90 plus resting heart rate taking amytriptyli... - Pain Concern

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90 plus resting heart rate taking amytriptyline 10mg for pain what is alternative drug that does not cause tachycardia?

lovedoncebefore profile image
18 Replies

Hi everyone I've been on amytriptyline 10mg for fibromyalgia and chronic pain several back & rib issues ..osteoporosis tmj the list goes on. I have been suffering for months with tachycardia and now pericardial effusion which I have read can be caused by amytriptyline. It has helped the pain but now with the heart issues it's time to come off of it. I have reduced to half a tablet to avoid any withdrawal issues as I am really sensitive to medications and even vitamins.

I have auto immune oral lichlen plantus.

Can anyone recommend an alternative to amytriptyline or recommend Duloxetine ?

I am researching the best alternatives especially at my age of 61. Amytriptyline never really helped my insomnia but did help the pain however the serious heart side effects are really worrying.

Would anyone recommend Duloxetine?

I use lots of topical remedies Inc hot water bottles and take tramadol ad hoc but I try not to take the tramadol it doesn't really help my pain much leaving me with severe dizziness and nausea. It's a shame the amytriptyline is causing heart problems because it definitely helped me manage my pain.

Happy new year to everyone x

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lovedoncebefore
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18 Replies

Do you by any chance have high blood pressure? My wife's heart rate is very low at around 45-50 bpm. We have discovered that it's most likely the Metoprolol BP medication she takes that is the main cause of the low rate. I ask about your BP because if you are taking something, maybe you could switch or even if you don't have high BP, you could maybe get on it anyway as a method to slow your heart rate. I would ask a cardiologist.

lovedoncebefore profile image
lovedoncebefore in reply to

Thanks so much for your reply. I have normal bp at the moment 130/78 it used to be on the low side before taking amytriptyline. Even though I have tachycardia and pericardial effusion on echogram my gp doesn't seem bothered and discounts my request to be seen by a cardiologist. I have researched myself and seen the many negative reviews with regards to amytriptyline affecting ones heart rate. I have been taking amytriptyline for one year and the high heart rate sometimes 124 started after 8 months or so. I have asked my gp to change me to duloxetine. I shall await their response from my e consul that I put in this weekend. Really hard here in the UK to get to sit in front of a gp all online it seems these days.Thank you again for the recommendation.

Happy new year to you and your wife.

Bevvy profile image
Bevvy

I am on duloxetine and have been for almost a year. I take it following spinal surgery for residual nerve pain. To put it simply I wouldn’t manage without it. Am on full dose but noticed a difference with smaller dose almost straight away. I take Tramadol for breakthrough pain but that isn’t every day or even every week!

Of course the medication doesn’t take away all the pain. Nothing could do that but it just makes things more bearable.

lovedoncebefore profile image
lovedoncebefore in reply to Bevvy

Thank you for your reply.Let's hope my gp sanctions my request to change to duloxetine. I too take tramadol every now and then I don't want to become dependent on tramadol plus it doesn't help the pain as much as amytriptyline.

Happy new year

Bevvy profile image
Bevvy in reply to lovedoncebefore

My gp was surprised at my request because it is unusual for nerve pain. I’d tried common medications but they didn’t help. It was a spinal cord specialist nurse who suggested it and like I said for me it works! I take amitriptyline at night and that certainly helps with sleep.

I wish you a happy new year and a reduction in pain!

lovedoncebefore profile image
lovedoncebefore in reply to Bevvy

You too. Thank you x

cyberbarn profile image
cyberbarn

My son is on amitryptline for nerve pain, and the GP tried to change him to duloxetine. Disaster! He went back to amitriptyline.

Everyone is different, everyone metabolises drugs differently. So you won't know until you try one.

I wonder if it is worth asking for a referral to the pain management team. They should take a broader view and make recommendations that will take everything into consideration.

lovedoncebefore profile image
lovedoncebefore in reply to cyberbarn

Happy new year and thank you for your reply.If amytriptyline did not affect my heart rate I would stay with it but unfortunately it does and that is a big red flag. I am still waiting for a reply from my gp with regards to changing to duloxetine. I have been waiting for a pain management appointment for over a year so I'll chase that up. I hope your son is doing well on the amytriptyline.

