Amitriptyline hell

[Heartbreaksally]

Ive been prescribed amitriptyline for severe and debilitating sciatica - still waiting on mri to work out the cause but its assumed to be some sort of disc issue.

But fuck me, I CANNOT wake up with amitriptyline. It takes literally hours if concentration and focus to get out of bed.

Ive spoken to gp who advised taking it earlier, but I'm already taking it at 4.30pm and can't wake at 7am. My parents are having to take my kids to school, and im wfh for the foreseeable, because theres no way I would 1. Make it in for 9, and 2. Be fit to drive.

I started 4 weeks ago on 10mg, and have been told to increase every week until Im up to 70mg. Ive spoken to physio and the orthopedic doctor I was referred to, and they've both advised to just persevere, but honestly this feeling is worse than the pain - which hasnt even reduced much (but doc says it can 6 weeks for amitriptyline to work). The only thing its helping with really is sleep, because I cant lie down but the amitriptyline knocks me out enough that I dont notice. But then when I wake up I feel even more tired, and like I havent slept at all with this groggy hungover feeling.

All the advice I see online is to just take it earlier. But how much earlier can I take it im already at 4.30? Which gives me enough time to sort my kids and get them to bed before I'm knocked out.

Im at the end of my tether, both with the pain, not being able to walk or lie down, and now with this awful drowsiness and constant hangover feeling.

The mornings are honestly so dreadful, taking hours to wake up. I dont know what to do.

I had to take this once for a bad nerve pain thing, I found it knocked me out for a few nights but then my body got used to it. You may need longer at each dose.

Can they try codeine instead? It doesn't last as long, I switched to this after a bit and it was much more effective with the pain.

I'm on cocodamol 30mg/500mg every 4-5 hours during the day as well, as well as naproxen every morning, and neither of those have had any side effects - although they only take edge off the kind of knawing achey pain and dont touch the burning, electrocuting pain or help with the sleep issue, which is why the doctor added in the amitriptyline. I honestly dont know how much longer I can persevere with both the pain and the drowsiness. On one hand, the amitriptyline is giving me a break from the pain when I'm knocked out, because I wasn't sleeping before so just had to endure the pain 24/7, but on the other hand the drowsiness makes it harder to fight against the pain the next morning because all my energy is going on forcing myself awake. Im honestly at my wits end.

Ive gone from being so active, walking everywhere, to being constantly housebound. Lying down and walking are the two main triggers for the massive nervey firework flareups so ive been told to avoid them for now, but its really starting to get me down and eat away at my mental health now too. I think that's where this grogginess has been the final nail in the coffin for my resolve, im finding it harder now to stay positive.

I just really hope this MRI comes through soon.

Ask to switch to nortriptyline

There are other drugs. Gabapentin. Pregablin. Low dose naltrexone (not on the nhs). Also as pp says noritryptaline usually has less side effects - why they haven’t already offered it I don’t know.

Amytriptaline didn’t do a lot for me but it also didn’t give me any side effects.

Some people get similar effects from gabapentin or pregablin but you can ask to try them if it’s intolerable. You have to really put your foot down with GPs when something is negatively impacting you.

The much prefer people to push through and won’t recommend anything else until you insist.

Thank you. I think I'm going to have to go down this route and ask for something else because this really isnt sustainable.

For one, im afraid of there being some kind of emergency in the night and me not being able to wake up and help my kids.

The whole thing is so frustrating, its been going on for months now. I had to pay for a private doctor just to get the original cocodomal and naproxen, and its been a fight since to get a normal GP appointment when they weren't working because I couldn't afford another private appointment. I still havent heard anything from my physio referral, but couldn't hold on anymore so have had to pay £50 week for private physio in the meantime. Seriously contemplating paying for a private MRI but it will be a case of going in to debt to do it.

Thank goodness that my job is able to be done from home and that my employer is so good working with me to accommodate it. If I couldn't, id have to put in a sick line and would only get SSP, which isnt enough to pay the bills and live on, never mind pay for physio! And thank goodness my parents are able to do my school runs for me.

I am going to try my GP for an appointment to discuss all your recommendations, and if push comes to shove pay for another private GP to get a more realistic prescription that doesn't turn me into a zombie.

That's a pretty fast increase! I would query if you should titrate up slower than that.

How long have you been on that dose of codeine? That's a high dose, and can certainly cause drowsiness as well.

Been on the codeine since November and it hadn't caused any drowsiness at all.

I was supposed to up my dose of Amitriptyline to 40mg on Friday but I just couldnt face it, so am still on 30mg with no steadying of symptoms at all.

Any way of accessing private healthcare through work? What a shitty situation for you.

I didn't do well on Amitriptyline or Nortriptyline either, they both made me feel like a zombie, even at low dose. I came off it as I had concerns about the long term side effects especially now I am getting older.

