Misc Amitripyline for pain Questions

[Cane2theLeft]

^I've heard that lower doses are needed to treat pain than are needed to treat depression and anxiety but I'm not sure about sedation. It would make sense though IME because like diphenhydramine, certain doses produce god-awful restlessness which is obviously quite counter-productive to sleep, this if present, usually resolves rapidly though, as does the hangover effect... also if you are a smoker, smoke more in the AM because as cholinergics, nicotine reverses some of then unpleasant hangover-like effects (purportedly).

To the person who said the withdrawal is opiate-like... I took higher doses of nortriptyline daily for 6+ months and upon abrupt cessation had no abstinence syndrome whatsoever (withdrawal). It may be good to taper, but especially a low dose like 10mg this shouldn't be necessary and withdrawal should be tolerable. I am not just using inductive reasoning here, I've researched anticholinergics quite a bit.

I have read in many places that the later-generation tricyclics have a better side effect profile (especially nortiptyline > amitriptyline) so I am also a bit surprised they went with amitriptyline but that is the gold-standard TCA and if a doctor isn't well versed in treating CP w/ TCA's it makes sense they'd go to amitriptyline.

 

[Volcano]

I refused amitripyline for sleep, I didn't like the idea of taking a TCA.

I haven't heard of a doctor prescribing a TCA for pain.

Neuralgic pain. TN, ATN, ATFP, these are all conditions in which ami is given not so much for the pain relief but for the depression that onsets with those conditions.

I am an ATFP sufferer, btw. Was previously diagnosed with TN, but we're juggling diagnosis's at the moment.

 

[Volcano]

I know somebody who swears by using Amitriptyline for nerve pain. As far as dependance goes, Its not going to be like an opiate type of addiction but when you stop taking the med you have to taper down gradually. Hey good luck i know that nerve pain can be really horrid hang in there

I have nerve pain, but like Cap'n Heroin over there, I just don't want to take a TCA.

I'm currently on:

Tegretol
Neurotin (barely take this stuff, it's prescribed for 'late night anxiety' and 'sleep issues')
Klonopin (winner winner chicken dinner - 1MG is right where I need to be to forget about the pain and sleep a good 8 hours)

 

[barnstable84]

It's times like these that I wish I smoked weed. Sometimes it would help (not mixing it with anything else though) but I refuse to touch it after my mother and brother both slaves to it and also some ex friends. Never have, never will.

To make things worse, last night I was massaging my knee and thought i felt a knot. When i pushed on it, i heard a crack and now i'm so swollen and in a heap of pain. I can't walk so i'm waiting for a friend to get here to take me to get looked at!

I hope anyone who has posted in this thread to say they have nerve pain or other chronic pain, i really hope you find something that will give you some sort of relief.

 

[Volcano]

I smoke a lot of pot. Not A+++ indoor shit, but a lot of good quality commercial grade pot.

I have a B.A. in Criminal Justice from a real 4 year university (2nd largest in my state) and well -- your family probably just has an addictive nature. I think Joe Rogan said it best when he said that if it wasn't pot that entangled those folks it would've been cheeseburgers or scratch off tickets.

Be lucky it's not alcohol.

And by the way, you can literally mix marijuana with just about any chemical substance known to man.


And yes, marijuana HELPS my neuralgic pain, though since mine is of dental origin (v3 trigeminal) sometimes I admit it's not fun to smoke it as the smoke passes beside my "trigger tooth"

 

[Cane2theLeft]

Neuralgic pain. TN, ATN, ATFP, these are all conditions in which ami is given not so much for the pain relief but for the depression that onsets with those conditions.

This isn't true and evidence of this is in the indicated doses for chronic pain versus depression. Substantially less is required to treat pain that is required for depression or sedation. Chronic pain responds to the serotonergic and noradrenergic effects of the TCA's, an indirect effect on the opioid system and other mechanisms of action not well understood.

TCA's are effective for pain regardless of the presence of depression (although depression can certainly exacerbate physical pain). Further evidence that TCA's have a primary effect on pain is their NNT numbers relative to other analgesics like opioids, anticonvulsants, local anesthetics and others.

 

[Nikolai]

I take amitriptyline 50mg per day to help with nerve pain. But I honestly dont think it helps much with that. I was also prescribed it to help me sleep which I do think it helps with a bit. I was taking 150mg's per day but was lowered because of a high heartrate. Amitriptyline is supposed to be the best anti-depressant that helps with nerve pain, it is prescribed to many amputee victims from the military etc. I didnt notice it help my pain, my neuropathy is very severe though. I would definetly tell someone to give it a try and judge for themselves.

 

[barnstable84]

I think Joe Rogan said it best when he said that if it wasn't pot that entangled those folks it would've been cheeseburgers or scratch off tickets.

Be lucky it's not alcohol.

Well, addiction definately runs in the family. My mother's side has alot of alcoholism involved, one sister of hers had a speed habit and my mum smokes alot of weed with my brother who is just a troublemaker. My mother herself was an alcoholic for a few years after PND after my baby brother was born and it was a really rough time. She has since given it up and new years eve 2009/2010 was her 10yr anniversary of no alcohol. She now preaches like crazy about it and how everyone else is an alcoholic, but I see some ex-addicts doing similar things (not all of them of course)

My brother who smokes with my mother is addicted to morphine.. I'm not judging anyone else with that type of habit because i've messed around with it briefly but wasn't addicted. He knocked on my grandmothers doorstep at her house where she is caring for her terminally ill husband and he had the nerve to ask to buy morphine pills and half a bottle. I could understand if the bottle was there and not used for any reason, but wanting to buy a very sick mans comfort just makes me want to kick him in the nuts.

Sorry for the long reply! I'm terrible and condensing shit to make it easier for people to read.

 

[halfoz]

i'm another car accident victim who was just prescribed amitryptiline by my meds doc.

i was involved in a 60mph head on collision and primarily suffered a "dashboard injury" to my leg - a tibial plateau fracture with multiple other fractures in the right lower extremity. the injury to my tibial plateau was so bad that docs used words like "pulverized" to describe the damage.

after two surgeries involving internal plates with 9 screws, bone grafts from my femur, and lots of recovery, i'm finally partially weight bearing.

pain management has been an ongoing struggle. started out post-op on huge doses of opiates.

6 months into it, i'm down to just relatively low dose of oxycontin (god bless oxycontin, its been a miracle drug for me for pain relief), klonopin, elavil (new med for me as of today) for neuropathic pain and sleep, lexapro (god bless lexapro too) for depression and anxiety, vimovo (naproxen and prilosec).

this is starting to feel like a ramble so i'll stop

 

[halfoz]

volcano, do you get migraines? the trigeminal never is thought to be complicite in these types of headaches.

i'm weaning off lyrica in favor of amtrypitaline right now. The amitryptaline seems to be more effective, but FUCK does it make me sleepy. Or perhaps it superpotentiates the klonopin i'm on too.

good knews though, also zero neuropathic pain.
now if we could just get something done about the somatic pain, i'd be doing awesome
(i;mn on 2x 20mg oxys per day, and am trying to built a case for norco for breakthrough pain)