Misc How dangerous is Amitriptyline?

[Man67]

If I tapper Amitriptyline down will suicidal thoughts stop? Has anyone tried that?

 

[DesertHarp]

If I tapper Amitriptyline down will suicidal thoughts stop? Has anyone tried that?

I wouldn't want to bet on that. I found that 45 or 50 mg of amitriptyline takes the edge off my depression sometimes. Higher amounts don't really do any better, but make my mouth and throat awfully dry. So you might need to experiment with gradually reducing your dosage. Suicidal thoughts can be chronically returning, just as the depression can be chronically recurring.

 

[Man67]

I wouldn't want to bet on that. I found that 45 or 50 mg of amitriptyline takes the edge off my depression sometimes. Higher amounts don't really do any better, but make my mouth and throat awfully dry. So you might need to experiment with gradually reducing your dosage. Suicidal thoughts can be chronically returning, just as the depression can be chronically recurring.

Thanks. The problem is that every dose under 100mg brings my insomnia back. For the last several years I am on 150 mg and will now try to reduce it to 100mg and see what will happen.

 

[3DQSAR]

I don't think there are many accidental overdoses but as a second-line antidepressant prescribed in the UK, it was responsible for 268 intentional fatal overdoses last year.

Unless a patient is on an especially high dose or hordes tablets for months, people do survive overdoses but it's sort of a known drug with which to end one's life.

 

[Man67]

I don't think one needs that much. 30mg /kg cause severe toxicity and coma. So if you have just 2 boxes with 50 (50mg) pills inside that would make around 60-70mg/kg for the average person. More than enough.

 

[Man67]

I know that tricyclics like Amitriptyline are the one type of antidepressant that you can OD on fairly easily. I take Lexapro (SSRI) and Remeron (tetracyclic).

​

What affects Tricyclic antidepressants more, alcohol or grapefruit juice?

 

[paranoid android]

What affects Tricyclic antidepressants more, alcohol or grapefruit juice?

Depends on the tricyclic. Speaking from personal experience you should never drink on amitriptyline. You get no good effects from the alcohol and you just black out. It's a dangerous combo

 

[Conky]

What affects Tricyclic antidepressants more, alcohol or grapefruit juice?

Definitely alcohol

Grapefruit interactions with tricyclics and other meds exists mostly on paper

I've never taken amitryptyline but I have taken its metabolite nortriptyline alongside all kinds of substances and did just fine

 

[emkee_reinvented]

Well, I'd beg to differ with your statement that doctors in the US are driven by profits and not positive outcomes.

Some doctors maybe, but any doctors that are in addiction medicine, family practice, general practitioners, and ones that take Medicare patients are in it because they love what they do and they genuinely care about the well-being of their patients.

What stood out most to me, is the lack of actual medical/ medicine knowledge.
Working on assumption not fact and the unequal relation between the 2.
Human-Client and a Human-Doctor

Nice example was the DETOX addiction 'specialist' dr.,
who prescribed everybody Magnesium Hydro Oxide 1500 mg a day.
For Magnesium. deficiency according to him all Alcoholic s have.
Though no ones bloodtest revealed this 'shortage'.
Its a laxative Mg-O-H. About UN-absorb able. They had no working internet.

So when 10 Kg lighter and at leave at home, checked i-net.
and SHIT The fuck been poisoning us with a laxative.

When i came there they took away my Magnesium Citrate and other supplement s,
Also took my anti Epileptic co med, 'cause i was addicted to it'.

Prescribed Clobazam. [1 of the few Benzo s you literally don t feel,
and has a ceiling/ 40 mg Which att was btw unavailable, supply trouble s].
So it was mostly unavailable ?So how can one become addicted to it i wonder ?

And if so, how come 20 mg Diazepam was total overkill or the 80 mg total on day 1.
Half would have been more as enough. imo.

So + =+

 

[LucidSDreamr]

I've been on 100mg Amitriptyline for a decade. It doesn’t work as antidepressant at all. It's off the label sleeping aid and I take it together with 20mg Zolpidem and 6mg Bromazepam. Just then I can have 4-5 hours of sleep (if I am lucky). Wanted to tapper it down but my Neurologist (who originally prescribed this poison) is strongly against it. Why?

Does he prescribe the bromazepam? He doesn’t want any excuse or need to have to raise the dose of a narcotic.

