Posted by TSA West on March 25, 2002, at 2:08:51
In reply to How to treat neuropathic pain ? pleae help, posted by ben on March 24, 2002, at 10:52:12
Hello Sir,
All you need to know about pain management with tricylics and their friends:
I've heard many times from people that amitriptyline produces a hangover on the next day or causes people to feel "brain-dead" as some have put it (ie, dysphoric). You might counter it by dividing the 25-mg tablet in half with a razor blade or commercial tablet cutter. If this still proves to be too much after trying it for several nights, you should switch to doxepin, which has a profile that is very similar to that of amitriptyline. However, doxepin has less anticholinergic and other undesirable side effects. Also, doxepin comes in a liquid form. I would say start with doxepin at a 10-mg dosage and, if need be, decrease it to only one half of one of these capsules as well.
People who divide tablets or capsules often complain of the terrible taste of Tricyclics and a numb mouth and tongue from the potent anesthetic action of many Tricyclics. This can be avoided by wrapping the half tablet in a small ball of bread and swallow the ball and medication whole. :)
If doxepin doesn't work or is effective or if it produces intolerable side-effects, another milder Tricyclic (eg, nortriptyline or desipramine). For vascular headaches, a Dr. Diamond recommended the use of trazodone (Desyrel), a nontricyclic Antidepressant with strong sedating properties but with minimal anticholinergic, which may be used when regular tricyclic agents are not tolerated. A 50- to 100-mg dose of trazodone hydrochloride to be taken at bedtime, with a maximum 200- to 250-mg dose...
Your servant and soldier,
TSA Wwwwwwwwwwwwwwww E Sssssssssssss T---------
poster:TSA West
thread:99846
URL: http://www.dr-bob.org/babble/20020322/msgs/99982.html