Helly666 profile image
Helly666

hi I have been on duloxetine 60 mg for three months . I love it makes me feel happy as an antidepressant painkiller in one. Have option to take two 60mg a day but only need the one . I also take cocodamal 2 in morning naproxen and omeprazole . I find taking the duloxetine effective at nighttime. Also have fibro arthritis.

lovedoncebefore profile image
lovedoncebefore in reply to Helly666

Thanks so much for the positive feedback on duloxetine. I hope it does the same for me too. 🤞Happy new year & thank you for your reply.

Shadowperson profile image
Shadowperson

I took tramadol for years for cervical and lumbar pain---cervical fusion (C3-7) and lumbar/sacral disk(L4-S1) issues. I get rhizotomies every 12-14 months to help with the nerve pain. When I went on clonazepam for sleep behavior disorder the doc dropped the tramadol and my neuro MD put me on duloxetine in lieu of the tramadol. It seems to be doing its job. I take meds for blood pressure and blood cancer. I am 76 yowm. Not sure how that might play into the scheme of things. I am told the meds I am on are with me to the grave---which could be any time between now and 2034, all else being equal. Think positive. Everyone says exercise is quite helpful, in moderation of course. I also take meds for IBS and GERD. Cyclobenzaprine helps now and then with the flu-like pain of fibro. And then there is the promethazine for the nausea. HA! Go figure. Good luck and hang in there. Wish I had better news. Don't forget about the good Lord---he is listening all the time.

lovedoncebefore profile image
lovedoncebefore in reply to Shadowperson

Happy new year & God bless 🙏 Thanks so much for your reply.

Thats good news the duloxetine helps you with the pain. Tramadol isn't that great for pain relief. It's never an easy road with prescription medications trial & error and the hope not too many side effects take hold. I do my best to stay positive and I keep my appointment every night (my prayers)

Sometimes one wonders why we have these health issues when others much older do not but I suppose, it just makes us stronger.

Let's hope 2024 is a healthy happy year 🤗

Trille profile image
Trille

Dear lovedoncebefore. I'm sorry to hear that a drug which helps you is now giving you intolerable side effects. As a 60 year old woman who has suffered chronic pain and severe daily migraines since childhood, I know it can be life changing to find something that really works for you in the daily (and nightly) management of pain.Do you have a GP or consultant who could perhaps advise you on alternative tricyclic anti-depressants that may have the same effect on your pain as Amitrypteline, but do not give you the side effects? Of course, you may well have been down that route already, to no avail.

I cannot take Amitrypteline or other similar drugs. What has helped me, over many many years now, to better manage my pain is the anti-epileptic medication Topiramate. Topiramate, taken daily as prophylaxis, does not make me pain free - by no means; but it does put a dampener on the pain so that I am - at least some of the time - able to relate to, and address constructively, my pain (rather than the pain just taking full control).

This may not be of any use to you, but I thought I'd mention it. - Not least because it is only the daily Topiramate that 'restores' sufficient clarity and focus for me to be able to do the other things that I need to do to manage my pain (e.g. mindfulness meditation, pacing, spotting and avoiding triggers, and that sort of thing).

I hope you find a way.

Look after yourself.

Anna

lovedoncebefore profile image
lovedoncebefore in reply to Trille

Happy new year Anna

Thank you so much for your reply.

Unfortunately here in the UK it's so difficult to get a face to face appointment with a gp.

I have been waiting over a year for an appointment with the pain management team.

Topiramate looks very intriguing. I will research more today but I do have osteoporosis and narrow angle ...not glaucoma as of yet but on a yearly monitoring with Moorfields eye hospital. Unfortunately I have several health issues which makes things a bit more frustrating when it comes to prescription drugs. I do try herbal natural remedies and spend a small fortune looking for some relief of my pain and fatigue. Here is what I found on drugs.com on topamax it's a review left with regards to pain relief.

