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.

My 83 yo dad won't take cocodamol becuase it makes him constipated, is this an alternative GP should be suggesting? He's basically bed/sofa bound with pain.

It does vary I took it for nerve pain and it completely zombified me. The idea is to take it an hour before bed and you sleep it off but I felt really out of it. There are lots of other tryptines to try though so if she doesn’t get on with one after a few weeks return to GP and can try the next one until finds what works best for her. It is a bit trial and error but can only find effective treatment if she tries IYSWIM

It depends why he’s in pain, amiltryptiline works for pain that’s being caused by inflamed nerves. I took it as I had “autoimmune response to a viral infection” found out later it was Lyme disease but it depends what is causing the pain as to whether it’d be effective.

Unfortunately amitriptyline tends to make constipation worse - it slows down the gut, they often prescribe it off license for diarrhoea based IBS (I actually like it for this reason as it tends to settle mine). Having said that, you can take laxido alongside amitriptyline and Cocodamol to counteract this.

Thanks. Either he's not taking the Laxido correctly or he's not finding it helps.

It's Osteoartritis and a stress fracture, which Drs say he should try to bear weight on but he can't without pain relief.

Yes had it for both neck pain and migraine prophylaxis .
Definitely made me sleep well
I found taking it about 2 hours before bedtime ensured I still woke up and didn’t get the hangover effect . Maybe a bit slower in the morning but definitely wore off within 30 minutes .

Cocodomol and amitriptaline is not a good combination, it can cause breathing issues.

It depends on the dose of amitriptyline. Plenty of people, even those with severe asthma like me, take both as long as the amitriptyline dose is under 50mg (ie a nerve blocking pain relief dose, rather than an anti depressant therapeutic dose - ie 150mg plus).

I’d be more concerned about taking Co-codamol for a prolonged period, cos of the constipation.

2x 20mg amitriptyline and 2 prescription co-codamol
, not asthmatic, but it affected breathing and gave a very floaty feeling, .

I'm on gabapentin. I keep cocodamol for emergencies.

I don't think Amitriptyline is doing much for my mum's sciatic back pain tbh other than make her feel drowsy. She takes Amitriptyline around 6.30pm and is about 10 days into taking them. Her GP has given her a month's course. Maybe time will tell - idk.

10mg is also very low. So the next step may be to titrate it up.

Just checked my DD’s dosage for neuropathy, it’s at 25mg per day.
She too had to go back until it got to the right dosage.

My mum is about halfway through Amitriptyline. Her GP hasn't mentioned about what happens after her month's course is up. Does she just stop her course of the 26 tablets or does she need a tapering course after? 🤔

She should be afraid. My husband had a catastrophic reaction to amitriptyline that left him with lasting neurological issues and housebound. I’d never go near it. Rare DH reaction might be but it is possible.

She needs a chat with GP to decide whether to continue or swap to something else.

Me too. I found it did make me slightly groggy at first but I just adjusted the time I took it to earlier in the evening and I found the grogginess wore off as my body got used to it.

Her GP has double the dose from 10mg per night to now 20mg per night. She's week 4 into Amitriptyline, but I don't think it's doing much for her sciatica other than perhaps taken the edge of the 'firey-ness' 🤷

It’s still a tiny dose. Hopefully this will be enough, but there’s room to go up. Sometimes you need to stay on a higher dose for a while so your nervous system settles down a bit. It’s an irritated nerve, after all. Then you can quietly reduce a bit.

DM had to go up to 3 before she made significant improvement. After 6 or seven weeks at that level she is now dropping back to 2 and if pain starts to increase she will go back to 3 for a bit longer.
It's not a quick fix but did start to feel better after a few days on 3.
It might have been said already but I looked up the NICE guidelines and you can only step up the dose after 2 or 3 weeks at each level (as I understood it).
DM is pain free now, except some stiffness from being less active for some months.
DM also found a TENS machine helped a bit, I got one from Amazon.
Hope she feels better soon.

I took a low dose of this prescribed by a gastroenterologist for ‘nerve resetting’ and I felt just fine. It worked for my issue. You do need to come off it gradually to avoid flu like symptoms but otherwise I found the 10mg dose harmless. That’s what they give kids.