Amitriptyline

[Dunkdl]

Doctor just put me amitriptyline, not sure if it will help with pain, also concerned about the side effects.

Any advice would be great, thanks.

D

[earthwitch]

It will take a week or so to get used to it so you don't feel zonked out.   To minimise the zonked out feeling in that first week, take it at night, but about 12 hours before you want to get up in the morning.  Maybe start taking it on a Friday (if you work Monday to Friday) so you have two days to get over the worst of the tiredness.   After that first week or two, it should be fine.   Not sure what your starting dose is, but the usual dose for pain relief starts at 10 mg and goes up to 25 mg at night.   Over 50 mg is getting into antidepressant doses and there is no evidence for it having any further benefit on pain relief at more than 50 mg a day.

It is possible you may get some of the other less common side effects, but most folk tolerate it quite well once you get over that initial tiredness.   I found I couldn't take any of that kind of antidepressant med because my heart rate would increase dramatically at the slightest exertion, but I think that is quite uncommon.

As far as its effectiveness, for most people it really is quite effective at helping with reducing your pain to manageable levels.

[Dunkdl in reply to earthwitch]

Thank you for your advice. Hopefully the tiredness will ease off, although I think it is exasperated by already suffering from fatigue. Doctor is looking to go up to 30mg over the next couple of weeks. I go back to the pain clinic in about 6 weeks for my 2nd appointment so I will see how I go. Just glad that I don't have to get up for work. 

[Cooper27]

It effects everyone differently, and you need to give it a couple of weeks to settle down. Initially you will feel a bit hungover, that feelling passes in a couple of weeks.

Always take at night. I would take mine 30mins before bed, as I'd zonk out within 30 mins. I slept like a baby on the stuff, but have a friend who found it caused insomnia for her.

I took a dose of 80mg for a year, but tbh, you'll know whether it willwork for you within around 3-6 months (if it isn't helping after 6 months, come off again). If the side effects outweigh the symptoms, come off it sooner.

[Megan75]

I found that the tiredness didn't really abate on 25mg and I gained weight which has made my pain worse. It did help the neuropathic pain somewhat. I found it also caused poor sleep after it was in my system for a few weeks and that contributed to the tiredness, a little similar to my experience with lamotrigine.

The dreams on it were fabulous though: entire plots for novels 😊

[Dunkdl in reply to Megan75]

Thank you for reply. I'm hoping that the side effects will be offset by a decrease in pain. Having just lost over a stone, I don't want to put it straight back on, guess we'll see what happens.

[margaretkemp65]

Hi I take Amitriptyline 20mgs at night for nerve pain, for the first few weeks it seemed to ease the pain,but not for long I now have to take Gabaprntin 900mgs as well as the Amitriptyline which seems to be working,i did not have any side effects from Amitrypline just felt a little tired, hope you get sorted.

[Ru55ell]

Hi Dunkdl, I have been on Amitriptyline, and it does affect everyone differently with Side effects and how effective it is. The main thing is to give it a chance to see how it can help you, but also be objective in weighing up the positives against the side effects. If you are zonked out all of the time with little benefit then it may be worthwhile talking to your doctor to see what other medications are around that can help.

In the early stages of my neuropathic pain diagnosis Amitriptyline was the first medication that was tried, and due to the side effects and little benefit I am now on Pregabalin which I find better, with less of the zonked out feeling from it. But it really does depend on how your body copes with different medications.

If you don't feel any benefit don't get disheartened, there are others available, and it's just a case of finding the one that works for you and your pain.

(I've also had a stimulator fitted since, and have managed to reduce my pain meds a bit which helps with the side effects, so there are definitely options available to help you out!)

I hope you get relief and aren't affected by the side effects! Good Luck!!

 

[Dunkdl in reply to Ru55ell]

A spinal cord stimulator is something that I have been researching and will talk to my doctor about.

[Ru55ell in reply to Dunkdl]

I was due to have a spinal cord stimulator fitted, but as my pain is localised to my knees I have had a DRG implant fitted instead. It's more targeted, and the stimulation doesn't 'overspill' into other areas as much. If you have more localised pain it may be worth looking at DRG implants as well as SCS so you have a few options to discuss.

[Toplady]

I tried Amitriptyline but made me so zonked I couldn't function. I now am on Nortriptyline which is working far better. It isn't doing much for the overall daily pain relief but is helping me sleep which I couldn't do before. I also have the most vivid dreams now which can be disturbing but it's a small price to pay for some sleep! 

[Dunkdl]

I have also tried tramadol and pregablin but had allergic reactions to both. Hopefully Amitriptyline along with Gabapentin and dihydracodeine paracetamol and naproxen with help. I go back to the pain clinic in a about a month for more nerve blocks. I have already noticed that Amitriptyline is helping me to sleep through the night.

[johnsmith]

Many drugs help with the pain in the beginning.  However in the long term they do not deal with the cause.  This does result in many cases with a deteriorating situation where there is an increasing dosage of medication to try and reduce the pain.  More medication more side effects.

Is the cause muscular, posture or disease.  Muscular and postural problems need treatments designed for these causes.  These treatments require payment as they are not available on the NHS.  Treatments would include chiropractic investigation, Alexander technique, Massage a such as cancer or infection then this needs investigation to determine the cause so that the appropriate treatment can be determined.

Hope this helps.

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I have been on Amitriptyline for 4 years for nerve pain. Initially it did zonk me out & it was difficult to wake up in the morning that did last for months but thankfully has passed.