Amitriptyline

[F.U.B.A.R.]

Apologies if there's already a thread on this, but I can never utfse.

My Mrs is currently suffering a serious bout of sciatica and in constant pain. Managed to drag her to the drs last night and he prescribed Naproxen 500mg twice daily and amitriptyline 10mg 1 or 2 at night.

Now I know that amitriptyline is a TCA that is often used for nerve pain, but how the fuck does this work then? The Dr gave us a load of spiel about it being especially developed for nerve pain, but I reckon that's more of an off label use - it certainly says fuck all about pain on the leaflet in the box.

Anyone know how much leeway she's got with the dose? Will she be ok taking extra through the day and will this increase the painkilling efficacy or just fuck with her head? She's had a history of depression and been on SSRIs and SNRIs in the past, none of which the dr queried, which I would have thought was relevant.

Any thoughts or advice will be much appreciated, as I trust you guys more than GPs most of the time.

 

[zephyr]

I was given lyrica and celebrex for mine as well as a steriod shot into the spine.

Lyrica is brilliant but takes 3 hours to start working.

Does not affect effexor

Sorry thats not helpful at all

 

[F.U.B.A.R.]

I was given lyrica and celebrex for mine as well as a steriod shot into the spine.

Lyrica is brilliant but takes 3 hours to start working.

Does not affect effexor

Sorry thats not helpful at all

Thanks Zephyr, useful to know what alternatives are available. She's only ever been prescribed diclofenac for her sciatica before now.

 

[Sadie]

I was given amies for my IBS. Was told I'd never be off them. They were 10mg. I didn't like taking them. I was too monged out. For what ever reason my IBS is in check pain wise. Im no longer prescribed them at request.

If she finds them to help with no hindrance then by all means continue. It is very useful for pain. It was the side affects that got me. My relationship with amitriptyline is in no way indicative of how others processs it.

 

[F.U.B.A.R.]

I was given amies for my IBS. Was told I'd never be off them. They were 10mg. I didn't like taking them. I was too monged out. For what ever reason my IBS is in check pain wise. Im no longer prescribed them at request.

If she finds them to help with no hindrance then by all means continue. It is very useful for pain. It was the side affects that got me. My relationship with amitriptyline is in no way indicative of how others processs it.

Cheers Sadie. Yeh, it's the side effects we're worried about, though hopefully she'll only be on them short term.

 

[zephyr]

Thanks Zephyr, useful to know what alternatives are available. She's only ever been prescribed diclofenac for her sciatica before now.

Yeah. I did not read your post as carefully as I could have. Damn drugs

 

[Sadie]

Cheers Sadie. Yeh, it's the side effects we're worried about, though hopefully she'll only be on them short term.

I'm all for the wait and see method when it comes to a competent, trusted doctor. Side effects can be wildly exaggerated in the first few weeks. It takes some time, patience and some times pain to get the balance right. Saying that, you know within yourself if something is not for you.

Wishing your missus the very best. My ex mother-in-law suffers from sciatica. It's brutal seeing her in so much pain.

 

[StoneHappyMonday]

I took them for about three years when wrongly diagnosed with nerve pain. For some people it works for nerve pain so don't completely rule that out. For me, and many others, it became the greatest sleeping pill, at 20 or 30 mg, ever invented. I am still convinced the NHS will one day realise this and it will end up as a sleeping pill(s).

I used to have hundreds as a backlog. Alas, those days are gone and thank god for pregabalin.

 

[Nicholai]

When I was on it, my doctor told me that you get the full benefit of it's pain-killing properties at 20mg per day.

 

[F.U.B.A.R.]

wrongly diagnosed with nerve pain.

That's shocking. It wasn't your cancer that had been misdiagnosed was it? If so, then that's even more shocking.

For some people it works for nerve pain so don't completely rule that out.

