Amitriptyline

Oral health effects

• Xerostomia (dry mouth)

  TCAs are strongly anticholinergic; dry mouth is common and often marked, with elevated caries risk.

  Mechanism: Potent muscarinic receptor blockade reduces salivary secretion.

  Clinical management: Hydration, sugar-free gum/xylitol, salivary substitutes, high-fluoride products; reinforce caries prevention.

• Dizziness on standing (orthostatic hypotension)

  Tricyclics block alpha-1 receptors; the label lists hypotension, particularly orthostatic hypotension, and syncope.

  Clinical management: Raise the chair slowly at the end of the appointment and have the patient sit upright for a minute or two before standing; steady them as they get up. Ask about dizziness on standing, especially after dose changes or in older patients.