Amitriptyline (Elavil) is administered to cats with ‘behavior disorders’ such as inappropriate urination and destructive behavior and for medical conditions such as cystitis, separation anxiety and more. It is an anticholinergic drug. It inhibits acetylcholine activity. Acetylcholine is a neurotransmitter (a chemical transmitter). In people, amitriptyline is used for all kinds of conditions such as reducing anxiety and relieving chronic pain.
A recent study by the University of Washington, published in JAMA Internal Medicine on the long term use of anticholinergic drugs by people, concluded that these drugs raised the risk of dementia in people aged 65 and older by 50%. This is not unexpected because treatments for dementia in people are designed to boost acetylcholine activity.
No one has written about this subject yet. I have just joined the dots and decided to put out a warning. The use of amitriptyline in people and cats is very similar. It is reasonable therefore to conclude that the results of the study may apply to cats as well.
My impression is that this sort of drug should be used with a great deal of caution as there are stories of cats reacting badly and when you add in the possible increased risk of dementia, amitriptyline as a ‘solution’ to behavioural problems becomes even more unattractive. In addition, for amitriptyline, cardiac side effects can be seen.