No not at all - I understand it can be very effective and is more commonly prescribed these days for neuropathic pain than it is for depression - though I think they need to update the information leaflet in the box as that says nothing about use for pain. What I was more concerned about was the fact he told us it had been developed specifically to combat neuropathic problems. Now I don't know if that was just a piece of professional bullshit to keep the patient happy or he actually believes it. But either way, prescribing them to a patient he's never seen before who has a previous history of clinical depression and attempted suicides, probably isn't the wisest move - especially considering she's been prescribed many SSRIs and SNRIs in the past and not reacted well to most of them. In fact, they often made her depression worse. However, I've since found out that the antidepressant dose is much higher than that for pain - starting at 100 - 150mg daily. This should give her a bit of leeway dosage wise.

For me, and many others, it became the greatest sleeping pill, at 20 or 30 mg, ever invented. I am still convinced the NHS will one day realise this and it will end up as a sleeping pill(s).

Heh, she's just starting to realise this now

 

[consumer]

It works for some patients but not others for neuropathic pain. I am at the beach for sunrise. When i am home i will check my mims book which has every pharmaceutical and its dosages and uses in it for you.

 

[StoneHappyMonday]

That's shocking. It wasn't your cancer that had been misdiagnosed was it? If so, then that's even more shocking.

It was shocking but not as sensationalist as my cancer. It's actually turned out to be something far worse than that. I have Peripheral Vascular Disease, also known as PAD (where the A that replaces the V stands for Arterial - Artery) aka arteriosclerosis. Fucked up my life far more than cancer. Short version - I have 2 blocked arteries in my right leg. You only have 3 arteries in your leg. So they won't operate (the operation only providing a temporary 5-7 year fix anyway) because if the op goes wrong I have a 10% chance of losing my leg. And I'm a bit young for that. When aren't you a bit young for leg amputation?

Anyway, it means my mountain climbing days are over and it's why my last two holidays have involved driving thousands (roughly 10000) of miles across Europe. Because I can't walk further than...not far...without stopping. No blood flow, no oxygen flow for those gradients. ANY fucking gradient. Has changed my life completely.

But....in reference to amitriptyline. This all started with a bad Hep C vaccination for when I went around the world in 2008. I immediately got hypersensitivity vasculitis - which is just the narrowing of veins or arteries caused by a bad reaction to a drug. My GP was brilliant and sent me off on holiday (the timing was getting so close) and told me it would go away. Which it mainly did. At least the purple blotches did. Until I returned after 6 months in hot climates back to rainy UK where it came back with a vengeance. But not the blotches. So off I went for hospital tests. And in the very first test, called a doppler test - they screwed it up and missed it. I had 3 years of tests (Hence 3 years of amis for my 'neuropathic' pain) and 12 specialists called me a liar. Because, I think, I'm pretty sure they were scared of me suing. I was never going to sue. I just wanted my legs back.

It was never to be. After I'd sorted out my cancer in 2013 I went back to my GP to beg for more tests as my walking was getting ridiculously bad. He sent me to a different hospital where I met the most brilliant Nurse ever called Kirsten who sat me down, rolled up my trousers - and diagnosed me with serious vascular problems within a few seconds via the doppler test. A month later an MRI confirmed the PVD/PAD/arteriosclerosis. Just the five years too late.

But hey, I got 3 years of decent sleep.

I only ever got 10mg pills. My son got 25mg pills for depression. He hated them so I ended up with his too.

NHS is brilliant. But not infallible. And there are times when I think back to those specialists, some who were downright nasty, and wonder what might have been if I was diagnosed earlier. The thing is if I gave you my symptoms, particularly throwing in the word claudication, and gave you google...you'd diagnose me within 5 seconds too. I never realised the importance of that word. They damn well should have.

All the best to your wife.

 

[F.U.B.A.R.]

It was shocking but not as sensationalist as my cancer. It's actually turned out to be something far worse than that. I have Peripheral Vascular Disease, also known as PAD (where the A that replaces the V stands for Arterial - Artery) aka arteriosclerosis. Fucked up my life far more than cancer. Short version - I have 2 blocked arteries in my right leg. You only have 3 arteries in your leg. So they won't operate (the operation only providing a temporary 5-7 year fix anyway) because if the op goes wrong I have a 10% chance of losing my leg. And I'm a bit young for that. When aren't you a bit young for leg amputation?