I have disc degeneration so feel for you. I take codeine for my pain (I also have endometriosis and adenomyosis) from time to time but have to be careful as it's so addictive. I also get by with my tens machine. I am seriously considering medical cannabis.

Have you see anyone at a pain clinic?

I found after a couple of weeks I was ok on Amitryptiline but was awful at first, the days were like being drunk and hungover. The Co codamol will have the same effect too, made me so drowsy and is addictive, whereas Amitryptiline isn’t. Try stick it a couple more weeks if you can. Eventually I was able to go to work on 30mg but at the start was awful. I found it really did help with severe sciatica. Good luck, mine is currently ok and off meds fingers crossed. Specialist told me that your body eventually stops sending out the pain signals but it did take a few weeks, maybe months. It’s so unbearable x

I was given Amitriptyline for neuralgia and it had exactly the same effect on me. I had to stop taking it as I just couldn't function. The GP didn't seem to believe me as I was on a relatively low dose. Please insist on trying something else.

I spent months trying to get on with amitriptyline, and it was awful.

In the end it wasn't solving my nerve pain issues, and as I was out like the dead then really struggling to wake up and spending the day as a zombie I refused to continue.

As a lone parent I was concerned that I wouldn't wake in the night if needed, and was struggling with getting us up and to school etc in the morning.

There are definitely other medications that your dr should be able to try you on instead.
Best of luck.

I can’t cope with Amitriptyline.

I do much better with Nortriptyline - only 10mg a day, though!

The reason that GPs want patients to put up with Amitriptyline is that it’s cheaper. But if you say you can’t tolerate it and ask to switch, they are supposed to try you on Nortriptyline instead.

Pregabalin creates dependency - it’s a short-term solution only. Codeine - ditto, and not everybody gets much of an effect.

And sympathies

I've had amitriptyline as migraine preventative but it just made me feel groggy in the morning. Just to check, have you been told to increase the dose if it's not helping with the pain? Just being knocked out by it is not what's supposed to happen. I think in your shoes I'd be demanding the scan, physio and everything I could think of. Easier said than done if you're in chronic pain though.

Give it up. Nortriptyline is worth a try.

I was prescribed it for migraine, only 10mg and pretty much comatose for 23 hours.

Tried powering through on the basis the side effects would ease but rapidly realised that I didn't have time for that as basic things like eating, let alone going to work weren't happening.

I prescribe a lot of amitriptyline and have yet to have a patient with as bad side effects as me but have been a lot more cautious with it since.

There's no point pushing someone to stick with amitriptyline if it doesn't suit them, there are other options.

I'd stay at 10mg for now and preserver with it, it does get better. It floored me the first 6-8 weeks but now I'm absolutely fine on it. I take it at 10pm and wake up at 5.30 and can drive fine ever at silly o'clock.

I’m like others in that I found it absolutely floored me for approx 8 weeks (on 10mg) and then that lifted. I iterated up but MUCH, MUCH slower than you are, and that worked.

You need to ask to change to Nortriptyline
same effect without the drowsiness

Having watched my 86 yo mum go through the side effects of pregablin and then the withdrawal which was horrific, I wouldn't touch it

I've had a number of disc herniations and amitriptyline was utterly useless for the nerve pain. Did nothing but make me feel groggy the next morning and dry my mouth out.

Gabapentin was the only thing that helped. Even oramorph wasn't as good as gabapentin.

Titration that fast also doesn't sound good. I'd go back and ask to try something like Gabapentin or pregabalin.

I had to take them when pregnant for migraines. I had 10mg and like you they knocked me out, it was awful but better than the migraines. With dd2 the gp suggested I break them in half as I was so sensitive to them, it did make a bit of a difference to waking up. The second time I took them for 12 weeks and my body didn't get used to them at all.

They are used for insomnia so the tiredness isn't exactly a side effect, it's how the drug works and just might not be for you.

I wish

I didnt even know that a pain clinic was a thing?

The only referrals ive had are to a physio - yet to come through so im paying privately for now - an MRI scan, also yet to come through and im debating paying for privately, and orthopedics - I did get an appointment with them, but was in the room for all of 3 minutes, told me I was already on the best painkillers and an mri scan had already been requested so there wasn't anything else he could do at the minute. He was very dismissive of anything I tried to tell him, and when I asked if there was anything I should or shouldnt be doing, or if I should continue forcing myself to walk through pain etc he said that was for a physio to say and not him... fair enough but ive been waiting for physio since november!

Yes, prescribed for the nerve pain but with knocking out being a bonus for not sleeping is how the doctor put it. I was started on 1x10mg tablet, and told to increase by 1 tablet every 5-7 days. When I spoke to GP and Orthopedics to say they were having no pain relief effect and only grogginess, they bith said it can take up to 6 weeks for it to build up enough in your system to have an effect on nerve pain, and about yhe same amount of time for the side effects to wear off so to just persevere

I have been referred for these, but they're taking so long to come through