Amitriptyline Prescription - First-Line Treatment - Q's about Dangers, interactions..

[isthisincognito]

A friend of mine has been suffering migraines, nausea and anxiety due to "stress".

He was signed off work and prescribed 2mg diazepam for a week, and then he's just been to the Doctor today, and they have prescribed him Amitriptyline and allowed him to return to work (His return to work is a positive move, as it relieves financial pressure).

He's never taken benzo's prior to his prescription last week, nor has he ever been on any kind of Antidepressants, he's drug naive recreationally, but does smoke a little weed (2-3 times a week).

I'm just a little curious about the decision to prescribe Amitriptyline before anything else, and does anyone know anything about risks, dangers, interactions etc.?

Does anyone have any personal experience with this medication?

I only question it, due to this from wikipedia.

Amitriptyline is used for a number of medical conditions including major depressive disorder (MDD) which is its only FDA-labelled indication.[1] This is also a TGA- and MHRA-labelled indication.[6][7] Some evidence suggests that amitriptyline may have superior efficacy compared to other antidepressants,[8] including the SSRIs.[9] Although it is rarely used as a first-line antidepressant nowadays due to its high degree of toxicity in overdose and generally poorer tolerability than the newer antidepressants such as the selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).[6]

He's stressed, but still of sound mind. I don't think he's suicidal, although there has been suicide in his family by a blood relative.

 

[Bob Loblaw]

~~~> BDDi

 

[Speed King]

I got a deal on a bunch of wellbutrin 300xl. I also take Vyvance. The wellbutrin has had a major impact on the morning grogginess. It helped get me going. 2 to 3 hours later, I will take 70mg Vyvance after that. I feel that it works (much better than any ssri's . I wouldn't recommend this combo unless there were benzos on hand.

 

[Kittycat5]

It does seem odd to try amitriptyline as first line for anxiety. Maybe it is being used as a migraine preventative but unless he was told this find it a bit odd too.

 

[Speed King]

I must of been buzzed pretty good answering that question. With any drug, your mileage may vary. I personally am on a over a half dozen legal perscriptions for everything from mood stabilization, to back pain, and ADD to name a few.

 

[Speed King]

As far as Amitriptyline is concerned, I am prescribed 10 mg. That 10 mg works excellent. It makes me sleepy ( I take before bed), it has antidepressant effects, which usually take a few weeks to be fully recognized.
Like I said, I take 10 mg. There are people who take 150 mg plus per day. That high of a dose may be something to be watchful of.
I do not know all the facts, but they will boost the effects of opiates.
There many ways to go with this, so in my opinion, the doctor may simply be playing it safe. I do not know your friends history or whatever. The diazepam seems pretty light also. There is nothing wrong with the Amitriptyline. It's been around forever. The doctor knows what he's doing. Remember it's what works best, not the name, popularity or certain milligram dose of medicine.

 

[isthisincognito]

He sent me a picture when he got the 'script, I just checked it and he's got 50mg tablets. I'm sure he said it was twice a day, but I might be mistaken as I think he only has 28 tablets (one month at once a day).

They do seem to make him sleepy. On saturday he took one at around 4pm, we went for a few drinks after and got home at around 12. The next day talking to him, he doesn't remember anything past 10pm, nor how we got home, Reminding him of our conversations he still couldn't remember.

Is this common with alcohol? He's usually the designated drive, so doesn't drink too much. I think he had maybe 4 pints, but didn't act drunk at all.

He seems to be doing ok, but has mentioned he's having nightmares - I said I wasn't too surprised as get nightmares and sleep paralysis in the days following a roll, So I told him it's probably down to the meds.

 

[sepultura]

Thats the only antidepressant I could ever tolerate but be careful, other than seroquel that med is one of the most known to cause balloon syndrome hhe ie, Xtreme weight gain.Still be aware of it, but if your a guy and under the age of 30 maybe dont worry about it quite as much, but if your female and/or over the age of 30 trust me, keep a watchful eye out!

 

[isthisincognito]

^ Well, he's a guy, but he's been trying to lose weight lately (with good success!).

I don't think I'll tell him, unless he starts piling on the weight. I looked up the side effects on the NHS website (I'll link below for reference). I couldn't see weight gain, but "breast enlargement in men and women" is listed.

Is that not common for other drugs though, I've heard people say Etizolam can give you breasts.

http://www.nhs.uk/medicine-guides/p...x?condition=Depression&medicine=amitriptyline

 

[sepultura]

I think thats more common these days even with just the use of plastics like BPA and stuff but yea others can as well.Thats CRAZY it didnt say weight gain on there because it is def is a huge, ( no pun intended) hhe side effect. He can just google elavil and weight gain and it will come up although as long hes your aware thats all he needs to be really. On the low dose hes on hhe and the fact that hes a GUY... 2 points in his direction.For me, I gotta say it did work well.

 

[bunge]

50mg is a dose for anti-depressant purposes and it has some anti anxiety properties though i wouldnt pick it as first line in any instance.

Your friend should take it at bedtime and that will mitigate any memory loss and alcohol is a big no-no on amitriptyline.
It was on the WHO watchlist for dangerous drugs because ofits popularity in drug assisted suicide, usaully in conjunction with opiates and alcohol.

Amitriptyline has made a come back in recent years and its finding new uses all the time but its still a powerful drug that can be toxic (especially to the heart) so following the docs instructions is important.

 

[isthisincognito]

Thats CRAZY it didnt say weight gain on there because it is def is a huge, ( no pun intended) hhe side effect. He can just google elavil and weight gain and it will come up although as long hes your aware thats all he needs to be really.

After I posted before, I checked wikipedia, and it's listed on there. I checked another site (webmd I think) and it was also listed on there. It should all be in the pamphlet, but I doubt he's even read it.

Your friend should take it at bedtime and that will mitigate any memory loss and alcohol is a big no-no on amitriptyline.

Yeah, The doctor advised him that he should take it when he gets home from work, and that he can't drive after taking it. He's not a big drinker (once or twice a month perhaps), so I doubt he's going to drink anymore whilst he's taking it.

I was supposed to see him tonight, but he's being a little off. I'll see him this weekend and just see how he's getting on.

 

[sepultura]

Just to let you know one kinda cool thing about it-I was prescribed a much higher dose like 50 up to 100 mg a day and lemme tell you when I first started taking it I got a pretty good buzz off of it. The sleep was amazing too.I felt like I was sewn to the bed but the next morning it was like I was coming of a psychedellic/mdma binge!You probably wont get as much of that with 10 mg and even if you did take more, those effects dont last long because your body acclimates but yea, its actually been known to be slightly misused I think by namely heroine addicts.