Anyway, it means my mountain climbing days are over and it's why my last two holidays have involved driving thousands (roughly 10000) of miles across Europe. Because I can't walk further than...not far...without stopping. No blood flow, no oxygen flow for those gradients. ANY fucking gradient. Has changed my life completely.

But....in reference to amitriptyline. This all started with a bad Hep C vaccination for when I went around the world in 2008. I immediately got hypersensitivity vasculitis - which is just the narrowing of veins or arteries caused by a bad reaction to a drug. My GP was brilliant and sent me off on holiday (the timing was getting so close) and told me it would go away. Which it mainly did. At least the purple blotches did. Until I returned after 6 months in hot climates back to rainy UK where it came back with a vengeance. But not the blotches. So off I went for hospital tests. And in the very first test, called a doppler test - they screwed it up and missed it. I had 3 years of tests (Hence 3 years of amis for my 'neuropathic' pain) and 12 specialists called me a liar. Because, I think, I'm pretty sure they were scared of me suing. I was never going to sue. I just wanted my legs back.

It was never to be. After I'd sorted out my cancer in 2013 I went back to my GP to beg for more tests as my walking was getting ridiculously bad. He sent me to a different hospital where I met the most brilliant Nurse ever called Kirsten who sat me down, rolled up my trousers - and diagnosed me with serious vascular problems within a few seconds via the doppler test. A month later an MRI confirmed the PVD/PAD/arteriosclerosis. Just the five years too late.

But hey, I got 3 years of decent sleep.

I only ever got 10mg pills. My son got 25mg pills for depression. He hated them so I ended up with his too.

NHS is brilliant. But not infallible. And there are times when I think back to those specialists, some who were downright nasty, and wonder what might have been if I was diagnosed earlier. The thing is if I gave you my symptoms, particularly throwing in the word claudication, and gave you google...you'd diagnose me within 5 seconds too. I never realised the importance of that word. They damn well should have.

All the best to your wife.

Thanks SHM, but her issues pale into insignificance compared to what you've been through. All the best to you mate...

 

[monstanoodle]

I'm on Amitriptyline (150 - 200mg).
It has a "Get some sleep" window that needs to be stuck to, or you'll just let it pass you by.

I have shitty pain that starts in my feet, to my calfs, to my knees, to my hips and my spine (mostly my lumbar but can crawl up to all of my spine)...

All Amitriptyline is doing right now is holding my grief back, like a dam... Come the funeral - who fucking knows.

I hope it helps.

 

[F.U.B.A.R.]

I'm on Amitriptyline (150 - 200mg).
It has a "Get some sleep" window that needs to be stuck to, or you'll just let it pass you by.

I have shitty pain that starts in my feet, to my calfs, to my knees, to my hips and my spine (mostly my lumbar but can crawl up to all of my spine)...

All Amitriptyline is doing right now is holding my grief back, like a dam... Come the funeral - who fucking knows.

I hope it helps.

Jesus, is that 150 - 200mg just for pain or for depression as well? That's a fuckin well high dose from what I can gather, so good luck and all the best to you man!

 

[Sadie]

Amitrytaline is an antidepressant. At those doses it serves it's purpose. They found that at smaller doses it was good for chronic pain.

Monsta, I wish I could be there for you and I hope you understand why I'm not at the moment

Love you so much man. It's good to see you posting again I just wish it were under better circumstances.

 

[F.U.B.A.R.]

Amitrytaline is an antidepressant. At those doses it serves it's purpose. They found that at smaller doses it was good for chronic pain.

I know. That was the whole point of my original question

 

[Sadie]

Never miss a trick me

 

[F.U.B.A.R.]

It works for some patients but not others for neuropathic pain. I am at the beach for sunrise. When i am home i will check my mims book which has every pharmaceutical and its dosages and uses in it for you.

Still at the beach mate?

 

[Jackal]

A little OT, but I have moderate to severe sciatica every few years due to to old injuries, and medication helps, also physiotherapy.

The silver bullet, in my case anyhow, seems to be a couple of intensive acupuncture sessions.