Amitriptyline is the least narcotic drug you are on. If you remove it from the mix the dose of one or more of the others theoretically has to increase to make up for the loss of Amitriptyline and keep you asleep

I would taper slowly off it since it will have a withdrawal.

Wow I can’t believe you’ve been on such a high dose for 10 years

This drug has the worse GI side effects I’ve ever seen from a drug. The dizziness it causes. It does have some positive almost recreational effects on mood in my opinion. The side effects are so bad on it I don’t blame you for wanting off.

Always feeling hungry no matter how much you eat. I hate that about this drug

 

[daturetard]

Does he prescribe the bromazepam? He doesn’t want any excuse or need to have to raise the dose of a narcotic.

Amitriptyline is the least narcotic drug you are on. If you remove it from the mix the dose of one or more of the others theoretically has to increase to make up for the loss of Amitriptyline and keep you asleep

I would taper slowly off it since it will have a withdrawal.

Wow I can’t believe you’ve been on such a high dose for 10 years

This drug has the worse GI side effects I’ve ever seen from a drug. The dizziness it causes. It does have some positive almost recreational effects on mood in my opinion. The side effects are so bad on it I don’t blame you for wanting off.

Always feeling hungry no matter how much you eat. I hate that about this drug

I used to occasionally take it to go to sleep. Was a good one for that but I wouldn't say it's recreational.. I might have felt less suicidal in the mornings but it's hard to tell. It's an extremely "blunt" drug. Almost up there with antipsychotics. I haven't ever had good effects from it aside from general sedation. Pretty sure I took it with oxy once and fucked up the euphoria. What do you like about it? Seems like there's a lot to dislike.

 

[LucidSDreamr]

I used to occasionally take it to go to sleep. Was a good one for that but I wouldn't say it's recreational.. I might have felt less suicidal in the mornings but it's hard to tell. It's an extremely "blunt" drug. Almost up there with antipsychotics. I haven't ever had good effects from it aside from general sedation. Pretty sure I took it with oxy once and fucked up the euphoria. What do you like about it? Seems like there's a lot to dislike.

It gave some euphoria and up beat feeling but nasty side effects

 

[Man67]

Last week my Dr. added Agomelatine to my mix of meds. Now listen to this. Before bed l take:150mg Amitriptyline, 25mg Agomelatine, 3mg Bromazepam and 10mg Zolpidem and CAN'T SLEEP more than 3-4 hours!?

I feel tired and dizzy when I wake up but not able to fall asleep again. It's driving me crazy. When this fog clears up I feel depressed and suicidal again. Nobody wants to take responsibility and tapper down my Amitriptyline intake.

The only thing that's keeping me alive is 10mg Endone (legally prescribed). Unfortunately I have to reapply every year for this lifesaver because it's a "controlled substance".

My Dr. will do it next month but I already feel helpless and anxious. What if they say no? My life will literally be over as 10mg Endone is a "glue" that's keeping me together.

I never took illegal drugs and don't have any connections as I isolated myself from the outside world. Sorry about ranting but this is the only place where I can tell my story.

 

[Conky]

Last week my Dr. added Agomelatine to my mix of meds. Now listen to this. Before bed l take:150mg Amitriptyline, 25mg Agomelatine, 3mg Bromazepam and 10mg Zolpidem and CAN'T SLEEP more than 3-4 hours!?

I feel tired and dizzy when I wake up but not able to fall asleep again. It's driving me crazy. When this fog clears up I feel depressed and suicidal again. Nobody wants to take responsibility and tapper down my Amitriptyline intake.

The only thing that's keeping me alive is 10mg Endone (legally prescribed). Unfortunately I have to reapply every year for this lifesaver because it's a "controlled substance".

My Dr. will do it next month but I already feel helpless and anxious. What if they say no? My life will literally be over as 10mg Endone is a "glue" that's keeping me together.

I never took illegal drugs and don't have any connections as I isolated myself from the outside world. Sorry about ranting but this is the only place where I can tell my story.

I feel your pain as I also struggle with sleep maintenance insomnia. Started last winter and seemed to go away in early April before coming back early September (2024) Not sure if there's a seasonal thing going on or not. I take several meds before bed and still wake up too early.

Unfortuately, daily use of prescription meds especially psychiatric meds can result in horrific withdrawals upon dose reduction or discontinuation and recovering fully can take a very long time. In some cases, unwanted effects may be permanent unless you go back on the med or something similar. It can happen even with the "safer" SSRI class.

