Amitriptyline and Pregnancy

[cloclo76]

My husband and I are ttc. I have been suffering from insomnia for a long time and take amitriptyline 10mg (the lowest dose) to help me sleep. i am now trying to count down the dosis to only 3 times a week. The advice about taking it during pregnancy is confusing. Some brands say that it's ok during the second trimestre, some do not recommend it and some are silent. Have you taken amitriptyline during your pregnancy? What was your GP advice. Your comments would be very much appreciated as I struggle to sleep now and I don't want to imagine during pregnancy!

[EmmaKateWH]

I was taking this for IBS and was strongly advised by my GP to stop taking it a minimum of a month before trying to conceive. I followed this advice. I have never read anything from a reputable source saying that it is safe to take this drug when pregnant. In much higher doses than the 10mgs you and I were taking this is an antidepressant. I have read in some places that if the mother desperately needs the antidepressant (e.g. to avoid suicidal thoughts), then doctors may take the view that the risks of taking it are outweighed by risks to mother of not taking it. I am sure that no responsible doctor would tell you that it was ok to take it in pregnancy when you aren't taking it for severe depression. The BNF which is the most authoritative piece of guidance about medications in the UK states that you should not take it if you are pregnant. If I were you, I would stop taking it now.

[sunndydays]

I take 10mg at night for nerve pain and it is absolutely safe in pregnancy, it has been being used for years and I have had four different doctors (GP, OB, Anaesthetist, Neurologist) tell me that it is fine. I am now 31 weeks pregnant. I started taking these way before I got pregnant and haven't stopped. Hope this helps.

[EmmaKateWH]

It is not known to be safe in pregnancy. A simple look on google confirms this. For authoritative advice look at www.bnf.org.uk. You have to register to use the site but registration is free. If you are happy to take a drug that is not known to be safe in pregnancy then that is a matter for you. Personally, I wouldn't touch it with a ten foot pole.

[littlenoodle]

I used to take it for nerve pain as well. I told my doctor I didn't want to take it when I was ttc and he said he didn't know of any problems with it, but it was up to me. I decided to come off it because I didn't feel comfortable taking it. I left myself over a month between coming off it and ttc. To help with the pain, I went for acupuncture instead and found it brilliant. Acupuncture can also help with insomnia, so if you're worried about taking amitriptyline, why not try that instead?

[sunndydays]

I am sure all my doctors wouldn't tell me it was safe if it wasn't as they would surely lose their jobs? If you are not sure then a quick call to your GP will be able to give you the correct information, much safer bet than google.

[bamboobutton]

i used it for insomnia too and G.P point blank refused to give it to me in pregnancy even though i was zombie like from lack of sleep.

i found out piriton is safe to use as a sedative, not the non drowsy ones though but i would do some research yourself before you consider it rather than taking my dodgy advice

[sunndydays]

I have never considered acupuncture for nerve pain, I say nerve pain it's more a crawling sensation to the side of my foot, I suppose though being diabetic they wouldn't want to do acupuncture on my feet?

[sunndydays]

can I just say I shouldn't have said 'absolutely' safe as everything has risks

[littlenoodle]

Sunndydays - I'm afraid I don't really know much about the science of acupuncture, but it might be worth talking to a few acupuncturists about it to see if you can have it even though you're diabetic. If you decide to give it a go, research the acupuncturist you go to and check out their qualifications. I went to one who was also a doctor, so I felt like I was in very safe hands! I really hope this works for you too. Even if amitriptyline is safe for pregnancy, it's no fun to be taking pills for years!

[cloclo76]

Many thanks for your comments. As I said, the advice is confusing but I personally would not feel comfortable taking it during pregnancy. I will try to find alternative (and less controversial) ways of helping myself to sleep. It's not easy... particular as I am working and have a 19 months old son.

[kri5ty]

I know this is an old post... but has anyone taken it recently?
I was on it for insomnia, stopped when found out I was preg, but still not sleepimg and can't cope, I'm 14 weeks so just in my second trimester

[kri5ty]

I know this is an old post... but has anyone taken it recently?
I was on it for insomnia, stopped when found out I was preg, but still not sleepimg and can't cope, I'm 14 weeks so just in my second trimester

[MissusTulip]

hi all, bit of a tardy contribution but I'm a shrink by trade, and the advice is that it is to be used with caution but it is not contra-indicated in pregnancy - so it is safe to use in general, provided you're monitored by your doctor. The recognised side effects in pregnancy are described in the relevant appendix in my bnf as 'tachycardia, muscle spasms and irritability in the neonate with imipramine' - translation: increased heart rate, muscle spasms and irritability in new born with a related drug, nothing there for amitryptline.

Amitryptline is quite an old drug and therefore it has been used in more pregnant ladies than newer drugs and we have more data on it, so it is one I'd offer the choise of to patients with depression, actually as one of my first choices of antidepressant. 10mg is a teeny dose and if it helps you sleep and improves your overall health then it'll be of benefit to you and baby. I've used it at 75 - 150mg for depression in pregnant ladies okay.

it's a hard choice and I hope that helps you decide what is best for you - medication, acupuncture or any of the other suggestions people have found helpful.

good luck!

