Insomnia/anxiety/amitriptyline

[chocolatesaltyballs22]

Hello, have posted before about my insomnia and the debate about taking amitriptyline. Have been on HRT for a year but it isn't really helping with my sleep so the doctor has given me some Ami to take 'when I need it' to help me sleep. Have got to the stage where I'm taking it pretty much every night but last night I was so exhausted I decided I would be able to sleep without it. I was so wrong. Awake till 1am and then maybe got 3 hours sleep. Currently on a train to London where I have to present to a room full of people and then won't get home til late tonight. I could cry.

I'm getting desperate and feel like this is affecting my job now. Last night when I couldn't sleep I was just getting more and more anxious about how crap i was going to feel today, and of course I know this makes things worse.

I wonder if I should go back to the doc and say I think I need the Ami every night, but will I get hooked? What are the alternatives? I can't go on like this.

Did you post about this before and were you the poser who got a bit cross with me for questioning the use of ami? Maybe that wasn't you, and you were part of the conversation and it was another poster who got ratty and rude!

The first step is to increase your estrogen dose if you have not done this already.

So if you are on 1mgs, go up to 1.5, or 2. (easily done with a patch or gel.)

Ami is an anti anxiety drug and yes, you could get addicted as it's an old tricyclic anti depressant. But the dose needed to really help is 75mgs and above- how much are you using?

Hi, no am sure that wasn't me!

I'm on Kliofem in terms of HRT, have already increased that dose which has helped all other symptoms except the insomnia. Doc not very sympathetic tbh, just feel like I'm pestering. I take 10mg of the Ami. Someone a few weeks ago said it only helps them if they take it constantly.

I have private healthcare and am wondering whether it's worth seeing a Meno specialist.

I hate to suggest the obvious as assume you do it already but...

sleep hygiene? No screens for 1 hr before bed?
no caffeine after midday?
no heavy meals at least 3 hrs before bed?
at least 30 mins exercise a day?
cut back on sugar and refined carbs?
try mindfulness or meditation daily?

Is kliofem a combined HRT or sequential( do you have a bleed with it?)

If it's the no bleed type it could be the Norethisterone which is adding to insomnia as it can sometimes override the good effects of estrogen.

Also, using a patch or gel with Utrogestan might help that's micronised progesterone and often sedates women.

Private health cover won't cover menopause as it's considered 'natural but also a long term condition. You can of course pay for an appt with a meno consultant, and it's usually around £250.

Yep have done all that X3. Not gonna lie, just want some decent drugs to knock me out for 8 hours straight every night!!

10mg isn’t much I think that’s the lowest dose you can have, people take this drug long term for nerve pain. If it works then speak to the doctor about it, insomnia is exhausting and if it works for you then I wouldn’t worry about being in it continually.

2nd night of very little sleep - feel like a zombie. Ended up taking 2nd Ami at about 1am. I don't know what to do.

Why not swap Kliofem (combined continuous) for a sequential type? I mentioned upthread that you might be better on estrogen-only for 2 weeks a month.

Also, have you thought of using over the counter anti histamines to aid sleep- like Nytol, or Piriton or even valerian (herb)?

@JinglingHellsBells I may do but my doctor isn't giving me any options and I feel like I'm just bugging her every time I go to the surgery. Her view is 'oh you should be ok on these.'

Over the counter anti histamines don't work either - I've tried everything.

How is your sleep at weekends when you don't have to get up for work the next day? Still 2-3 hours? If it's better at weekends, I'd suggest exploring if it is work and stress related? Even if you enjoy your job, you could still have underlying stress.

Yeah it is much better at weekends, but still not perfect. I think maybe yesterday I didn't switch off from the day properly. Got home from London at 10 and went straight to bed. Don't know what the issue was the night before though. I did have a big presentation yesterday which was probably going round in my head.

I may do but my doctor isn't giving me any options [ask her for some?] and I feel like I'm just bugging her every time I go to the surgery. Her view is 'oh you should be ok on these.

If you can stand up and give big presentations, you must be able to have a proper conversation with your GP.

And as PP said, look at your lifestyle. Maybe the work you do needs looking at?

I know you're right, somehow I just have a doctor phobia and the one they keep booking me in with is the least sympathetic person on the planet. I just need to bite the bullet and go. Not today though. As that would involve actually getting dressed and leaving the house.

I took amitriptyline recently for nerve pain (10-20mg a day for about a month). I found it interesting that one of the side effects mentioned on the pack was that it would make me drowsy. In fact I found the opposite. It kept me awake at night.

I hadn't been sleeping for about a month previously (kept awake by the pain when on less effective painkillers) so although I was still sleep deprived at least I wasn't also in pain!

The weird thing is that it works sometimes for me, but not always. I think it may be a timing issue re last night. I took it at 10pm and then attempted to go to sleep straight away. Then took another at around 1am when I still couldn't get to sleep. If I take it an hour or two before bed it seems to work better.

Choc, been exactly where you are. Everything you wrote I could have written. I'm on Amitriptyline too, for the same reasons. I also take Melatonin which I order online from the States.

I only take Ami twice a week because I found that the more I took, the least it work. It also came with some side effects, weight gain and worse, my bowels didn't like it at all. I also have to be careful because of a family history of glaucoma. I now take 10md twice a week. It's enough for me because even though I don't sleep well most nights without it (and indeed, even occasionally on it), at least I know that in all likelihood, I'll will get a better sleep in a couple of days and after 4 years of disturb sleep, I know that somehow, miraculously, even though it doesn't feel like it, I will somehow cope the following day, even if badly.

Saying that, my GP has assured me that it was safe to take, and could do so every night if I wanted to. It is not addictive and a dose of 5 or 10 mg is little (compared to 50mg + if taken for depression).

My anxiety is a lot better since I've been in it, but it was already much better before I started, so don't know if it is because I'm now full menopausal or whether it helps with that too.

I was on HRT for some time, tried different ones, different doses, but it never make any difference with my sleep. It doesn't work for all. Working ft in a demanding job certainly doesn't help, but some people have no option but to keep going, so I really know where you're coming from.

Ami is an anti anxiety drug and yes, you could get addicted as it's an old tricyclic anti depressant. But the dose needed to really help is 75mgs and above- how much are you using?
Sorry Jingle but this is incorrect. The dose to treat depression is indeed 50mg or more, but for the purpose of sleep, 5 to 10mg is enough. And no, it isn't addictive, which is why GPs are happy to prescribe with little supervision.

I've seen three different GPs during this time (sadly GPs have all left and gone in my practice!) and all three have said it was safe to take without the risk of addiction. Mine is now on repeat prescription for 6 months worth.

of course you should go back to the doctor. Even if you know that diet and lifestyle are important, it's clearly nowhere near enough. You don't have to suffer in silence.