Coming off amitriptyline

[Runaround50]

Hi
I've been taking 50mg of amitriptyline for well over a year now, primarily for nerve pain.

In the main, I suppose it works. However, I'm not too happy as I seem to be dependent on this drug for sleep also ( menopause sleep issues, another story!)

How do you come off this drug? Is it a case of tapering off slowly?

Earlier in the week, I reduced by 12mg and slept okay. The following two nights, I was wide awake!! I'm shattered at the moment as my sleep is so sporadic. There have been times when 50mg hasn't worked.

No idea what to do. Menopause and sleep issues appear to be ruling my life!

I once took this for 6 months for nerve pain, but I didn't have any sleep issues so not sure my way of stopping it will work.

I was told to half the dose and stick to that for 2 weeks. Then start taking it every other night for 2 weeks. Then just twice a week for the final 2 weeks. I was told that should stop any side effects from cutting it out, and it worked fine for me.
You may need to do it more slowly though as you have been taking it for longer. Good luck x

If I miss a dose, I don't sleep basically. It's pants. I don't feel great anyway, hugely tired and foggy. I'm worried that without it I'll be even worse and in pain as well. It's pants.

Yes you should definitely taper off. Have a chat with your GP about it as you can have withdrawal with stopping it.

Magnesium is good for menopausal sleep issues. Worth a try whilst you reduce.

@picklemewalnuts Yes, thats it exactly, you don't sleep if you don't take it. Horrendous!!

I'm going to have to tackle this carefully as I've a job to consider and can't afford to be off work with this crap of menopause and sleep.

Thanks all, will put a plan together.

First step would be ask GP about alternatives- that's where I am.

Then get your current meds in the little 10mg tablets, then you can reduce to 40 for a fortnight, see how you go.
Then 30 when you are ready, etc.

Don't rush. More haste less speed and all that. I took myself off sertraline a few years ago- really slowly- no ill effects at all.

I’ve been prescribed it for sleep. I don’t think I’ll ever come off it. However, I think a very gradual taper will be the correct way.

@picklemewalnuts which alternatives are you considering? I like your plan going forward, I will have a go and see what happens.

@DoesItMakeYouFeelBetter what dose do you take? Does it make you feel a bit tired and groggy during the day.

Ive got a pill cutter, so thought I might chop of 12.5mg ( somehow ) and try that instead of the 50mg.

Why do you want to come off it? I have been prescribed 10mg for menopausal sleep problems and it has transformed my life. I'll not be coming off it voluntarily 🤣

@GeorgeTheFirst Ah you see, 10mg doesn't work anymore for me. I started on 10 a have worked up to 50, but I don't want to go higher.

So quarters? Take three quarters a day instead of a whole one?

Mine are teeny. I don't think they'd be easy to cut.

I want to consider something else because of constant fatigue and brain fog. I'm so dopey and slow. That may be the Fibro, not the meds, but I want to check! What's the point of getting sleep if the meds make you feel exhausted anyway!

Someone mentioned pregabelin, others are talking about CBD etc. so I'm just starting to explore.

So it's not working so well anymore and you want to come off it rather then increase dose? 50 isn't a high dose, like all medication it's weighing the benefits and the costs/side effects to find what's right for you. Although their tends to be more sedation at higher doses, It's ability to treat nerve pain can actually decrease as the dose goes higher.

I think reducing by 1/4 of a tablet each week should work ok. Some medications don't cut well, you could give the pill cutter a whirl and see. Otherwise I'd see 'the GP for 10mg tablets then go down by 10mg a week or even a fortnight. You might find your sleep has a chance to stabilise a bit more if you draw the process out. If you're experiencing any emotional/mental side effects from menopause you might find these increase as you come off it too as it's predominantly an antidepressant.

I'm on 30 mg (built up from 10) and it really was a wonder drug for pain to start but I'm getting used to it and it's only been 3 months. I'm gonna go back to go

If you haven't already found it there's a chronic pain board on here. Amitriptyline is a common first medication to trial for fibromyalgia. Pregabalin (epilepsy), Gabapentin (epilepsy), Cymbalta (antidepressant), low dose Naltrexone (treats addiction at high dose), ketamine are the most common medications used.

You might find taking your dose a bit earlier say 6/7 pm if not already reduces the side effects, though exhaustion and brain fog could also be the fibromyalgia. If you're pushing through doing to much that tends to increase things like brain fog too.

I've not come off that one, but I've come off others.

You've likely got rebound insomnia. I'd either chat to your doctor about getting some sleeping tablets while you get back to normal (although those can cause rebound insomnia too), or taper off a little and then stay at that dose for a week before tapering a little more.

The suggestion of magnesium from a PP was a good one. I've got chronic insomnia and magnesium is one of the few things I'd say is genuinely effective.

50mg isn’t high,
If your going into menopause and it’s affecting your sleep, then it’s not going to go better without anything. It’s the hormone depletion that’s causing it.
personally if your getting sleep on it, I’d stay on it as sleep deprivation is s…
magnesium glycinate is the one for sleep issues, unfortunately didn’t work for me🤦‍♀️ but give it a go
I’m 65 and still wake 3-4 times a night and ages to get off in the first place.

If your definitely wanting to come off the 50mg
presuming it’s 1 whole tablet
id personally see if you can get the 10mg tablets(cost may decided thou)
Then you can just drop by 10mg a drop instead of 12.5mg
Id also do each drop for at least 4-6 weeks

Do not swop for sleeping tablets.

hHave you asked for HRT

I gradually tapered it off by 20mg over the course of a week each time, for three weeks, until I finally stopped. I found my sleep was not as good but that only lasted 4-5 days and then back to my normal (menopausal) sleep! I too, took it for nerve pain (trigeminal neuralgia query TMD).

Definitely taper gradually. I stopped it dead accidentally, just forgot to take it two nights and then worked out why I was feeling awful (shaky, nauseous and weak) but carried on through the withdrawal as it had long since stopped working anyway and was fed up with the side effects when on it. I was ok after about 3 days. Afterwards I read that you aren't meant to stop it suddenly.
Sometimes amitriptyline does just stop working for sleep even if you're on a high dose.

I was taking 50mg at my peak and loved how it helped me sleep.

I gradually weaned myself off it, and then when I stopped completely, I started taking an OTC antihistamine every night. Its brilliant for my eczema and really helps me sleep. I don't sleep if I forget so it definitely works.

I use Piriton or the pharmacy alternative. The ones you buy off the shelves don't work.

That's a good idea, vintage. I hadn't thought of antihistamine.

Thankyou all so much for your input , it's been very helpful. M

Realistically I'm loathed to come off amitriptyline completely, as I do get some sleep on it. I've experienced the side effects of not taking it and they are pretty grim.

Last night I took 37 mg as opposed to 50 and managed to sleep ( I did take a drop of CBD oil too).

I guess it's all about weighing up the pros and cons?

I am on HRT but it doesn't help with sleep. I am going to trial the gel though ( been on on the patch for a while now) to see if that helps.

Somehow I must get sleep!

@VintageThoughts why did you decide to come off the amit if you don't mind me asking?

Is it the piriton tablet you take, in the yellow box?

I have been taking 30mg for years and have no intentions of stopping as it is the only way I can sleep. I have tried in the past but it works and I have zero side effects from it. I also take HRT and have done so for 16 years but they make no difference to my sleep pattern but they do keep me sane ----- well almost.

@FiveShelties yes I'm beginning to think that I may have to stay on it a bit longer. I took 37 mg last night and managed to sleep.

I suppose there are more people than you think who require some form of sleep aid. I was worried about being dependent on it.