Amitriptyline

Question: Hi, I’m currently taking amitripyline at 25mg per day. I have been taking it for the last 6 months with a gap when I thought it wasn’t helping but went downhill without it. Don’t know whether it is helping now – still in quite a lot of pain – not sure whether to stop or not. 25 mg doesn’t seem much compared to doses below. What doses are other people on who take amitriptyline? I’d be grateful for some info before I go back to see my GP.

Answer 1: 25mg is a pain relief dose as opposed to a dose for the treatment of depression. Have you tried taking analgesics with it? Alternatively, you could ask for a more sedative tricyclic. Dothiepin is one. Have you tried taking analgesics with it? My former GP said they worked well together.

Answer 2: I am on 50mg daily, and have been now for about 9 years. I would love to put the dose up, and one of my consultants suggested it, but I don’t think I could function on any more!!!I am already dopey enough in the mornings because of it! I am not sure how much it helps the pain, but I know that without it I would get even less sleep than I do now. I can’t sleep on my right side at all due to pain, and the pain often either wakes me up or keeps me awake, but at least with amitryptiline I get a solid patch of sleep, even if it is not always enough.

I think a lot of people on the arthritis groups I belong to, and the chronic pain sites find that the best therapeutic dose for pain starts at 75mg. I am still working full time, and driving, so I think that is out for me, because I often have to drive early in the mornings, and amitryptiline is known for its effects on driving ability. Many do find it very helpful, so maybe see if you could try a higher dose, but be warned: especially for the first few weeks, DO NOT DRIVE EARLY IN THE MORNING!!!

It also helps if you can take it at least 2 hours before bedtime, because it takes a while for it to work, and also, the earlier you take it, the less time it will affect you in the morning. Due to my job (I am a violinist in a symphony orchestra), I am often not able to take it until midnight-1am: that then means I am absolutely wiped out the next morning, and often means it doesn’t take effect until 3am…it really does play havoc with your body clock, because it stays in the system for at least 12 hours…

Answer 3: I think the doses vary depending on the effect it has on each individual. I am taking only 20mg (for 5 months now) and within 2 weeks saw a drastic improvement. Previously, I couldn’t stretch my arms out to the sides or in front of me, but the upper arm pain completely vanished. The company doctor recommended to my GP that I try Amitriptyline, and she was amazed by the effect it had on me at such a low dose. However, it also had drastic side effects because I was so sensitive to it.

Sleepiness was/is a problem. I was sleeping for approx 12 hours a day, so am only working part-time. I’ve recently reduced to 10mg to try and allow me to return to work…watch this space…


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