Also, you may want to ask for extended release Zolpidem or something else that has a longer duration. It may or may not help but it's not a big ask in any case.

 

[paranoid android]

If you want someone for sleep z drugs are far better the elavil

 

[Man67]

I feel your pain as I also struggle with sleep maintenance insomnia. Started last winter and seemed to go away in early April before coming back early September (2024) Not sure if there's a seasonal thing going on or not. I take several meds before bed and still wake up too early.

Unfortuately, daily use of prescription meds especially psychiatric meds can result in horrific withdrawals upon dose reduction or discontinuation and recovering fully can take a very long time. In some cases, unwanted effects may be permanent unless you go back on the med or something similar. It can happen even with the "safer" SSRI class.

Also, you may want to ask for extended release Zolpidem or something else that has a longer duration. It may or may not help but it's not a big ask in any case.

I tried extended release Zolpidem several months ago. Couldn't sleep at all but felt dizzy and sleepy all day.

Regarding 150mg Amitriptyline which I'm supposed to take for the rest of my life because of withdrawal symptoms I'm speechless. THEY hooked me up (it was originally prescribed for my chronic headache) on a toxic medication which never worked for depression.

How many people ended their life due to the fact that antidepressants are handed out like lollies? Nobody will ever be held accountable. Sad but true.

 

[Conky]

I tried extended release Zolpidem several months ago. Couldn't sleep at all but felt dizzy and sleepy all day.

Regarding 150mg Amitriptyline which I'm supposed to take for the rest of my life because of withdrawal symptoms I'm speechless. THEY hooked me up (it was originally prescribed for my chronic headache) on a toxic medication which never worked for depression.

How many people ended their life due to the fact that antidepressants are handed out like lollies? Nobody will ever be held accountable. Sad but true.

Of course you don't have to take amitriptyline. I was just saying that if the withdrawal symptoms are making your quality of life worse vs continuing the 150mg, then it may be worth it to stay on that dose. Because there's no way to tell how long the withdrawals could last. If you really want to stop taking it, you may have to taper very slowly over several months and possibly switch to a different AD with a longer half life and taper off.

And yeah I agree with the last part. Many doctors prescribe these antidepressants without educating the patient about the possible side effects they could get. It's literally unethical but they get away with it. It's happening with antipsychotics as well.

 

[4DQSAR]

Amitriptyline is STILL the standard by which the activity of other antidepressants are measured.

One may ask why more modern, less effective (as it turns out) antidepressants were developed. The main reason is that in overdose (generally intentional), amitriptyline can be fatal in high doses. The more modern alternatives were all based on them being much safer in overdose with effaciacy being a secondary objective. It was the fact depressed patients were occassionally using their medication to end their own lives.

But it's worth noting that even amitriptyline is effective in less than half the people who are prescribed it. Doctors don't like to mention this fact but the truth is that it's more likely than a given medication won't work work for a patient. But I know that people often think 'would I feel even worse if I didn't take this medication?' and do not return to the doctor and ask for the dose to be altered or a different antidepressant employed.

There is no such thing as a totally safe drug but it has been in use since 1961 and remains a common choice as treatment for depression. Doctors do base their prescribing on their education and there experiences so if a doctor prescribes a given medication, it's because they have done so many times and understand that the outcomes have been generally positive.

It's important to look how common a given side-effect is. All of the common side-effects aren't that serious and if someone is liable to a more serious side-effect, it will tend to manifest quite quickly, not after years.

 

[Man67]

Of course you don't have to take amitriptyline. I was just saying that if the withdrawal symptoms are making your quality of life worse vs continuing the 150mg, then it may be worth it to stay on that dose. Because there's no way to tell how long the withdrawals could last. If you really want to stop taking it, you may have to taper very slowly over several months and possibly switch to a different AD with a longer half life and taper off.

And yeah I agree with the last part. Many doctors prescribe these antidepressants without educating the patient about the possible side effects they could get. It's literally unethical but they get away with it. It's happening with antipsychotics as well.

If by some miracle 25mg Agomelatine start to work can that be a substitute for Amitriptyline?

 

[Conky]

If by some miracle 25mg Agomelatine start to work can that be a substitute for Amitriptyline?

Based on agomelatine's pharmacology, I don't think it would be a suitable substitute for amitriptyline. Agomelatine acts mainly as a melatonin agonist with much lower affinity for other receptors.