amitriptyline for nerve pain - what are the side effects/how do you manage them? be honest!

[Pavlovthecat]

I have just been prescribed 25mg daily for ongoing sciatic pain (although she was very honest in saying it might also lift my mood slightly and make me feel more able to cope with pain too which is a good side effect!).

She said that side effects on such a low dose should be minimal but look out for constipation, dry mouth and blurred vision.

I have also read numerous other common effects and wondered which ones are the most re-occurring/what am I most likely to experience on this dose, and how do you manage them?

Thanks

The biggest side effect I find from Amitryptiline is it I find it really hard wake up in the morning. I take 50mg, I started off on10, it was increased to 25mg, then up to 50. Recently it was put up to 75, but I really, really couldn't Cope with it at that dose.

I have to take my tablets no later than 8pm if I am to have any hope of getting up. I do get a dry mouth, but I drink lots and lots of water and eat grapes or sugar free gum.

that is really useful about struggling to get up. I find it hard enough as it is due to stiff and sore back, so grogginess is not good. I was on gabapentin and the grogginess in the morning was horrendous, so hope it is not as bad. How quickly does it make you feel sleepy, or does it not affect you in the evening?

I'm on 50mg too (started on 10, and it was doing nothing, so the GP moved it up to 50mg). I find that I do have a really dry mouth all the time, and am constantly drinking water and it does tend to knock me out. I take it at bedtime so that isn't a problem - I took it at lunchtime at work once, and ended up having to go home as I was so tired. I also find it hard to wake up in the morning. They are manageable side effects though.

Bit worried that I might have to increase the does again though, or combine it with gabapentin as I am still getting a lot of symptoms. Off to see the consultant on Thursday so will discuss it with him.

Pavlov - Did you find Amatryptiline more effective than Gabapentin?

sorry pavlov, not sure I answered your question! I manage side effects by taking a bottle of water everywhere with me, and by only taking the tablets at bedtime....and having a very persistant DS alarm clock.

I take 20mg at night for pain and to help sleep which is suppsoed to ease the pain. I don't get many symptoms - i do get a dry motuh, I keep a pint of water byt the bed (as don't sleep well most of time due to pain and take the water). I also take it aobut 7/8pm.
I hav ebeen on it for years though and don't feela s groggy as some do, perhaps I jsut re-act differently to it

I did get put on 75mg by the Rheumy and it was horrendous, horrible nasty dreams.

I also take Gabapentin, 3 times a day.

In fact I counted up i take 19-21 tablets a day!

Hi, I was on this for about 3 or 4 months last year due to trapped nerve. I actually got on really well with it, thoughI know some people don't. It was the only thing that helped the pain too! I did feel a bit groggy but in a nice relaxed way (25g a day initially then up to 50g). The dry mouth stopped after about a month. No other symptoms.

This drug was used as anti-d in the 1960s and 70s I think. But the dose was about 100-150g a day! My GP remarked that all the patients on it must have been walking about like zombies! Glad there are better alternatives out there now for depression.

I had to come off it, it did nothing for my pain, and it kept me awake until 3am then put me out cold until gone 3pm every day. Wasn't sustainable at all. Hope it works for you though!

angry not sure yet, only prescribed today, but GP thinks this much more likely to help than the gabapentin with less side effects. I could not function on gabapentin, although I was told the side effects took 6wks+ to wear off, I just could not manage them until that happened and decided to accept the pain. I am trying to find a happy medium.

Gabapentin has always been more effective for nerve pain relief alongside other painkillers but with that spaced out feeling. Amitriptyline did very little for me pain wise but sent me to sleep which in one respect was quite good.My GP prescribed them only to take at night so I found that they had no effect when I needed them to plus even if I took it quite early in the evening I could not get up in the morning- so tired still to the point of being unsafe to do anything. So difficult to find the right balance.

I felt like I had flu about a week in and stopped. Then a friend's consultant gave her some advice and I followed it.

Take it for two weeks and the side effects lessen/stop. It works.

I have a dry mouth now and that's about it.

I've taken amitryptiline for nerve pain to no effect.

What did work (but you might not want to try it) was cigarettes.

The patches/gum etc don't do much, but a cigarette will give me about 4 hours pain relief.

I have been taking it for about 4 months now, and the side effects haven't really lessened. It looks as though I will be on it permanently as well, so am keen to find an alternative if there is one. Has anyone tried any alternative/complementary therapies that help with nerve damage? I'm normally a bit suspicious of anything woo, but would be interested in looking at anything else that could help.

angry I had a thread going about alternative/complimentary therapy which was very interesting but fizzled out, it was based largely on chronic pain, not nerve pain specifically but that was discussed. I will go resurrect it if I can find it and link you to it/post on it myself, as I am forever exploring the options that minimise the drugs I have to take. I said to my GP, one of the biggest problems with coming to terms with the condition I have, as much as the pain itself, is the amount of different drugs I have to continuously take in order to be able to function normally, and there are costs to that in terms of how else I feel and what other things go on with my body. I hate it. I want to be drug free, and pain free and it makes me so down when I realise that is not going to happen, well, not for a long while at least. Perhaps that is why the doc gave me this rather than pregabalin

I am not looking forward to drowsy. I am drowsy enough in the mornings as it is and find it difficult get motivated. I did not take it last night as DH had to go get the prescription (because I forgot to pick it up) and he did it on route to a friends for a coffee. I was asleep when he got home and he did not realise I needed it at nighttime. I now have it so will see how I feel tomorrow.

brilliant post thanks ted

Ted - possibly a daft question but are those things you listed - magnesium,zinc vit d etc ok tot kae with medication such as gabapentin, tramadol etc?

I did read something once before aobut people with Fibro having very low vit d levels, but never actually got round to trying to do anything aobut it as my GP at the time pooh poohed the idea

Thanks for the information ted, will look into VitD supplements and talk to the GP about it. I hadn't heard about this before, so great to get some new advice like this.

My problem is not pain as such, but problems with sensation - constant feelings of cold burning, cold water running down my back and legs, pins and needles, stabbing sensations etc. It's a constant joy .

My consultant has suggested trying effleurage techniques to help with this. He has advised that you really need to do it for about half an hour at a time, at least three times a day, on the affected area. As my problem is a reult of spinal damage at T7/T8 this basically means my entire lower body, so its not terribly practical/effective for me. It might be helpful for any of you who have smaller areas affected by nerve pain.

sorry, that was meant to be ted, not ted!

I adore amitriptyline, got used to the grogginess pretty well ( I was on a low dose) But it made my tachycardia worse so I'm not allowed it - boo hiss.

Hi to all. Another drug less alternative is to have an abrasion done. It has worked well for my dad. He is now having a second spot done. Abrasion is when they burn a nerve so it does not transmit pain. It has to be done up to a few times before the nerve stops growing back. Everyone reacts differently to the speed and how many times it grows back. Slower each time until it stops growing back. My dad was a little over a year the first time and it did not grow back again. He only feels a very little itch like feeling in the area done. That is the only side effect of the treatment. I am going to have one done for my back pain as well. Will update when I have mine done. Check with your specialists to see if it might be for you.

Hi, I am also on a lot of meds. I take Lyrica (prebagalin) for nerve pain. It's similar to gabapentin I believe, but is newer and supposed to have fewer side effects. Of course being newer it is also more expensive so NHS may be reluctant to prescribe. Anyway I am fine on it - it's best to build the dose up slowly.

Amitriptyline is a top drug IMO - obviously not for everyone but it seems like a lot of people get on with it very well and the side effects do settle.