Topamax (topiramate) "I was put on Topamax 2 months ago after a serious car accident that left me in a flare up of my fibromyalgia. I have not reacted well to medications in the past and have had serious reactions which lead to serious consequences to the other meds I was on. Topamax has been the only medication that I have been able to tolerate well. It does take a while for it to start working though and I have had a few side effects but none that I'm not willing to put up with and 2 of them have gone away since I have started the Topamax."

I will definitely look into topamax it does look very promising. I have never heard of this drug for the treatment of fibromyalgia. I am still waiting for my gp to get back to me about changing to duloxetine from amytriptyline.

I hope I hear back from my gp by the end of the week so more time for me to research the topamax. Thank you so much for writing back and providing the information on topamax.

I hope you stay well and pain free..🤞 and let's hope for a healthier happier new year. 🙏🤗

Trille profile image
Trille

... and Happy New Year to you :)I know that NHS primary care services are inconsistent and patchy, to put it mildly, and I am lucky to have an excellent GP and to have been seen by the pain management clinic, several neurology departments, and psychiatry/psychology in Oxford where I live.

I have also been to other hospitals/consultants in the country - specialist services caring for one or more of the many 'co-morbidities' that plague me. You write that you, too, have different health issues. As you know, this complicates matters (and, in my frustrated and life-long experience, it also makes a certain type of doctor very unhelpful). But it does also mean that it may be perfectly reasonable for you to seek out specialist services in different areas of the country and ask your GP to refer you there. Maybe that is something you could consider?

As regards side effects of Topiramate, I had some initial loss of appetite, but it wore off after appr. 3-4 months. Other than that, I tolerate it very well.

I do hope you find a way forward.

... and you're always welcome to contact me if you have questions, you think I might be able to help with, or if you just fancy a text-chat :)

have a good evening

Anna/"Trille"

lovedoncebefore profile image
lovedoncebefore in reply to Trille

Good afternoon Anna

I hope you are well. Well I managed to speak to a gp yesterday who didn't even check my history so I was having to explain all my heath issues which is just so frustrating. At the end of my phone call I was confused. The gp said oh we don't prescribe duloxetine for fibromyalgia...I said well there are lots of reviews on drugs.com with regards to its use for pain and fibromyalgia. I mentioned Topamax also but got no response with regards to it. I think he was looking medications up on the Internet as we spoke.

Anyway cut a long story short he eventually prescribed duloxetine 30mg and I am to call them in 3 weeks for a review. I must say you are so lucky to have a good gp with access to so many other specialist. I remember asking my gp for a referral to a specialist out of London some months ago but I was told that we (the gp )are not on their picking list and abruptly that conversation was ended.

I am still waiting for pain management to contact me about an appointment I have been waiting over a year. Yesterday and today my pain is through the roof so I am not in A good place right now. The pharmacy said the 30mg duloxetine is out of stock and must be ordered so I just hope I dont have to wait too long.

Wish me luck 🙏

I hope you have a lovely weekend and yes that would be nice to chat sometime 🤗

Graffiti profile image
Graffiti

I am prescribed Pregabalin which helps my pain. Tramadol affects me very badly. I add in Cocodamol if I have a bad day. I hope you find relief.

mauschen profile image
mauschen

I have been taking Duloxetine for 8 years now. It was prescribed by a neurologist for spinal pain and neuropathy.

As someone else mentioned, the fact that it has antidepressant properties is a bonus because as everyone who has ever experienced nerve pain knows, the debilitating symptoms of nerve pain negatively impacts psychological stability.

I found that my initial 60mg dose was very helpful however, I had to reduce to 30mg because one of the adverse effects of Duloxetine is hypertension.

Obviously, I don’t derive the same benefits on 30 mgs as 60 mgs but I feel that it helps, whether or not the effect is psychological, I don’t know.

I take Bisoprolol 5mgs for a fast heart rate however, my comorbidities and yours will be different . Duloxetine might not be suitable for you which is why it is important for you to discuss your suitability with your GP or consultant.

When my mood improved, so did my appetite for exercise. I attend an Aquarobics class 2-3 times per week which really helps to manage my pain and mobility.

I wish you well.

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