My nearly 83 year old mum is scared to take Amitriptyline

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My nearly 83-year-old mum is experiencing acute sciatic back pain and has been prescribed Amitriptyline 10mg by her GP. However, she is hesitant to take it due to fears of feeling drowsy and groggy. Have any of you experienced similar concerns with this medication? Can anyone share their tips or hacks to manage the side effects of Amitriptyline? At the moment she's taking 15mg/500mg of Cocodamol. Your experiences and recommendations would be greatly appreciated to help ease my mum's concerns. Thank you in advance for any insights you can provide.

I took amitriptyline for many years to reduce frequency and severity of migraine. I started at 10mg and built up to 150mg. I found that I slept well but I didn't have a "hangover" from it. Never felt groggy by day.

It also increases the risk of falls

Are you with her when she has her evening meal? That’s when I take mine. I sleep like a baby and wake up at a sensible time.

The impact is more noticeable initially- wouldn’t drive after I took it, in the first months. However a little while on and I’m confident to drive- it doesn’t turn out the lights the way it initially did.

I eventually swapped to nortriptyline because of the memory issue, but that was more because I hadn’t continued to improve than because it was particularly terrible.

Would she start to see if it helps, then if it does but she’s noticing cognitive or memory issues swap to something else?

My preferred bedtime is between 11pm and midnight. When I take amitriptyline 10mg an hour beforehand 10pm) I will have a fair night and wake around 7am, when the dogs ask to go out, but I will definitely need to sleep during the next day. I might have breakfast at 8 then sleep from 10-12, or I might sleep from 9-3, which is horrible.

If I take amitriptyline at 7 pm and go to bed at 8.30-9pm, I may sleep until 8am if the dogs are quiet, and get through the next day without a nap.

I don’t take it every night now, and never if I expect to drive, or look after grandchildren the next day.

ETA I’m 70 and take it because osteoarthritis in my hip affects my sleep.

My late mother was given it for back pain, had a dizzy turn and fell downstairs. Mum would have been in her 80s at the time.

Our practice nurse wanted to give it my husband for stroke pain. Our GP refused.

Of course. I think the difficulty with all these things is some people are much more affected by them than others, but unfortunately unless you give them a go you just never know.

For reference, I have lupus and other really painful autoimmune issues and I take amitriptyline, Cocodamol 30/500 the strongest strength and occasionally tramadol (although not alongside the codeine obviously)! I find I function really well, I can drive safely, I look after my son who has complex needs, etc etc. It basically gives me a good quality of life. Other people would barely be able to get out of bed on the doses and things I take 😳🙈 and that’s okay, we are all different but I think it’s important to show that there are people like me who do take these things with very minimal side effects. The only issues I have ever had is an occasional bit of constipation (easily solved with a day of laxido).

Absolutely @Sparrowsandbudgies . It's hard giving experiences because I wouldn't want to put someone off when it can give that quality of life to some, but for me it was awful and I couldn't function at all on it. You're right...you have to try before you find out which camp you are in, unfortunately.

I'm not surprised, the last time my DH took it he was so groggy the next morning I thought he might have had a stroke. Difficulty walking and talking. It was scary. I've had it in the past for a week and it just meant I slept really well, no side effects at all. I don't think you can predict.

True but I'd be wary of taking it if I lived alone.

Does she have a physio? When I had sciatica my physio talked me into taking to painkillers to help sleep and improve what I could do in physio sessions. She was a remarkable physio and got me moving and sleeping again.
Also would the gp consider Gabapentin instead? They seem very reluctant to prescribe due to the addiction risk, but if she already on loads of codeine, it seems silly. Its very effective for nerve pain.

I do know someone who said it made them feel completely out of it. To the point they collapsed in the shower and hurt their head quite badly. But idk if they were on a higher dose.

I guess she could try stronger opiates, like dihydrocodeine 30s? She would need them prescribed though. The other thing they might offer is pregabelin or gabapentin but both of those have very serious withdrawal symptoms and dependence potential. As well as making some people very drowsy.

Is there a possibility that someone could stay overnight for the first few doses just to see how she is mobility wise when getting up for the loo ? It would hopefully reassure her moving forward.

I took it for several and and never had the grogginess symptom. Mind you, it didn't work for me at all, so maybe that's not helpful. Was prescribed it for migraines.

It’s pretty individual so she’ll only really find out by trying it. I took it late evening for back pain and later for migraine and it was brilliant. Only side issue I had was a dry mouth, just sucked sugar free sweets, lol. Defo worth trying in my view.

Yes, that's true. I think with someone elderly and alone, it's risky.

Thank you all. I do live with my mum, but she's terrified of taking it still. I said maybe try taking half (crushing it up) , but she's read and double-read you can't do that. She is in complete agony with it. We have tried deep freeze gels, ice packs, and yes physio (but it only made her back worse), Ibuprofen (didn't work) and takes currently eight 15mg/500mg Cocodamol per day 🤷. Can Ami be taken in half?

I think best to check with the pharmacist.

Would she be less scared if she took it in the morning? It’s counter intuitive, but maybe she’d be reassured that nothing was happening to her while she was too tired to notice and get help!

I know it is mentioned as a side effect but I didn't feel any drowsiness with amitriptyline, I also did not experience any pain relief either. I was advised to take it at bedtime so if there was drowsiness it would not cause a problem, is this an option for your Mum? I now take Nortriptyline, I take all my pills in the evening so any side effects don't bother me while I sleep.

Well, my mum's just taken her first one (Amitriptyline) - 7.34pm! Her sciatica's real bad today and after weeks of much contemplation, she decided 'I've got to try something. I can't keep having this pain - I'm on fire with it'. So please God, she'll be OK 🙏.

Good luck. I know it helped me although it didn't help DH so fingers crossed her experience is more like mine.

How did she get on?

Thank you for asking 🌹. She had a good night's sleep last night - first time in a while! She started feeling drowsy an hour after taking it (7.30pm last night) and went to bed about 10.20pm. She only had very slight grogginess when she woke up and said, "It's not done a thing for my back though". I said, "Give it time and keep taking it nightly now", which she will. She's using ice packs and Ibuprofen gel today. Fingers crossed, after she's taking it (Amitriptyline) for a little while it'll start to do something. I hate seeing her in pain. Again, thank you for following us up! x

No meds are without risks or side effects. I was prescribed amitriptyline but decided not to use it as I thought the side effects would make my autoimmune worse. I see it didn't help with her pain.

I suggest tens machine and/or acupuncture to address the pain. I find acupuncture very effective but it doesn't last. It's worth a try though.

That’s good. Fairly positive for a first go! The pain relief won’t kick in for around 1-2 weeks, so it’s important to keep going with it if she doesn’t feel too bad on it. Hopefully it will help her.

My DD takes it for neuropathy and she doesn’t get groggy. You take it at bedtime. It has less of a drowsy affect and is safer than the cocodamol she is taking.