Fibromyalgia Action UK
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Amitriptyline

Hi all, I'm in the process of being diagnosed and started on this med tonight. Just wondered what others experience of it were like. I know it was originally an anti depressant med but found to have other benefits. The GP said he was giving it to me to help with 'my perception of pain'. Has anyone else been told this?

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'Perception of pain'! Being rather cheeky I think your dr.

It was originally a drug for depression and other conditions to do with the brain. It was later found to be helpful for nerve type pain. This is quite well known and I wonder why your Dr has implied it has purely psychological properties... very strange.

I'm on low dosage and it helps but doesn't fully take away my pain (I'm not keen to increase strength of medication). Give it a good month plus to get in your system, may help you sleep too. I find it best to take early eve after dinner.

Give it a go, hope it helps xx

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Hiya I carnt take them on Prozac and pain patches wen needed tho they send me funny hope the tabs help you x

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Hi Mumsiana

I take an alternative to this called Nortriptyline which is basically the same as Amitriptyline but without the sedative effect. I have found it to be adequate with other medications but that's all. I have always said to members that finding the right drug combination for Fibro is half the job done.

I want to genuinely wish you all the best of luck with your medication.

Ken

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Thanks everyone, I must admit that I felt a bit put out by what he said, as if I'm imagining it all! Good to know some time frames but know we are all different with our individual responses/reactions. I've started on 10mg at night and then to increase to 20mg so time will tell. Thanks again 😊 xx

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Perception of pain is probably not the best phrase. . . Sounds dismissive. Whether or not, it's been shown to work on a neurological level in low doses so please persist with it. I was on 20mg for about a year. It didn't really work. I do progressive muscle relaxation and tai chi. That's from a video not a class so I can tailor it to suit me and don't feel pressured to do all the exercises. Gentle movement really helps.

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I have taken amitriptyline for about 10 years, I have a spinal fusion and lots of nerve damage. I used to take it twice a day, I tend to take it once in the evening.

It can make you feel very tired, if you are waking up feeling hungover, try taking it a bit earlier in the evening. I find it very effective and take a very high dose, I would give it at least a month or two before deciding if it is working x

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Hi there, I am not sure how I would have reacted to the 'perception of pain' comment, if only these people had the pain we have for just one day their perception would likely be very different.

Amitriptyline does help with the pain, the benefits can differ hugely between different people. It also helps with sleep and at first you are likely to sleep fairly well but that can change. I also take it, along with other meds, and it is best to take it roughly 12 hours before you need to get out of bed as some people experience a hangover type of feeling in the morning if they take it at bedtime and have to get up early. Good luck, Linda.

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Thanks everyone, really good to hear your experiences and advice xx

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Hi again Mumsiana,

Your doctor sounds rather dismissive, but hang in there :)

I was put onto Amitriptyline, and like you it started with 10mg and went up to 20mg. They were great for helping me get some much needed sleep but lately I have found that they are not as good as they were, looks like I need a review :) Anyway what suits one may not suit another, so good luck and I do hope they help with your pain :)

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Perception of pain.? I would be spitting feathers if my GP said that to me.! I take amitriptiline too,and I find it very helpful in controlling my pain. But take it early in the evening,as it lessens the "hungover effect" next morning. Good luck.xx

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Pain killers generally work in one of two ways: Some reduce the inflammation and pain at the site of the pain, and others work by blocking the pain receptors in the brain, so, I'm guessing he/she was just referring to the way the amitriptyline works, because it is one of the group that does exactly that - blocks your perception of the pain. Don't take it as a personal attack (unless there are other reasons for feeling that way - tone of voice, any other "throwaway" comments?) because to me it would instill a greater confidence in the doctor - he/she actually knows *how* the drug works! That's a great thing!

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As commented by anon, pain reducing medications work by causing different chemical reactions in the body.

