amitriptyline and other TCA anti-depressants (sleeeepy)

[Melonfish]

Tricyclic anti-depressants appear to all have a similar affect on the body, which is shortly after taking them you are asleep whether you are standing or not. they don't half knock you out, however it is the morning after that i'm seeking advice on. has anyone got any experience with them?

I've been off the bike for a good 4 months now, at first i thought i had labyrinthitis (turning into david bowie wouldn't be all that bad i guess) and so did the doc, but as it progressed it eventually turns out i suffer from a form of migraines known as Vestibular migraines (lots of investigations have been done, MRI, specialists etc etc.) in essence i'm drunk without being drunk, at least when i have an attack, which are frequent without the meds.
i have been prescribed 20mg of amitriptyline nightly which is an anti-depressant the way it works is by inhibiting serotonin absorption in the brain so you have more happy chemicals knocking around rather then being soaked up by your receptors and leaving you feeling like a deflated balloon full of the blackest black times infinity, the knock on effect of this is it prevents migraines, they don't know why but it does. all i know is it stops me from falling over and i'm not depressed about all the lovely foods i can't have anymore (trigger foods such as chocolate and caffeine!)

ok, the side effects are well known, you take them at night as they make you sleepy but the morning after is like waking up after a night drinking, it is Really, REALLY hard to get up which for me is a polar opposite to how i was before, i was usually awake before the alarm, i am now increasingly sleeping through it.
so i'm groggy in the morning, less alert, my hope is that jumping on my bike in the crisp air and dicing with the morning traffic will awaken my brain like it did before i was taking these, i do find that i am a bit zombie like for a while and you can imagine my trepidation of cycling 7.5 miles in the morning against idiot drivers.

has anyone got any experience of cycling on these meds and can they offer advise?
thanks!
Pete

 

[fossyant]

I have and will post more later when near a keyboard. It wasn't good for me.

 

[fossyant]

Right then, found a keyboard.

I was prescribed Ami for nerve pain in my left arm. This was during the time my shoulder was mashed from a RTA. Anyway, a few months after having my shoulder decompressed, I was still getting nerve pain. The Doc recommended trying Ami, so I started on about 20mg, building upto 60mg over a couple of months. Main side effects for me were dry mouth, and feeling like a zombie. As the dose increased it was imparing my ability to think straight, not great when your job is 'mentally challenging'. To top it off, I was out on a training ride that I'd done a couple of months earlier pre medication. On one climb I was taking it relatively steady, but my HR was maxing out. When I got home I compared the data from both rides side by side, and sure enough my HR was running 10 bmp higher for the same level of output. This got me worried.

I decided to come off them, but I went cold turkey, thinking that 60mg wasn't much. That was a mistake as I was violently sick. Went back on them and came down over a number of weeks.

The doc then tried me on gabapentin, and my god, it was like geting a frontal lobotomy. Felt like someone had slapped me hard on the forehead. Stopped these promptly.

I was undergoing physio at the time, and the physio found tightness in my left hand side (trigger points) along the spine and in my trapezius. Long story short, pain clinic agreed to try steroid injections in the trigger points. My trapezius needed two injections to get it to come out of spasm. They worked. The main issue was the swollen trapezius pressing on the brachial plexus nerves, and in turn causing pain in my arm and hand.

I've been offered Ami again recently for my plumb problems, but I told them to shove it ! In my case the side effects were worse than the pain.

 

[numbnuts]

I'm on 75mg amitriptyline at night been on them for years after damaging my spine

 

[roadrash]

600mg gabapentin 3x daily and 50mg amitriptyline at night but combined with 50 microgrammes an hour fentanyl pain patch ,for spinal damage, was horrible at first for reasons as mentioned by @fossyant, got used to em now though , no longer any bad effects

 

[fossyant]

Flippin heck !

 

[SatNavSaysStraightOn]

yep - used to be on a large dose of it (75mg first thing am, 125mg a night, plus tramadol (2 & 50mg 4 times a day for pain) and sleeping tablets as well (under a psychiatrist and pain specialist at the time)) - for chronic pain after an arm injury damaging the nerves in my left wrist leaving them over sensitive to pain - needed 11 ops before the pain was manageable. The injury itself is what left me slightly paralysed down my left side of the body after trapping the spinal cord in the neck.

The following day always interesting. I would wake up bright and breezy, manage about 60-90 mins and then it would hit me and I would find myself 'falling asleep' no matter what I was doing. It would also leave you feeling dizzy and spaced - coherent thought was not great and conversations with people during the 'dizzy/sleepy' period were not an option. Coming off ami was hard, seriously hard and had to be done slowly because of the dosage I was on - I quit my PhD (organic chemistry) because I could not manage it with the meds. Been back on it once since (for pain management) and won't do it again if I can avoid it.

 

[Melonfish]

Ok, so i should basically MTFU and get on with it hah. crikey some of the meds you guys are on i couldn't imagine functioning and here i am whining about feeling groggy in the morning from 20mg of amy!

 

[Bam]

Have you tried taking the Ami earlier in the day? when I was taking it at bed time felt like a Zombi for a couple of hours after I got up in the morning, so I started taking it around 6pm and seemed to be a lot better in the morning.

 

[e-rider]

I take 50mg Ami for nerve pain daily - dry mouth often, and occasional sleepiness but nothing major.

 

[dan_bo]

About 8 years ago I had an ami on a sunday afternoon. Came to wednesday teatime. Avoid if poss.

 

[tuffty]

I was given 20mg of ami as a muscle relaxant for a very stiff and painful neck. Its only an anti-depressant in larger doses - I was told 100mg up - at 20mg its just a mild muscle relaxant or should be (can see why that would work for migraines). I had no side effects at all and happily rode up the Tourmalet whilst on it. Sounds like maybe you are having an adverse reaction to it, might be worth a word with your doctor as I was told there were alternatives if it didn't work.

 

[roadrash]

some people react different to others, often when people hear what i take in a day they say bloody hell its enough to knock a horse out cold , but obviously i didnt start on such high doses, believe it or not,before i suffered spinal damage , a couple of paracetamol taken for a (rare) headache used to send me to sleep.

 

[MrPie]

Been suffering from 'migraine associated vertigo' for over a year now. Initially it was bloody awful and it took several months to diagnose. Cut a long story short, my neurologist prescribed nortriptyline as a potential remedy as ami and gabapentin meds are known to have intolerable side effects for some folks. Nortriptyline is better tolerated by most so it may be worth revisiting you neurologist. Started off on 10mg and increased in 10mg increments each week until I was comfortable with the effectiveness vs prophylaxis. I settled on 40mg taken at night.......after a couple of months the dry mouth disappeared and now all is well. I still have the odd migraine but frequency and intensity has greatly reduced.

I suspect my migraines started after coming off the bike in a chain gang at 25mph. There is a family history of migraines too but my symptoms are not the traditional flashing lights with headache, more supreme grumpiness, stiff neck and sleepiness with vertigo lasting up to 3 days. Vestibular exercise works too......the exercises are very simple yet very effective. I 'm now thinking of reducing my dose and finally getting off the meds gradually.

Don't let this beat you! There is lots of great information on the web with a bunch of support groups / forums for this condition.

 

[ttcycle]

If you're struggling with ami, speak to your doctor to see what alternatives there are as suggested above. Everyone responds to medication in different ways, I was put on it a few years ago and can remember the horribly sedating affects on the lowest dose so can feel your pain.

Hope you get things sorted.