Pregnant women: A connection to malformations is suspected but not proven. Avoid the drug if possible in the early stages of pregnancy (first three months).

Nursing mothers: Amitriptyline is excreted through breast milk. Avoid the drug or breast-feeding.

Children: Contraindicated before the age of 5. Even for older children it is rarely sensible (maximal daily dose: 2.5 mg/kg).

Elderly people: Very cautious dosing (increased danger of orthostatic hypotension and confusion): begin with 50% of the usual adult dose.

Renal failure: No dose adjustment necessary.

Liver insufficiency: Individual dose reduction is recommended.