amitriptyline and other TCA anti-depressants (sleeeepy)

[mrandmrspoves]

I have been on Amitriptylene for about 6 months for chronic shoulder pain. I increased my dose weekly in 10mg increments and at first I felt like a zombie - to the degree that I took the bus to work as I felt unsafe to drive. Prior to starting the Ami I was only getting about 4 hours sleep at night - so at first I had lack of sleep and sedation. I maxed at 40mg and have had partial relief of my pain and now tolerate the side effects ok - so may ask the dr to push my dose up again.
it may be psychological - but since starting the tabs my average mph has dropped by about 4mph and I just can't seem to get it back.
Overall though, I have found the Ami benefits far outweigh the negatives.......and one advantage is I used to wake 2-3 times a night for a pee, and now I don't (I mean I can wait until morning - not that I pee the bed and sleep through it!)

 

[Boredtotears]

Hi, I take ami nightly 5mg to keep my migraines under control, I found taking it early in the evening, (once I was in and not needing to go back out) made it easier to get up on a morning.
Speak to your doctor thou, hope you get it sorted. I rarely have any migraines now

 

[RichK]

Was on 10mg for a while & found timing was important. 3 hours before bed... would then be OK in morning. Take it later & it "the hangover effect" (as my GP described it) would really kick in.

 

[numbnuts]

one advantage is I used to wake 2-3 times a night for a pee, and now I don't (I mean I can wait until morning - not that I pee the bed and sleep through it!)

Amitriptylene is also given to children to stop bed wetting.

 

[fossyant]

Looks like I might be going back on it as it seems the only option I have for my pain. The tramadol is way too strong with side effects

 

[doog]

I have been on amitriptylene for about 18 months. I've had two spinal surgeries and these things are brilliant. Im not the only one who thinks they are, many people in the health profession dont have a bad word to say about them.

Im only on about 10/20mg a night, simply to get me through that 4am back pain. As stated above it does prevent you from going to the loo in the night which is a bonus. I have heard in that in much larger doses they were used as an anti depressant ? On my low dose, there is no difference...im still a miserable sod

However its important to take these tablets 12 hours before you want to get up, or you will feel a bit like a zombie......not much just slightly 'detached'....

 

[doog]

Looks like I might be going back on it as it seems the only option I have for my pain. The tramadol is way too strong with side effects

Have you tried diclofenac or Naproxen for your nerve pain ? Takes about 5 days to kick in . I didnt do well with Tramadol, although gapapentin worked better I think they are both for drop dead type pain, similar to morphine / Oramorpth.....short term / high impact and you suffer the side effects. Long term both diclo or Naproxen plus amiltriptyline at night have done the job..

 

[fossyant]

Not so sure if it's nerve pain, but Ami, Gaba, and pregablin all treat pain for a longer term. Not happy, but I'm not getting any less pain from my under carriage and it's been suggested a few times. Back to the consultant on NYE so hope to have a way forward. Tramadol is, as you say, short term fast impact, although the pain has been that bad, it's only just took the edge off. I've been terribly dizzy all day and only just coming round as I haven't taken any since breakfast.

I can't carry on using the tramadol, and ibuprofen and paracetamol aren't cutting it. I'm also unable to ride now.

Got to keep the Ami dose low though this time as it sent me doo-Lally last time.

 

[roadrash]

good luck, i feal your pain (so to speak)

 

[mrandmrspoves]

Not so sure if it's nerve pain, but Ami, Gaba, and pregablin all treat pain for a longer term. Not happy, but I'm not getting any less pain from my under carriage and it's been suggested a few times. Back to the consultant on NYE so hope to have a way forward. Tramadol is, as you say, short term fast impact, although the pain has been that bad, it's only just took the edge off. I've been terribly dizzy all day and only just coming round as I haven't taken any since breakfast.

I can't carry on using the tramadol, and ibuprofen and paracetamol aren't cutting it. I'm also unable to ride now.

Got to keep the Ami dose low though this time as it sent me doo-Lally last time.

Good luck in getting the pain sorted. If Tramadol works for the pain but has too many side effects you may find a slow release form helps. Alternatively Codeine Phosphate +/- Parecetamol can be useful in tailoring the dose as you could go anywhere from 8mg, 15mg, 30mg or 60mg up to four x daily.
Another possibility would be transdermal patches of Fentanyl or Buprenorphine or similar.

 

[roadrash]

fentanyl patches are brilliant for me

 

[fossyant]

Patches sound a possibility. Currently in bed as I feel so dizzy and due my next one soon. I only view tramadol as short term. I am back in work next week.

 

[vickster]

Fentanyl is a pretty hard core opiate. I think you'll need a pain specialist to initiate, not a GP. If under pain management, you could also ask about oramorph (and a stool softener!)

 

[fossyant]

Started on ami. Bollock has 3 month stay of execution. If not setting by April, chop chop.

 

[vickster]

Ouch, hope it gets better!