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Anyone get pain relief from low dose of amitriptaline or nortriptyline..elavil/pamelor.


I have generalized and provoked vulvudynia,pelvic floor dysfunction, muscle spasms and referred pain in my abdomen and perrinal area. I've already tried neurontin,cymbalta,septra,uribel,diazapam,doxycyline,tramadol,vicodan,percoset,diflucan,lidocaine,ketamine compound,baclofen/baba/lido compound, herbal remedies, pt, coccyx block, xanax, Zoloft,. I'm now on the last antidepressant drug class,tricyclics. If this don't work im out of luck. Anyone get pain relief from meds in this class..if so at how long did it take to kick in and at how many mugs? Thank you for responding and any other suggestions welcomed.

16 Replies


Yes I find its the only way to guarantee I have pain free days for my illness. I take 10mg each morning. I would advise you to go on nortriptaline as amitriptaline causes extensive weight gain in most ppl. I put on a stone in 3 weeks and months down the line I still trying to lose it. I had no weight gain with nortriptaline though.

juliansmom in reply to Toots29

I've been taking twenty mgs. Of nortriptaline for eight days. I'm supposed to work up to thirty over the next two weeks. Do you remember how long it took before you noticed a decrease in your pain? Thank you for responding.

tigerlilly6 in reply to Toots29

I put on loads of weight can't get it off was on 200mg every night pain worse since stopping it will ask about Nortriptaline thanks Sarah.

I'm so sorry that you have gone thro' such a bad time. You seem to have tried so many medications. I don't know the technical side of medication but I am on to my fourth and it seems to be working. I have Pudendal Neuralgia following a botched operation last year. I started out on amitriptaline, which didn't help at all; then went on to tegretol and that helped for a while but then I started to react badly to it so came off that. Then my GP tried gabapentin but again it didn't work for me, so now I am on pregabalin and after tweeking the dosage I have found some relief.

I think as with all medications, including herbal and 'traditional' therapies, we all react differently and need to find what is right for us. Just now this is working for me but it may not in the future as my body chemistry changes. I do wish you all the best in your search for peace and a pain free life. i would also add that I have had very good support form a physiotherapist and now a GP both of whom use acupuncture to help relax muscles and ligaments that tighten up and cause more pain. I don't know if this would help you but it's maybe worth looking into.

juliansmom in reply to juliahall

Thank you for responding. I've had very bad reactions both mentally and physically to neurontin and cymbalta and to the pain killers as well. I haven't tried acupuncture yet. How much pain relief do you feel you are getting from that. I could not tolerate the internal myofascial muscle release; it was way too painful.

I think around 2-3 weeks until I saw a marked difference. I do however take my medication in the morning rather than at night like most people do. For me this works so much better as I can function during the day.

I was on a lot of medication at one time but now I just take imipramine and found some of my other medications were making my illness worse, I have pfd and interstitial cystitis. Have you looked at the foods and drinks you are consuming? It may not be a factor in your illness but it plays a huge role in mine. Good luck.

juliansmom in reply to Toots29

I have vulvar pain and burning and bladder and urethral spasms and pelvic floor tension. My diagnosis is vulvoynia but because of my bladder issues I follow the ic diet religiously and it keeps that part of my pain at bay. Unfortunately I have not been able to control my vulvar or urethral pain yet. I agree many meds I have tried made my condition worse.

For me acupuncture really helps as my thigh and buttock muscles were tightening up in response to the nerve pain in my pubic area. The needles are placed in my buttock and down the outer thigh, and sometimes at my knee. I feel that it helps but of course I can't prove it as I am also on medication, so it may be either or both that are working for me. As for the tablets, I now take two 75mg morning and again in the evening with the option to take one or two thro' the day.I have only done that once. It took about six weeks on this medication to find the right dosage for me, but I have had the problem since April 2012 and have been trying all the other tablets.. I did foolishly take only one tablet one evening because the pain had just about gone and I felt great so thought I could start to reduce the dosage myself; silly me! I was in a lot of pain the next day so I won't be trying that again for a while. As my GP tells me, this kind of medication needs to build up to be effective. The one problem I have is that I can become constipated and I find that means more pain so I take Laxido drinks for that. I hope this helps.

Thank you. I have constipation from meds causing me addition abdominal and anal pain as well. I will look into acupuncture and the laxido drink. I have muscle spasm down my left buttock and leg as referred pain from my pelvis. I take flexaril for that pain and find it works really well.

I have tried the meds you mentioned and got no relief from amitriptyline or nortriptyline. Both of these meds tend to make me very nauseous and without a hint of pain relief. Good luck on your search for pain relief.

I have pudendal neuralgia and vulvodynia and amitriptyline stopped working for me. I am now on 600mg pregabalin which reduced the pain from the first tablet. I felt very drunk and was acting silly for the first six days but now have no side effects at all.



I have vulvodynia & had muscle spasms in back, legs & buttocks. Notriptyline at 10mg per day helped with the burning vulvodynia pain (I tried amitriptyline first but couldn't tolerate the side effects). For me it started reducing the pain after about 4 days. With the muscle spasms physio helped me & also reduced the vulvodynia pain (she didn't do any internal work - just external trigger point release - I was riddled with trigger points). Plus doing stretches at home.

Have you tried lidocaine cream - it may help (didn't help me but I know it helps some women) - works by numbing the area.

Good luck x

juliansmom in reply to SusieQ100

Thanks for responding. I can't find a physio. That accepts my health insurance in my area. And I also was not able to get any relief from lidocaine gel or ointment though many women do. My body seems to resist every effort to heal of course...I do stretch a lot at home.

I have the same thing as you. Ive tried so many medications and nothing works for me so far except exercise and tramadol. Im on notriptilyne again, as I was on it a year ago and stopped beause of a seizure. Now it seems to be creating urinary inconsistency and worse pelvic floor tension...but I haven't even been given an accurate diagnosis

This is an old post. The nortriptyline gave me about a 50 % reduction in pain depending on the day. I'm sorry it caused you seizure. I'm on 40 mgs. And won't go higher. How many mgs. Did you go up to? I also take tramadol for bad flare ups because it hurts my stomach if I take too often.

I'm on lyrica now. It's definitely helped with anxiety related to my pfd. I use a nasal aspirator I bought at a natural foods store and I mix natural baking soda with water and clean myself with it after I pee. Keeps the burning away. It really works! I think the key to this beast is relaxation techniques and medical pain management. Lately I've had frankehauser injections and they seem to be making a difference.