It helps firstly to understand the pain process... You have pain receptors (A) all over your body, these nerves are bunched together and linked to the brain via a nerve junction (B) running up the spinal column into the brain, where another nerve junction (C) transferred them into the brain. Once in the brain and spreading from junction to junction (D) the level/type of pain is determined by the number of nerve junctions firing and the frequency of the firing.

Hopefully that was basic but informative. Drugs can interact at any point A to D, all you should perceive is a reduction in pain no matter which point the Drug interacts with.

i.e. (If I remember correctly)

Paracetamol interacts at point A.

NSAIDS e.g. Ibuprofen inhibits signals at point B.

Tricyclic antidep. e.g. Amitryptaline inhibits at C and D.

GABA drugs e.g. Pregabylin or Gabapentine act on D.

Hence the multidrug approach used for FM patients to make sure we get the full spread of pain suppression.

Good luck with your pain management, and if you feel the Dr was being sarcastic with you insist on seeing a different doctor.

As a side note any patient with complex medical needs, including FM, should be seen by the same Dr every time, I have also found it best to book two appts preferably the last two of the day.

Once again good luck.

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I'm on max dose of tramadol and amitriptyline. The tramadol was for the pain relief and ami was as a muscle relaxant, as with the fibromyalgia I suffered from "restless leg and arm syndrome" I do wean myself off every few months for a while as both can be very addictive..also do some research on side effects although personally I never really suffered from any effects.

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Thanks for that, I also suffer with both restless legs and arms and is great to know that the ami may help with that. He's reluctant to give me more tramadol at the moment but may need some to tide me over as the pain has been terrible since I stopped them and only have the ami. Want to try and manage with the least amount of meds but still need and want to function. Guess it's a bit of trial and error to find the the right balance xx

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I have just been put up to 75mg and it does help me sleep, its a bit difficult to tell if it does anything for the pain.

I also take Ropinerole for restless leg syndrome.

We all tend to use what works best for us in order to make our lives better.

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Hi Mayrose,my gp told me he couldn't increase my amitriptyline from 50mgs as that was the maximum maintenance dose. I find that some nights I could do with a higher dose as I struggle to settle, but as I say, my gp refused to increase it. Julie xx

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It was my shrink that put it up he seems to think that if i sleep better my brain will work better ? We have yet to see.

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Hope it helps you, let us know when you find out, hope it's good news, Julie xxx

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Current maximum for use as a general painkiller is 75mg.

It is higher if you are struggling with migraines, higher again if you have societal anxiety combined with Chronic and Acute depression.

Good luck and HTH.

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I have been on 75mg for quite a while now and definitely helps me sleep not sure if it helps with the pain though

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Hi there, I think being able to sleep helps me deal better with the pain. I have never thought of amitriptyline being anything other than a sedating type sleep aid and not a pain reliever. My gp told me it was originally an anti depressant but that it was found to help aid sleep in patients. Like I say, it helps me get a grip on the pain after a night's sleep.

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I was given this to help me sleep but alas it never worked :(

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My dr told me that the Brian is a powerful thing. Having just presciped Cymbalta and then asked I f I wanted to see a Phsichiatrist can't spell! I said yes and saw one for about four meetings do suffer from depression . Have been diagnosed with Polymyalgia several times ? Fibro seems to be a forbidden word . Do they really think you want to suffer the pain and not live a decent life My poor daughter suffers from it too and we have both worked as nurses she is extremely well qualified perhaps my brain is at fault when I see the selling mistakes,!!!

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Just to put other’s minds at rest FM is a type of polymyalgia. (PM). Some of the PM forms can be exceedingly nasty with resultant arthritic conditions on top of the standard FM stuff.

You also have some PM, that are shortlived.

This is no way takes away from your FM diagnosis, if necessary download the FMA leaflet on educating your GP.

GOOD LUCK AND HTH.

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this post is from 3 years ago and fm is not a type of polymyalgia. PM will respond to steroids. PM is a differential for fibro.

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Thanks for the update, I was going off my experiences as my GP obviously felt Polymyalgia was the blanket term and the rheumatica version being separate as you describe.

Always happy to learn :-)

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