Quote Originally Posted by Belleblue View Post
I wasn't aware that heightened anxiety was a common start up side effect with TCAs, I always thought that was just the SSRIs/SNRIs.

So it could be just an initial SE and may be worth another try.
As a generalisation the initial TCA side-effects tend to be less severe than from SSRI/SNRIs, as do withdrawal symptoms, but they may still occur, Belle. It all comes down to individual biology. If the heightened anxiety becomes more than an inconvenience then please seek help from your GP as there is no need to suffer. Trying to white-knuckle through it is counterproductive.

To the best of my knowledge I have no heart issues.
Then amitriptyline is unlikely to cause any significant problems. I've been taking the TCA dosulepin, which is so cardio toxic that the UK drug regulator removed it from the BNF and is limiting its availability, at above the maximum recommended dose for about 25 years and my ancient heart is fine despite having been under extra pressure since I had half a lung removed 14 years ago. I do get an ECG every year as part of a comprehensive annual check up.