Amitriptyline prescribed at Pain Clinic for night time sedative..however leaflet states its for Depression & Bed this correct?

Just picked up new script and read the leaflet...any views really appreciated please or,is there another sedative that sounds the same but spelt differently...worrried as already take citalopram ..and thought i was going to get some good sleep of more than 3 hrs..



27 Replies

  • Hi bea

    Can undrstand your concerns. Presumably your GP has prescribed Citolopram and now Amitriptyline so it would be on computer. Amitriptyline is an anti depressant and relaxant. They've found it helpful for pain but use lower doses for pain than for anti depressive effects. My pain consultant said doses above 25 mg for pain are pointless as they don't work and your more likely to get side effects!. Do watch out for a dry mouth. I take it and get a very dry one but I take 25 mg!. I expect your starting at 10 mg the lowest to see how you get on? It does help sleep. Hope it improves yours. X

  • Pain Consultant I saw advised me to step up the amitriptyline to max of 50mg, which I've never done. I find 20mg combined with gabapentin apparently gives a lot of symptom relief. Whatever the merits of amitrip or otherwise as a nerve pain killer I find it brilliant at getting me off to sleep, I was becoming addicted to zopiclone but fortunately I was able to come off that no problem - also I seem to worry less now

  • Hi Haydock

    Glad you find Gabapentin and Amitriptyline good benefit for sleeping. I take both too but find them not enough for my nerve pain!. Hope it continues. X

  • Amitriptyline is a very old drug, first discovered in 1960. It was used for depression to begin with, and could, theoretically, still be prescribed for that purpose. However, SSRIs are now the most commonly used drugs for depression and amitriptyline has fallen out of use for that purpose.

    But when amitriptyline was used for depression it was discovered that it reduced neuropathic pain and also helped some people with sleeping. I would guess that those uses are now the most common use for it.

    I have no idea whether there will be any interactions with citalopram. But be aware of serotonin syndrome, which is very dangerous - it can be induced by both citalopram and amitriptyline :

  • Feels like i have been fobbed off with this old drug medication! It really does depend who you see at these pain clinics and am upset to read your post but i do THANK YOU for your info. I was recommended the SI injection in June..and now feel i am at the back of a very long queue....


  • Amitriptyline is incredibly common in the treatment of pain - many find it really helps them, so please don't feel fobbed off. Most chronic pain sufferers have tried it at some point.

    They very rarely use amitriptyline for depression these days, as better medications were developed. The would have given 300-600mg to treat depression, but for pain they use much lower doses, typically 10-25mg, so nowhere near the antidepressant dose. They can't change the original leaflet without a new drugs study though, so I know it's confusing!

  • I don't think you've been fobbed off. Amitriptyline is still very commonly prescribed and is a useful drug in a doctor's armoury for various issues.

    Like many pain, sleep, and depression prescription medications it is addictive, so keep the dose as low as you can. I was on amitriptylline for a while at low doses and I managed to stop taking it without any difficulties that I can recall.

  • Old medication is good, at least they understand how it effects people over time.

    Personnally, I've found Amitriptyline to be helpful, especially when I wasn't getting enough pain relief.

  • Just because a drug has been around for a long time doesn't mean it's less effective. Amitryptoline is used successfully for many patients. I take it for nerve pain but it does have an effect on sleep.

    Don't think you have been fobbed off. The pain clinic will be trying it to see if it helps you. Give it a trial but at a low dose it might not be so effective.

    Hope it works


  • At a low dose, it is to raise your pain threshold and to help your muscles relax a bit, I’ve taken it for a lot of years and it’s helped me control some of my pains. It is used for my fibromyalgia.

  • Yes,i take 3 amitryptline for bedtime to help with the chronic nerve pain in my sciatica, nerve pain, and menieres disease if I tool 6 that would be for depression. It was found accidently to treat for pain and bed-wetting as well. I came off sleeping tablets to go on them and they make a difference of 3 xtra hours sleep and sleep comes faster on them than zopiclone. Im glad you brought this up as this is important. What do you suffer from? BEA.

  • I also slept fantastically on them, even through the most stressful period of my life I got a solid 8 hours! It's a god send for some pain sufferers to get a good night of sleep :)

  • Hi ..have scoliosis in lumber region, widespread OA and had a mild stroke which has left me with a slight limp but awful right thigh pain...have good days and not so good where i can only go a a snails pace..but getting more than 3 hrs sleep is my goal at the moment so will trial the amitryptline ..

    Best wishes to you


  • Are you getting physio? What about mobility aids?

    I used to hate using crutches (embarrassed to leave the house). Now, I kind of like them. I can get around easily, and probably have more mobility that some overweight people (they're also great exercise). You can even get suspension (really helps with shoulder/ arm pain).

  • Yes i use one crutch and on really bad days, two. And yes i am able to lots of leg swings with them throughout the day to try and stretch muscles. I've had intensive bouts of physiotherapy but found that it didn't relieve pain and sorry to say caused more...

  • Hi Bea61, Amitriptyline was originally designed for depression and is in that class but has been found to help pain. It is just used "off licence" and has been used for pain relief for decades. Pain Concern have produced a great leaflet:

  • I've been using a 25mg dose for about 6 years, to be fair I don't notice any difference with my pain but I have it with 2mg slow release melatonin.

