Low dose amitriptyline

Has anyone found low dose amitriptyline (5-10mg per day) helpful for managing neuropathic pain? I will only be able to start on a low dose and wean up very slowly, if at all. This is because I was put on it at a high dose (for depression) many years ago and ended up very ill in hospital. I'm quite nervous, as you can imagine. I'm also wondering if a low dose will actually do anything and if it's worth the risk?

Thanks in advance.

17 Replies

  • I had no idea it was used for pain. I had it prescribed as I don't sleep well at night and my nurse practitioner thought it would help me sleep. I hardly ever take it...just maybe once a month, so I can get one decent night's sleep, but it makes me feel dozy the next day. I suffer chronic bone pain and arthritic pain, but I have not been prescribed this to help. Sorry i can't be helpful. Perhaps you should speak to your doctor or nurse about this. Good luck :)

  • I tried it to help me get some relief from pain so I could get quality sleep. I didn't do too well. They tried me on nortriptiline which has less side effects but if really messed with my balance and combined with the rest of my meds, made me too tired to work.

  • I have amytryptoline and neurontin at night

    And neurontin in the morning. All at low dose. The combination certainly helped me get relief from nuropathy .

  • Have you spoken to your doctor about your concerns with regards to this medicion, has he/she looked that far back in your notes? My surgery is a "Training" xurgery and has new Doctors every year, so he/she may not be aware of your previous issues; certainlt worth asking. Best of luck

  • I take 10mg of Amitriptyline every night and it has helped with my neuropathic pain, linked with my IBS. I take it about 8pm and this means that I'm not 'spaced out' or dozy in the morning. I tried 20mg, but felt while the 10mg was working I would stick with that. It seems to work well for me. I would certainly give it a try.

  • I had it. It gave me sleep paralysis and didn't help with pain. I switched to gabapentin (neurontin) three times a day (2400mg split over the doses)

    It must work for some, but there are other options if it doesn't help or if you don't want to try it.

  • I was given 10mg for IBS and it didn't work for me at all,I had no effect from it either.My husband takes it now and again for neck pain that leads to a bad headache ,it makes him sleep well and works for him just fine.Which shows were all different I think if you've been prescribed a drug it's just a case of suck it and see,give it like a month if ,your not happy with it go back and see your GP. Do they know you were I'll on it years ago ?

  • It didn't really help with pain but was so good for my restless legs, let me have good nights' sleep and helped the diahorrea caused by the Leflunomide I take for Lupus. I take 10 mg at night and don't feel at all drowsy in the morning. However, I do now have high ringing in my ears which could be a side effect.

  • When I was first diagnosed with CRPS Amitriptyline was the drug that my doctors prescriped first.

    I was started on a low dose and did find this very helpful in combating the pain but I am very sensitive to medications and found that this was causing me to become very depressed; although I was not depressed at the time.

    The only thing you can do is try it and if it doesn't make a change the wean off it.

    I am now on a high dose of Gabapentin but this is due to change in my pain etc.

  • Hi there,

    I can imagine how nervous you are of starting Amitriptyline after serious side effects before. I am assuming your Doctor knows the full extent of your previous reaction? I have been on this dose for 9 months now and have found them extremely helpful. I am also getting a great nights sleep.

    Can I ask why they have decided to put you on these if you had this reaction?

    Hope this helps and please do come back to us for support.



  • I was prescribed that at 10mg when the co-codamol i was on was making my migraines ten times worse, for me they didn't make them better but they didn't make them worse like the co-codamol did, but as I spoke to other people who have been put on that, it works for some and not for others it's just finding out what works for you, for me gabapentin helped somewhat the only thing that I've found to have worked for me, but recently been taken off them so migraines have got worse again. Hope these work for you, or you find something that does work for you.

  • I was on 10mg for nerve pain in my rectal-anal area and it did stop the burning & pain, but the next day I was so sedated! I stayed on it till it no longer worked and they wanted to up the dose. I said no because sedation was too bad and I was not functioning from that. I do wish I could have tolerated it as it was the first drug to help my nerve pain! I hope you do well on it. I am also on Neurontin 1800mg for the terrible neuropathy in my feet, I cannot walk at times. Does any one get good relief from this drug, and is dosage too high? It worries me!!

    Sending blessings & hugs to everyone!!!!


  • I was initially prescribed gabapentin for neuropathic pain but the side effects were dreadful and I changed to nortriptyline starting at 25mg and increased to 50mg. This is taken in the evenings and does not make me sleepy. The only side effects I've had are a dry mouth - this was bad for the first few days but eased off and you get used to it (keep some sucky sweets handy). I was specifically prescribed nortriptyline by the pain consultant because of the bad reaction to previous pills so it may be an option to discuss with your doctor. The pills have definitely helped with the all-the-time pain but do not remove the flare up pain (not sure anything can). The pills do take a few weeks to get the maximum effect.

    Good luck

  • low dosage amitriptyline has been used for pain for a long time. It has its downsides - no alcohol.

    It is also prescribed wrongly far too often because the prescriber often cannot be bothered to investigate the causes of pain.

    A lot of pain is caused by the way we use our muscles. Change the way you use your muscles and the pain can decrease. The use of amitriptyline is likely to interfere with good muscle control and so could prevent you from getting help from muscle specialists who could teach you how to reduce your pain.

    Hope this helps

  • I'd be a bit wary of taking even a low dose if you ended up ill with it before.

    But, your question about low doses - yes Amitryptylline is proven to be very effective for neuropathic pain at low doses, with no additional benefits for neuropathic pain once the dose gets into the anti-depressant range (50 mg a day and upwards). If its going to work for you (it doesn't for everyone), you should get noticeable results at less than 25 mg a day, and for some people it can be as little as 10 mg a day.

    There are other antidepressants that are being used for pain modification though. If you really are concerned, then ask your doctor if there is some other med you could take.

  • Hello Crashdoll. I am on 20mg amitriptyline for neuropathic pain and it doesn't help at all. I also have a lot of trouble sleeping due to pain and insomnia. I keep hoping it will help. I am also on Pregabin 100mg. It also isn't helping. I see my GP to get it increased on Friday. He won't increase the amitriptyline because it would clash with other medication I am on. I think it all depends on the person to whether it helps or not.

  • Thank you for all the replies. The reason why I'm trying it again is because no one medical is convinced that my supposed 'reaction' was actually a reaction at all. Basically, what happened was that I had just started amitriptyline when I had a mini stroke. I was only 18, so it was obviously a shock. I am so worn out with pain and fatigue, that I am willing to risk it again and try something different.

    I am aware of the side effects. Rheum said the best way to manage the drowsiness is to take it a good few hours before bed to avoid the hangover the next day. She is positive that it may help me cut down on the codeine which also makes me very drowsy! I am very keen to cut down on the codeine, so this is my experiment.

    Fingers crossed!

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