[kri5ty]

MissusTulip thank you so much :-) i have come to the conclusion that my insomnia will be causing more harm to the baby anyway... 1-2 hours sleep a night cannot be good!

I have tried everything else in the past, as i didnt really want to take medication for it, but after years of different things and drugs, Amitryptline was the only thing that worked!

Again thank you :)

[mopsytop]

hi kri5ty am having exact same dilemma - I take it for migraine relief - I normally take 20mg/day. Stopped at 5 weeks pregnant (when I found out) - hadn't stopped before as had literally only just started trying so had no idea would get pregnant so fast.

The past 3 weeks my headaches have been so bad, have had to spend so much time in bed and finding it really hard to cope with the pain (and the stress of missing work also) and am debating whether or not to start it again. My doctor said it should be fine, and the migraine association also advises it as safe. But it's just so hard to know what to do.

Also debating acupuncture but need to find a reputable practitioner...

[mopsytop]

EmmaKate I don't know where you got your information? Any GP/specialist I have seen said it is safe in pregnancy, but obviously they can't do trials with it, so they can't say it is 100% safe, as they basically can't say that for anything. But as far as they know from lots of women taking it over the years, it causes no problems. It is not contraindicted. But it is a bit worrying that your GP is giving you entirely different information. This is why I am worried about starting it again ...

[kri5ty]

mopsytop the previous posts are over a year old i just googles the thread and posted in it to see if there was any new news!

I stopped taking it as soon as i foud out i was pregnant, befor emy GP told me to, but i went back as i was not sleeping at all, and they just said i couldnt take it... to be honest i dont think they really knew, so were just going with the guidelines, i may write to the consultant who originally prescribed it me, and see what he says

i feel for you with the migraines, i used to have them, and i am very greatful i havent had one for a few years, there must be nothing worse as you cant take much now :(

[mopsytop]

Oh I didn't see that - duh! It is really hard at the moment. I am finding it hard to cope tbh. It's just the past 3 weeks that it got really bad. Hoping so much that by week 15 or 16 it calms down. They are hormonal anyway so I suppose being pregnant is not helping. My doctors thought it might have opposite effect - i.e. improve things - but how wrong where they. That's why I am not feeling so hopeful about week 16. But acupuncture may help I suppose?

[kri5ty]

pregnancy helped with the majority of my symtoms which i am greatful for, just the insomnia i cant cope with.. i want my lovely beautiful tablets back!! lol

[Fluffeh]

I take this at 100mg each night. I was seeing an obstetrician as well as an endocrinologist, neurologist and neurosurgeon and they all agreed it was safe for me to take.
I trust their judgement and believe they were honest as I did have to stop taking some of my other meds when ttc.
I'm 24 weeks pg now and so far so good :)

[BionicEmu]

Monthly I was taking 200mg of amitryptyline a day for both pain & depression. When I found out I was pregnant my GP wanted me off them immediately, so I reduced the dose over 3 weeks. It was a nightmare, severe depression hit me very hard, I was having hallucinations etc. I don't think these were withdrawal effects, just a consequence of not taking the medication that worked for my illness. What withdrawal effects have you been having?

Anyway, I was referred to the peri-natal psychiatrist, who put me straight back on them. I am now almost 37 weeks pregnant and managing ok on 150mg a day. My obstetrician is aware & happy that I am taking them.

I have been warned that baby will have to stay in hospital for a couple of days for monitoring (although I am also taking 90mg dihydrocodeine 4 times a day for pain, and there's a possibility of withdrawal from that too.) Other than possible withdrawal, which I have been told breastfeeding may help lessen, my psychiatrist & obstetrician have reassured me numerous times that there is no other risk to the baby.

[Fluffeh]

I read that in excess of 90% if it is metabolised by the body and of Te amount that may pass into breast milk, it shouldn't have an effect on the baby. It was on the site that has a list of medications and their effects on breast feeding/breast milk.
My obstetrician is happy for me to keep taking it when breast feeding :).

[staceyleigh]

Hi I suffer from fibromyalgia and have been taking amitriptyline form many years for the pain, insomnia and depression. I was told to stop taking them immediately by my doctor when I found out I was pregnant. Im now nearly 19wks, not sleeping, very depressed, anxious and in severe pain. I have an appointment to see the health nurse for pregnant women but she has told me the doctor should never have taken me off them and that I can carry on in pregnancy. Im very confused and scared that if I start taking them I will do harm to my baby, although they are happy for me to take tramadol and temazepan! which I haven't taken. I know nothing in pregnancy is 100% safe but just some clear medical advise which isn't conflicting with each medical profession would be good. Im hoping the specialist nurse will be able to spread a bit more light on this subject and finally be able to help me and put my mind at rest before I make a decision. I will keep you posted.