    (for hypermobility spectrum disorder and insomnia)

    On days where I have done a bit more than I'm supposed to together they knock me out in about 30 mins. I have been told that I may not notice the pain difference, only when I've come off it for 2 months I did, it was alot worse without them.

    It's usually used before they try you on stronger muscle relaxants, like anti epilepsy medication.

    You don't notice a difference after 3 months return to your GP and discuss other options. (I say 3 months because the medication needs to build up in your system)

    I hope you find the relief you need soon, you have had a bit of a roller-coaster with you health, I know that it's like to be in constant pain and just wanting to be functional.

    Best wishes

  • Thank you and Best wishes to you too.


  • Amitriptyline is a tricyclic, likewise imipramine. They were both designed initially for purposes other than depression, but ssri's are now favoured as an overdose of ssri is not so harmful as a tricyclic. The one you have been prescribed is more commonly used for pain relief and a sleep aid at low doses, so you should find some benefit. By the way, imipramine is a very effective antidepressant ... and it was originally designed for bed wetting too.. so don't be put off by it's other uses. Best way is to try and see. Both citalopram and amitriptyline raise serotonin levels so be very careful to stick to the low dose

  • Hi! Thank you for your comments...I had one tablet last night and was still awake several times with pain..suppose i have to let it get into my system before seeing any results...

    I wondered why i need to be careful about sticking to the low dose? I am not medically trained so perhaps you can enlighten me....

    Also, i am rather heavy at the moment, since being on Pregablin for 9 years, i have put on nearly 3 stone...despite quite healthy eating..its the lack of exercise -tried swimming put not confident and have difficulty getting into the pool and i will not use a hoist - sorry if that offends anyone...

    I am also interested in whether GPs/Hospital Clinicians take this into account when prescribing meds...surely if you have more body weight you would need a higher dose of medications than say someone who is lighter who perhaps would get a better result from the low dose of any meds...Hope I am making sense!!

  • Hi the low dose is because both raise serotonin... and too much serotonin is a bad thing, it can make you very ill! . But where you already taking citalopram, the secondary one , in your case amitrip, just happens to be another antidepressant. So Doctors have to exercise caution.

    Perhaps you should raise your query about dose V weight with the people who prescribe for you. I'm a bit of a light weight and I'm drug sensitive

    The pain meds you've been on, together with citalopram are probably contributing to the weight.... it's a pity you don't do the swimming, it's very therapeutic... what's the problem with the hoist if you don't mind me asking?

  • I too take Amitriptyline, and for the first time in years I can sleep despite the pain of CRPS/RSDS. I do hope you take these as your doctor prescribed because they will make your life so much better.

  • what are the side affects in the beginning of taking amitriptyline if you don't mind me asking.i have them but scared to take them along with mirtazapine.

  • Side-effects mentioned here:

    I think the commonest is dry mouth.

  • Hi Bea

    I have been taking amitriptyline for at least 12 years for pain it doesn't kill the pain but it makes it easier to sleep and work full time.I am 63 and suffer from fibromyalgia, arthritis and have had cancer in the last year but I get up every morning and look forward to a new day and new experiences so try the tablets and stay is to short ,so live your life and love your life as you only get one


  • Hi Bea

    I was prescribed Amitriptyline around six years ago. I take 2 X 10 Mg tablets every night. I have Scoliosis in my lower spine. At first I didn't really understand what was wrong. I thought I was just a bit "achey". After months of diminishing sleep to the point of reaching only 20 minutes per night I went to my doctor. One very quick Adams Forward Bend Test later and I had my diagnosis. I had also lost two inches in height. It is the crumbly pads/ degenerative kind of Scoliosis I have. I didn't fall off a horse, have a car-crash or slam a bike into a wall. It was just a gradual thing and I never saw it coming or even realise what it was when it arrived!

    I have found that awareness of posture really helps. Careful how you sit. The Amitriptyline REALLY helps me. I sleep pretty well most nights. It is a cumulative drug, so keep taking the prescribed dose and let the drug's effect build in your system. The pain never goes for me I'm afraid, but the drug sorta numbs the acute edge of it and allows me sleep. I try to avoid painkillers through the day but occasionally resort to Ibuprofen 400mg or Co-codamol 500/8mg.

    I take my two Amitriptyline tablets around 45 minutes before bed and I read every night in bed. I keep a good supply of good reading by my bedside should I wake and not get back over to sleep. If that happens I don't beat myself up about missing sleep either, I just accept I'll be a bit tired! Stay off the wine as Amitriptyline doesn't go well with Alcohol. I wish you luck and a bit of restful sleep when it comes. Be good to yourself.

  • Thank you Lanark,will persevere but do worry about the other meds i take Co codamol, pregablin,statin etc but will do anything to stop waking up every few hours and having to crawl out of bed to relieve the lower back pain and stay upright for some time.. Always have one-two cushions at my back and use an ergonomic chair at work..have had to go part time and this has impacted on finances greatly but feel staying in work although a challenge is good psychologically.

    Hope you continue having better sleep and my sleep pattern improves!

    Best wishes