Amitriptyline thread

[alice-emma-louise]

First day I took mine I felt dreadul and it took a good few days for the excessive drowsyness to wear off. And a good few months to adjust to the energy drain an hour or two after taking but now I'm much better and it makes the world of difference so it's definitely worth sticking with it until you get past the side effects.

Allie x

[pink]

I can definately notice the difference if been drinking substantially on a night (i.e. my hen nights / family weddings / the v v rare girls nights in the pub) and dont take it - my pain levels afterwards so its definately worth persevering with (for me anyhow).

[pretzel]

I went away for three days a couple of weeks ago and forgot to take mine with me, I only take a very small dose anyway but I noticed the difference, not on the first day but by days two and three definitely. Once I got home and was back on them again my dreams picked up pace massively and my sleep patterns became much heavier again. It really is worth persevering with for the difference it can make to how you feel.

[notsparklynow]

Hi all

Well I know it's only just about a week, but I don't know yet that it's making much difference. I get a sudden drowsiness 20-30 mins after taking it, but it's not as bad as it was on the first day! I'm not sleeping through yet - still wake up several times after I've been sleeping for 2 or 3 hours. And I'm way too sleepy in the morning. I don't know how much of that is jet lag or how much is my own fatigue or how much is the amitriptyline. But I do know that getting up at nearly 10am has to stop - I'm back to work on Wednesday and I need to be up at 7am at the latest. I will struggle severly I think. Do I need to / should I advise my employer about the medication (just in case I have a problem)?

The consultant told me that it could take up to a month for it to start having an effect, or that he could increase my dose. Does increased dose increase side-effects? The drowsiness is hard enough at the moment without making it worse. I find it hard to imagine (at the moment) how it can help me to get better sleep.

Anyway... I'll be patient and see what happens.
Keep your fingers crossed that I can retrain myself to get up at a far-too-early time for me next week!!

notsparkly

[Stone]

I've found that for me the side-effects stayed the same with increased dose, but the expected effects kicked in suddenly as I passed a 'threshold' dose. (not sure if he explained to you how to increase your dose; some consultants like to do this under supervision and others suggest you do it yourself, but don't fiddle if he didn't tell you to!)

You do need to keep at it for it to work properly as part of it is about getting into a new routine - this also means getting up at the right time each day and making sure you eat at regular intervals. I get up at 7-8 every day (having had the amitrip at 8 the previous night), have breakfast, lunch at around noon, dinner at 7:30 and bed at 10 - even quite small deviations from this cause me massive swings in pain/fatigue/concentration, but some of this will be autonomic stuff. Once you've got yourself into a pattern you can start to experiment a bit more I also set myself an alarm on my phone to remind me to take my pills - otherwise I usually forget.

If you think it will be a problem getting up then I would say it can't hurt to tell work - but it depends how nice they are. If I rolled in at 11 my boss wouldn't bat an eyelid but yours might In theory they can't hold it against you if it's a medical thing but obviously this varies, especially with small firms.

Hope it helps you, anyway

Stone

[Chloe♥]

Setting an alarm on your phone is a good idea. I rarely miss a dose, but that's because when I'm staring at the ceiling and wondering why I can't sleep, I realise I haven't taken it. Then I take it late and it takes forever to drift off and I wake up late tomorrow... Blah.

[notsparklynow]

Hi Stone

thanks for your reply. My consultant is seeeing me 4 weeks after I started them to see whether I need to increase or just continue with the same dosage.
Regarding my work (I'm a teacher) so they won't be thrilled if I roll up seconds before the first lesson, or worse not at all!

Good point about the routine - didn't really consider that. Well going back to work will get me back into my routine so that will help. I like the idea of setting an alarm for taking the tablets on time - my memory is shocking so I have been struggling to take them when I ought to.

I have started noticing a slightly heavy feeling in my chest once the drowsiness kicks in - is that a side effect or just because my body has been made to feel tired? Weirdly I've also noticed that I can't stand the smell of my electric air freshner a little while after I've taken the tablet, but it's fine during the day!
I guess I still have a lot to learn about how this affects me. typing is a much slower process...!

Thanks again.

[nonyanomemory]

hi I just wrote in a post that I was logging off as I have already written a post which I think may be somewhat pedantic so will make def log off after this post!

I cannot tolerate amitriptyine or dothiepen (sp) as they both unfortunately give me uncontrolled palpitations and other unfortunate side effects including urine retention - yuck.

However I am posting to say that my daughter who has EDS was started on a very low dose of amitryptyline and could barely stay awake during the day and also suffered with really bad dizziness. It was suggested she take the medication much earlier in the evening to avoid these side effects but despite perservering they did not abate. So she is now on a liquid dose via a papette? which even the prescriber couldn't quite believe but it was the pharmacists suggestion as she really has severe EDS and her specialist felt that perservering was worthwhile. She has been on this regime for some months now and it was explained that in order to see an improvement she must perserve. On this method the dizziness is slowly going but she is still struggling with the sleepiness. As with any med it is worth perservering if the side effects outweigh the benefits but she is still unsure that this is a med she can tolerate.

