Amitriptyline thread

[nemonie]

Have you considered getting a contraceptive implant, that may be better for leveling out your mood. Large hormonal swings can be sometimes mistaken for depressive mood swings instead and it's best to use a contraceptive that gives a steady dose to control the mood changes.

[Eloise]

Just doubled checked in THE book of all drug interactions.

Bascially - there have been a few isolated reports that imipramine (a sister drug to amitriptyline) has occasionally had either increases OR decreases of levels within the blood stream when taken at the same time as oestrogen containing oral contraceptives. But this is a theorectical problem and has never caused any problems in actual patients with side-effects or lack of effectiveness.

So amitriptyline is a different drug in this group and there is no reports for this - but it has been reported just incase there maybe a cross over. BUT in the doses used for pain relief, which are lower than that usually for anti-depressant dosages, there is unlikely to be any issue at all. And absolutely NO problem with progesterone only contraceptives.

Sorry for the waffle

Modnote: now merged with existing Ami topic (Please save general discussion of contraceptives to the relevant topics leaving this one for Ami related issues only).

[Willo]

I'm now into week three of taking amitriptyline and have upped the dose as suggested by the rheumy who prescribed it to me.

Sleep quality I think is better but using the iphone sleep cycle app I can see that I'm moving a lot more and I'm having more dreams/nightmares that I remember when I wake. I've also more often than not woken up in a vile mood that has maintained throughout the entire day.

How long do I keep going with the meds before calling it a day? I can cope with the dreams/nightmares but the vile temper is not something I want to put up with (nor, I'm assuming, does anyone else around me!).

I have felt better pain wise, I'm assuming because I've had a better quality of sleep so that bit's great too.

[notsparklynow]

hi all
i'm just wondering whether I need to up my dosage.
My rheumatologist was happy I'm getting to sleep better, so kept me at the same to review again in December.
Recently though I've been feeling just as sleepy during the day as I was before I started. I'm having a lot of dreams (weird ones too) and just feel like it's not really working. Can I ask my GP to review my dosage as my rheumatologist asked my GP to write my prescription? Or do I need to go back to the rheumatologist for this?
Not sure what to do; but I don't want to be sitting here sleepy again.

[Fiona-Jane]

hiya,

have you tried taking the dose a little earlier? i need to take mine quite early in the evening or i end up really sleepy till late afternoon.....

and i'd expect your gp would be able to change dosages or maybe swap you onto something else, mine's pretty good with stuff like that and it's not a new type of medication etc so all gps should be fairly knowledgeable of it (and they all have that magic book of drugs, dosages and interactions etc... i sooo want one! )

fi xx

[notsparklynow]

i did start taking it at about 7 or 8 but found it made me too tired before I was ready for bed. So now I take it about 9 and I'm ready to go to bed at 11. Still takes about half an hour to actually get to sleep.
The main problem is that for about two or three weeks I've had some really odd dreams - i'm very busy at work so i know my mind is obviously preoccupied with that - but i thought the ami was meant to help me sleep deeper so it seems to me it's not quite doing that now.
I will try and see my GP about my dosage - he's quite good so I reckon he can adjust it easily. Just didn't want to offend my rheumatologist!

[bearone]

hey all

i've been given amitriptyline today, and shall be using it for the very first time in my life, tonight! i don't sleep very well, haven't in so long, and although i take a mixture of meds (oxycontin, paracetamol, dihydrocodeine, fluoxetine and naproxen) i still am in so much pain, and often unable to sleep at all. 'good nights' often have around 3-4 'slots' of 30 minutes sleeps and i feel so tired and groggy and unable to cope then with the pain of the day, cos i haven't been able to 'refresh' my mind and body so today i was prescribed the 'ami' to help with the sleep and also the build-up may help the pain of the daytimes too, so all in all, i'm extremely happy to be trying this new med!

i have to say, i've read through just about this whole thread on this drug, and the majority state how well it has worked in aiding better sleep, so i am so very hopeful that i will start getting some sleep!

i am to start on the lowest dose this evening, which i'm going to take around 8pm, for a 9pm bedtime, and hoping to be asleep by 9:30pm ish, and am able to up it myself by one, after 3 days, if i feel the need, and then again after another 3 days or so, should i feel the need. my doctor is so understanding and so amazing!

so hopefully i shall be posting again on here, within the week, and saying just how well it's working at helping me to sleep (see how hopeful i am! lol).

thanks for all the posts so far guys, cos they really have made me WANT to try this, and i hope i have the same great results

kathryn xxx

[Stone]

I'm coming off the amitrip now, as I'm finding the morning drunkenness feeling worse than not sleeping! I hoped that cutting down would help but I'm sleepy even longer in the mornings now...

Tempted to get a pill splitter and taper the dose more slowly, but why does taking less make the side effects worse?!

Stone

[Eloise]

Maybe because it is not the side-effects of the amitrip that is causing you to feel sleepy and rotton in a morning - but an indication of your fatigue from your condition. And that by reducing the dose you are not sleeping as well at night and hence making your fatigue worse in the morning.

I guess you will just have to up and down the dose to find out at what level you find the balance of sleep at night and drowiness the next day is best for you. But you need to do this slowly and give each dose level a good few weeks so that normal variations in how you are don't cloud the change in the dosage. i.e. you may just been in a bit of a flare for no apparant reason but be blaming a change in your amitrip (or conversely, be on some really good days and think it is your amitrip dose change).

