National Migraine Centre
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How do I deal with serious constipation when taking amitryptaline?

Have had migraine for over 40 years. Have been on 20 mg per day amitryptaline for about a month and it certainly helps with the headaches. I can cope with the constant drowsiness and the thirst, but the constipation is such a serious problem, I am beginning to think I will have to stop taking it. I have LOADS of fibre, fruit, dates and water (and, at the moment, Senokot) - all to no avail! Can anyone help, PLEASE?

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maybe ask for a smaller dose

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Less than 20mg?

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Have you tried either walking,exercise or yoga they all help to get things moving so to speak! Less salt and more fluid. I find apples work for me as well tho sounds like you may need more than one! Good luck :)

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Thanks for replies!

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Have you tried taking Magnesium which is used for migraine prevention but can have laxative properties as well. Of course under your doctors guidance. I have lived with constipation & drinking water & more water is very important. Try & avoid caffeine as that dehydrates. If you wanted to try Magnesium make sure you buy the Citrate or Chelated forms which will be absorbed more readily into the blood & is not solely going to end up in the toilet. If you are constipated take the highest dose ie. 600mg for as long as it takes & it should give you the result you are looking for. If you don't want to take Magnesium daily then my surgeon recommends taking a spoonful of Epsom salts mixed with water until it dissolves & squash to swallow it down with. Stay near the toilet & hey presto you should go in a few hours as long as you drink loads. If not repeat the process. This is not habit forming like most laxatives & doesn't cause me any tummy ache. :-) If you would like anymore info on any of this let me know I'm happy to answer your questions.

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Thanks Karryon - Magnesium definitely seems worth a try! So grateful you took the time!

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If you speak to your Pharmacist when you purchase some Magnesium to choose the best type for your needs. Either a kind for laxative effect temporarily or a kind for Migraine prevention. I'm not sure if it will work fast enough for your current situation but can help long term to prevent further problems.

Epsom Salts is also a form of Magnesium but is absorbed in the intestines. Epsom Salts will pull water into your bowel & hence the desired effect. That is cheap & effective for the immediate problem. Alternatively ask the Chemist for Osmotic laxatives as they draw water into your intestines & as long as you drink the liquid they will give you relief. Drink plenty afterwards as well to replace what you have lost.The Magnesium I take is Citrate form which is supposed to 99% be absorbed into the blood stream & not into the intestines. I was wanting it for migraine prevention & not a laxative but ultimately I've killed 2 birds with one stone. I have to adjust the tablets if my bowel gets too over active. This can give you stomach ache if you take too much. :-( You will figure this out yourself with how your body reacts to it. The Chemist can also recommend a tablet form of something that works like Epsom Salts.

I'm over in Australia so can't recommend brands & so forth to you. Also a good idea is to Google Magnesium & you will see what kinds people take for laxative properties. Good luck.

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It will improve with time, as will the dry mouth.

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Hi..I too had issues with amitripylines side effects. Unfortunately that class of drug has many side effects. Can you dose reduce to 10mg? I would suggest being on the lowest dose possible that offers you the most therapeutic benefits.

What senna dose do u take? U can take 1-2 tablets per day as per the instructions however that can b increased up to 3 if needed. Senna is a stimulant laxative so will increase bowel motility, however you probably need to add in an osmotic laxative to draw water into the bowel to make the stools softer. U could take sodium docusette tablets with the senna or add in lactulose. Or if that fails u may need to try laxido which is a stronger dual action laxative. I'm a nurse prescriber so use these medicines routinely in my practice. Hope this helps.

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Just to add laxido is prescription only however lactulose and sodium docusette can be purchased from the pharmacy.

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I was on Amitrypyline, 20mg, and experienced the exact same symptoms as you. The only thing that helped me was a daily dose of flax seed or linseed. I bought the seeds and ground them myself but you can buy them ready ground. A tablespoon or two on my breakfast every day was all that was needed, it may take a couple of days to work, but I never had constipation problems again. After 2 years on Amitrypyline I found it was no longer working and the migraines returned, but I still take the flax seed.

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I agree try asking your doctor for laxido sachets - its fairly new and doctors may not know it but either google it and print page or get them to look it up - its the best one I have now come across and can use with Senakot. If that does not work then definitely rethink your dose!

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Magnesium is good. but also try mirolax, not a stimulant laxitive, but does work. I also have constipation from amitryptline, Dropping dose not worth the consequences. It is a good drug for headaches, unfortunately constipation comes with it. Use mirolax daily.

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If you want to take something natural, as opposed to putting to putting more chemicals into your body, maybe give Chia Seeds a try.

Soak 2 tablespoons in a large glass of water for about 20 minutes until they expand - tasteless and okay to drink. Good for constipation and preventing diverticulitis.

I've suffered with lifelong constipation, Chia Seeds work for me. However I do take other stuff too, ie. prunes, ground flaxseed, fish oil.

Try googling "Chia Seeds Constipation".

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