Most health professionals with a knowledge of hms do recommend this med so I think its worth giving it a go. I totally understand that you need to be alert for work in the morning. My son has epilepsy and when he initially started on medication the neurologist started on the lowest dose possible to minimise side effects very gradually increasing the dose.

My daughter felt silly initially telling the prescriber that even the lowest dose caused such problems but I encouraged her to be frank. So we shall see.

If she forgets and takes the med after ten o clock the next day is a write off.

I wish you luck and hope efficacy improves and side effects abate asap.

Kind regards nonya

[leashy11]

Does anyone know if there's a link between Ami and asthma? I've recently upped my dose a bit and now I'm waking up every morning with a tight chest and wheezing which hasn't happened to me in years. Could it be the Ami? Nothing else has changed and I'm finding it pretty alarming to wake up on the verge of an asthma attack every day.

[lil_miffy]

thought id add something my gp told me today about ami. incase it helps people.

He said that ami, for pain relief really only works if you are on other pain meds as its acts like a booster. It does help with sleep and some general pain relief but if you are taking other pain meds and they arent working as well as hoped for then ami might give the meds an extra boost.

Not sure how accurate this is but it certainly helps me to understand how my meds all work together and why i have to take them regulalary and not just when i feel i need them.

[Eloise]

Amitriptyline does act as a pain modifier in its own right and can be used alone (and is for pure nerve pain i.e. following shingles). However, your GP is right - it does also act to boost the pain relief effect of other pain killers and so is its main mechanism of action for pain caused by injury etc. So it depends if your pain is nerve pain or muscle/joint pain - if that makes sense?

[notsparklynow]

Hi all

(Didn't know if this shoudl go in the amitriptiline thread or not)

My GP has been thinking about me getting and IUD or IUS (cant remember the difference) as I still get PMS on the combined pill. Now I'm on amitriptiline I don't know if I can do that.
I get really emotional and mood swings when I'm pre-menstrual and feel it's affecting my life adversely - hence the thinking about something other than the pill.
Personally I reckon I should go back on the prozac because I reckon I'm emotionally unstable full stop, but that's another story...

Any ideas? I see my GP about contraceptives and my consultant about the amitriptiline. He didn't even tell me there was a risk of increased side effects when taking amitrip and the pill. Pah, what does he know?

notsparkly

[Eloise]

There is no interaction between amitriptyline and any contraception (combined pills or intra-uterine device (i.e. mirena)) and no mention of any increase in side-effects in any reputable information about any of the products in any combination - so there shouldn't be a problem with either.

(Drug companies HAVE to inform about interactions and side-effects and this is where I look - however I did find a website of not known credibility stating that oestrogen containing pills (but not IUD/progesterone alone) can cause either an increase OR decrease in amitriptyline side-effects. But this had no reference or evidence to back it up - so I think it should be ignored)

The herbal antidepressant st johns wort interacts to reduce the effectiveness of the combined pill - but that is the only interaction I can find.

As for whether the IUD will be better for mood swnigs than the combined pill - well that is probably an individual choice as people respond differently to the different hormones. The IUD is locally acting within the womb and so there are very low levels in your system to affect your mood or increase bendiness and joint problems. Although if the combined pill is stabilizing your moods then swapping off it may cause you problems.

Prozac (fluoxetine) does have some evidence for the treatment for PMS and so you can consider this. Depending on if you are on a low dose of amitriptyline and if it is effective you maybe able to be on a small dose of both of them - but this is something you need to discuss with your GP and consultants as which one or a combination of a bit of both would be best for you.

[Eloise]

BTW - I am on a fairly high dose of amitriptyline and the combined pill microgynon, and so if there was any sort of interaction or increase of side-effects I would have looked it up for myself when I started on them. However I will check in THE book of all interactions when I am work tomorrow - but I am very doubtful of finding anything of importance.

Also - have a read through all the pill and mirena/IUD threads as the pro's and con's of them all have been discussed at length with everyone sharing their experiences as well.

[notsparklynow]

Hi Eloise

thanks for your reply.
It says in my amitrip leaflet to "talk to your doctor if you are taking any of the following" and oral contraceptives is on the list. I don't know why. I presumed there were no contra-indications as I hadn't been told of any, but there must be a reason why.
And no, the combined pill doesn't stabilise my moods. I'm slightly better on them than without, but not as good as I used to be before I had kids and started to hurt.

It all sounds very confusing and I just want to start making things better.

Thanks for your advice and assistance