Amitriptyline - how long to work & alternatives

[royalair]

I've tried ami for 5 weeks- got up to 40mg but saw no benefit to my problem (possible irritated nerves creating sensation of needing to pee). Can anyone advise whether maybe I didn't give it long enough to work? I found the side effects tortuous - felt drunk, dopey, tired, depressed almost & absolutely hated the way it knocked me out into a drunk type sleep- I couldn't even remember sleeping the next morning- not pleasant. Would lower dose for longer have worked or is it likely it just wouldn't work when 5 weeks made no difference?
Are there any other similar drugs with less side effects that anyone else uses? Thanks so much. Getting a bit desperate

[MatildaTheCat]

I never managed to get my dose up from 10-20 mgs so 40 sounds a lot to me. Did it help with the sensations at night? I've never been cerrtain how effective it is for my nerve pain but it helps me sleep through it IYSWIM?

I take gabapentin thorough the day which has similar side effects until you get used to it but is very effective for my nerve pain. I'm considering switching to pregablin but they are similar. Sadly all of these meds have cognitive effects but IMO would be worth lowering your dose of ami at night and trying one of the others in the day. The side effects do wear off to a large extent. The dose has to be started low and increaswed very slowly so no easy answers, I'm afraid.

[TheFairyCaravan]

There are 'cleaner' alternatives to Amitriptyline, I think Nortriptyline is one of them. There are others, I can't think of the names right now. (I've recently had surgery and am drugged up a bit).

I take 60mg of Amitriptyline for pain and nerve pain. It has taken 9 years for me to get to that dose. I started off at 10mg. I still have to take it at 7-7:30pm otherwise there is absolutely no hope of me waking up in the mornings. You do get used to it after a while but I would say they've started you off on too much tbh.

[royalair]

Thanks ladies. I started on 5mg and worked up to 40mg over the 5 weeks. That's what gp advised. In fact she said to keep going until synptom stopped but gynae that I saw said the Max she ever prescribes is 25mg. What do you do when even the drs don't agree

[MatildaTheCat]

You do what suits you. Increasing to 40mg over five weeks is incredibly quick. I would say you start at 10 and only increase to 20 when you have mostly overcome the side effects and so on. Pushing ahead when you are still suffering the effects is crazy advice probably from a GP who has never had to take it.

So reduce,experiment and see how it goes. As I say, I've never got past 20 in three years but it gets me through the night which is fine by me. I can only waken up with a nice hot cup of tea from DH and some concerted effort but once I'm awake I am fine.