Amitriptyline again

David had his second visit from the CPN today. A very nice chappy who clearly has a good knowledge of chronic pain.

On his first visit he spoke at length wih david about his depression and pain. This bout of depression has lasted almost a year this time and nothing can get him morivated.

Anyway. CPN spoke with his boss an rather than put D on yet another drug, suggested increasing the Amitriptyline from 75 at night to 150. CPN wanted to speak with me as to how I felt.

Funny really as I wrote about D reducing the drug a couple of weeks ago and how he gets nughtmres when reduced.

Nw here is the CPN doubling the dose.

D still drives and whilst he takes Amitriptyline at ight - will it affect him during the followinf day? The lower dose he was on was for muscle relaxant but now this higher dose would be for its correct use.

Any thoughts please?

Pat x

7 Replies

  • Sorry Paton I don't have an answer to this. But I was wondering, if David has depression, would a SSRi not be an idea for him ? I'm going to discuss it for me with my GP this week as I understand this group of meds acts as a mild pain reliever as well as an antidepressant. Selective Serotonin Re-uptake inhibitor, SSRi, such as Prozac, Citalopram etc.

  • Hello Pat

    Bob here

    Amytryptalene is an anti-depressant in its own right, and is given for neuro pain at between 25mg -75mg remember the main use of these meds is deppression not nuro. the drug is generally used at double the dose say at 150mg, normally at night.

    Because your husband if I remember is on a decent dose of other medications this is a good call by the CPN , doing two jobs , a good bang for buck med, excuse spelling getting late, tired

    All the best


  • Take the amitriptyline ealier eg no later than 9pM TO AVOID hangovere/ tired affect next morning. also one of the ssri types duloxetine is also recommended for pain in fibromylagia and conditions such as inflammatory arthritis this could be an alternative for pain and depression and is non drowsy.. may be D's mental health means he is usuitable for ssri eg manic depression/ bipolar depression ssri not a good choice, I dont know anything about David and his health but there may be some good reason why amitriptyline not SSRI is being advocated.

  • Hello Pat

    Just a thought I need too take citalopran at a reduced half dose I am a manic reactive depressant at a reduced dose and 75mg dose of Amytryalene,your D is possibly best on former. The two effects cover his condition well, I am on the limits now for my meds and they want to lower the the aforementioned ssi When they can without effecting the amytrypalene

    All the best


  • Thanks friends for this advice.

    I think you Bob are a pain consultant in disguise!!!

    Going to pick a quiet few days and give 150 a try. Now just got to find those few quiet days.

    Pat x

  • Amitriptyline helps some people with Chronic pain, but I respond better to a similar old medication, nortriptyline. I'm now on a higher dose of that for the depression.

  • My other half had a lengthy bout of severe depression a few years back, has come out the other side fortunately, but it's hard-going so I feel for you.

    I think the thing about taking ami at night time is that it can make you sleepy so therefore it's good for sleep, as well pain & depression! So hopefully it will have worn off by the morning. perhaps best not to drive first thing after taking the first few doses until David knows how it effects him. A bit tricky if he really needs to drive - I had to fiddle about with the timings of some of the medications I took for pain so that I could get to & from work safely, but I'd talk to the CPN again if it's causing problems or if the timing needs changing.

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