[nonyanomemory]

hi Stone,
My daughter has had very similar reactions to the ami as you. The effects intolerable for her versus the efficacy. Eventually she has been prescribed a liquid ami and this has helped. The gp and pharmacist think she suffers with a sensitivity to medications which really makes the taking of some meds quite difficult despite her compliance. I know we are not allowed to discuss specific doses but basically the liquid version is a very small amount indeed but as she has problems with pretty strong reaction which are not her fault and unrelated to flares etc this has been the decided way forward for her. The sleepiness/drunken feeling,, she has, also caused dizziness and vision problems which was extreme was definitely not related to anything other than the reaction to the med. I really wish it had been different as I know for many ami is fantastic. I unfortunately cannot take ami as it causes terrible palpitations and even trying dothiepin didn't help.

Efficacy always has to be weighed up agaisnt adverse side effects. Fortunately our gp is very understanding in this area, possibly because I have odd reactions to some meds and he errs on the side of caution also now with my daughter! One case where like mother like daughter definitely applies unfortunately.

I'm sorry you haven't had success with ami, I was really disappointed when I had the same problem. Its very frustrating when a med that works for so many isn't suitable.

[alice-emma-louise]

Hi Stone - I'm sure you've already tried this but I'll mention it anyway - I suffered terribly with what you've described but now I take them at least 12 hours before waking and it seems to work well. Might conk me out a bit over the evening but only occasionally and nothing too bad, and it's worth it for the extra sleep I get!

Alice x

[Stone]

Maybe because it is not the side-effects of the amitrip that is causing you to feel sleepy and rotton in a morning - but an indication of your fatigue from your condition. And that by reducing the dose you are not sleeping as well at night and hence making your fatigue worse in the morning.

Good point. It also may be counteracting some of the effects of the tramadol as I felt terrible after taking it yesterday!

I think I'll just have to experiment and see, it's all good fun

Stone

[everhopeful]

I found it helpful for all the things it is prescribed for...pain relief, sleep and my dodgy subluxing hips. I have no problems taking it and after 3 weeks thought, "hey this is great", until I realised I was eating much more AND my metabolism had slowed to literally nothing! Checked the notes in the box to find these two problems are side effects.
After 2 docs encouraged me to try it again, I have found MY solution and my Doc has agreed that this is fine for ME.
I now take it, basically, when I am desperate.....when I really want to feel zonked out, when I need to catch up with 3 or 4 days of dodgy sleep and subluxing hips. The pattern that has emerged lately is....grit my teeth and plod on as I can sun-thur and then make up for it on friday and saturday night when I don't have to get up to an alarm clock!
Can't wait for christmas when I have 2 weeks off work and no school run responsibilities!!! Please note though, that this is what works for me and my lifestyle and commitments and it has been approved by my own GP for me. It may be worth a chat for some to find a compromise between not taking it at all, and having some form of use when "desperate for relief of pain and a decent sleep"! Liz

[notsparklynow]

Hiya

My GP has given me guidance on how to up my dosage myself and so I'll be trying that over the next few weeks. He asked why I thought it had worked so wonderfully after the first month, only to be complaining a month later that I'm still exhausted - and I reckon it's because I'm back at work now and I have so much to do that combined with the pain I'm finding it harder to sleep. I've been getting about 6 hours a night, waking at least 4 or 5 times. my husband complained the other day that he'd woken up twice, two nights in a row - I wish that was it for me! Some nights I wake every half an hour and when I get up I dont feel in the least bit refreshed.
I hope the upping of my dosage does help - I don't know what else I could do otherwise.
I have a lovely comfy bed now and it has helped to not worsen my pain - but I still don't get enough sleep. Never did even as a baby. Fingers crossed - I'd love a few hours of solid sleep!

[bearone]

hi all...

well, i've been taking amitriptyline now for 8 days, upping the dose every 3 days as advised by gp (and cannot up it anymore on her guidance), and i have to say, unfortunately, i am NOT impressed

the first night, last tuesday, it seemed to work - although i still woke a few times, i woke up and got up for school with my little boy, feeling better than i have in years, thinking i'd finally found MY 'wonder med'. but since that ONE night, i have had no effect from it.

take last night for example...i had an early night, after taking my oxycontin, paracetamol, naproxen, and amitriptyline, yet woke up in agony at least 7 times (when i woke at 12:30am, i was actually awake for about an hour), and then eventually gave up on getting any sleep and got up at 4:14am. it's now 4:53am and i'm shattered and in pain. just had to take some more paracetamol and dihydrocodeine just to top up, and now i will sit/lay here on the sofa, with my hot water bottle at the bottom of my back, and my heated wheatbag around my neck/shoulders, as usual, just watching the clock tick by until 7:30am when it's time for my little boy to get up for school.

i know i'm tired enough to sleep, cos i haven't slept properly in years, and every daytime i'm pretty sure i could quite easily fall asleep (but i try NOT to, in case it messes up night-time sleep pattern even MORE) but after having new meds given over the past few months, and finally amitriptyline last week as well, i had hoped i was 'set' for sleep and pain relief. but i'm still not sleeping, and still get VERY little pain relief - tonight i've tossed and turned because of the horrendous pain in my shoulders, hips and back...each time i woke i tried to find a comfortable position...but it wasn't to be, so, frustrated at not being able to sleep, and still in pain, i finally gave in and got up to make a coffee and take 'top-up' meds, in the hope that i can 'wake up' artificially before my little lad has to get up for school.

however, i'm now wondering (if it's possible) if i could be unresponsive (i THINK that's a word lol) to some or all of my meds...? maybe i'm just clutching at straws, and this is my lot for life maybe i SHOULD sleep in the day, as many times as i CAN fall asleep, even it does mess up night-time pattern, just to actually GET some sleep, a couple of hours here and there as i can?

can anyone advise ANYTHING please?

hugs to all in pain xxx