in cats?

Amitriptyline can significantly improve the quality of life for a cat with anxiety or other behavioral disorders. But pet parents must be aware of potential negative side effects. 

The most common side effects of amitriptyline in cats include:

• Drowsiness, low energy, or sleeping more

• Dry mouth, resulting in increased thirst and urination

• Drooling after administration  

• Increase or decrease in appetite

• Constipation

• Hyperactivity and agitation (rare paradoxical effects)

Allow your feline friend to rest as necessary and provide constant access to fresh, clean water. If your cat seems to be spending more time in the litter box or if you notice any changes to their stool, contact your veterinarian for advice. If you're concerned about changes to your cat’s appetite or if they are gaining or losing weight, consult with your veterinarian. 

Most side effects associated with amitriptyline are usually temporary, mild, and go away on their own. But if you are concerned, talk to your veterinarian.

As this medication alters the levels of chemicals in your cat’s brain, it is best not to discontinue it abruptly. If you need to stop giving your cat amitriptyline, first consult with your veterinarian. They can give you instructions on how to slowly lower the dose of the medication safely.

What are the most serious risks of amitriptyline in cats?

The most serious side effects of amitriptyline in cats are associated with an overdose. That’s why it’s important to work closely with your veterinarian when your cat is prescribed this medication. 

Signs of serious side effects of amitriptyline in cats include:

• Vomiting

• Severe incoordination or falling down

• Collapse

• Pale gums 

If you notice any of these signs while your cat is taking amitriptyline, call your veterinarian or a pet poison hotline for advice immediately. 

Amitriptyline may cause changes in your cat’s blood levels. It should be given with caution to cats with liver or kidney disease. In addition, amitriptyline has been known to cause cardiac arrhythmias in some cats. 

Your veterinarian may want to run bloodwork and conduct an ECG (electrocardiogram) test on your cat before starting the medication. They may then request follow-up checks periodically (every 6 months) while your cat is taking the medication to ensure that your cat’s health is not negatively impacted. 

Does amitriptyline interact with any other cat medications?

There are many medications that interact with amitriptyline. Let your veterinarian know if your cat takes any other medications, vitamins, herbs, or supplements. From there, your veterinarian will be able to determine if any of your cat’s existing medications will interact with amitriptyline. 

What should you do if your cat misses a dose of amitriptyline?

Amitriptyline is typically prescribed for cats once a day. So, if you miss a dose of amitriptyline, give the next dose as soon as possible. Then, resume your regular schedule for the next day. Never give two doses of amitriptyline at the same time to “catch up” or give two doses within 12 hours of each other. 

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Written by:

Sarah J. Wooten, DVM, CVJ

Dr. Sarah Wooten, DVM, CVJ, is a well-known international influencer in the veterinary and animal healthcare spaces. She has 16 years of experience in private practice and more than 15 years experience in veterinary media work.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Ghanasyam Bey, DVM

Ghanasyam Bey, DVM, is from Cleveland, Ohio, and attended Princeton University for undergraduate studies. After a year of biology research at Duke University, he attended Ohio State College of Veterinary Medicine.

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