For most people, amitriptyline does not work straight away and needs several weeks before the full effect is felt as a pain treatment or migraine preventive.

Typical time frames

• Sleep often improves first, sometimes from the first dose or within the first few days.

• Pain or migraine symptoms usually start to ease after about 1–2 weeks, but this early improvement can be mild.

• Full pain‑relief or migraine‑preventive effect commonly takes around 4–6 weeks, and some guidance notes it may take up to 6–8 weeks in some people.

Why it varies

• The condition being treated (nerve pain, migraine, depression, sleep) and the dose used can change how quickly you notice benefits.

• Individual factors like metabolism, other medicines, and overall health also affect how fast it works.

When to talk to a doctor

• Do not stop amitriptyline suddenly on your own; doses are usually reduced gradually to avoid withdrawal symptoms.

• If you feel no benefit at all after about 6 weeks, or if side effects are troublesome, contact the prescriber to review the dose or treatment plan.

If you say what you are taking it for (pain, migraine, mood, sleep) and your dose, more tailored expectations can be given.