Post Stroke Pain and Numbness

[mstrmind10]

My mum had a stroke recently and she now has some numbness and pins and needles in her right side. As I understand it this is post stroke pain or neuropathic pain.

3 weeks ago the doctor took her off her the 30mg citalopram and put her on an initial dose of 10mg of amitriptyline. Her anxiety and depression started to get worse, to the point where she seems clinically depressed. After speaking to the doctor today, he increased the amitriptyline to 20mg. She is also taking 5mg of zopiclone to help her sleep at night. I have yet to see any improvement in the numb feeling in her right side, though it might be early. What I have observed is that her mood hasn't yet improved with the amitriptyline, but recently it does about 30 minutes after she takes the zopiclone.

Anyone taking amitriptyline for post stroke pain and could share their experience?

How long should we continue with it before trying something else?

How can I tell what symptoms are from citalopram withdrawal, depression or side effects from amitriptyline?

Thanks.

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Dear mstrmind10

I am a chronic pain patient neuropathic. That level of pain needs an opioid or Tramadol type of medication. She will also need a epilepsy type drug to work with it. Rivitril at 2mg with possibly 10mg Tramadol might be a good start, You will be able to tell if the dose is working for her. She will be less vocal or aggressive. I don't think the amitriptyline should be stopped. Neuropathic pain is dreadful, like giving birth every day. Advocate for her, if her Doctor will not cooperate then look for one that will. Your mother is not going to become addicted to these drugs and it is foolish for Doctors to think that. Tell hi that you have research her condition and that you are confident in the medications you would like her to try. They are not high doses at all. I have to aging parents in their 90s and it breaks my heart when I see the dementia patients in dreadful pain and no one who gives a dame. Do some research and stand up to your Doctor. Tell him you are not sure if the dose will be enough but that is the dose you would like her to start on,

Good luck and God Bless you. I am not a Doctor so speak with professionals who can help you but at least you have a base to start speaking with them about.

Anna

[PainConcernHelpline Moderator Community Champion Pain Concern]

Dear mstrmind10 ,

Thank you for your post and sorry to hear that your mum has been unwell after her stroke. This must be difficult for the both of you, but she is very fortunate to have you by her side.

I understand that her doctor has prescribed amitriptyline for post-stroke pain, but as she started taking it her mood has declined.

I was wondering if your mum thought about seeing a therapist at any point? It is of course possible that the medicine alone is what is not really working for her - but it would also be understandable if she felt depressed or anxious due to having been through a major, life-altering experience that still has its negative effects on her life.

It sounds like you are doing a fantastic job in keeping in touch with her doctor and monitoring her well-being. If it appears to you that the medication is doing more harm than good, it is certainly something worth to keep bringing up with the doctor and perhaps start discussing alternatives.

But if your mum keeps feeling unwell, it would be worth looking into processing all she is (and perhaps you are) going through with a professional therapist. Your doctor may be able to help with a recommendation.

In any case, if you would like to understand more about the type of medication your mum is taking, we have a great leaflet on amitriptyline here painconcern.org.uk/amitript...

We also have other online and printable materials which may come useful in understanding more about her condition, for instance one on neuropathic pain here painconcern.org.uk/neuropat...

Hope that your mum will feel better soon, it sounds like she has a wonderfully supportive child by her side.

Wishing you the best,

Moderator 3 on behalf of Pain Concern