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Re: How strong is Amitriptyline's sedative effect?

Posted by Mtom on August 1, 2020, at 12:09:49

In reply to Re: How strong is Amitriptyline's sedative effect? linkadge, posted by Skeletor on May 10, 2020, at 15:06:52

Interesting. I was taking Escitalopram, started low, lots of side effects, hoping they would go away I kept titrating up, got as high as 7.5 mg and side effects kept worsening - anxiety-jitteriness, nightmares and REM sleep disorder.

I started decreasing Esc dose then cross titrating with Mirtazapine, again starting low. I only got Restless Leg Syndrome a few tunes after starting Mirtazapine when my Escitalopram dose was still fairly high. RLS went away as I decreased Esc dose.

Mirtazapine caused worse nightmares initially but these eased over time.

I took Amitriptyline many years ago and sedation was worse than Mirtazapine, couldn't get out of bed in the morning. I "think" that eventually improved, but don't clearly remember, and only took it for 6-7 months. I had been undergoing intense situational stress causing anxiety and moderate depression, I fixed the situation and quickly felt better. I don't know if the Amitriptyline had helped as my stressful situation changed shortly after starting, but when I stopped Ami I remained feeling good for many years.

The Mirtazapine sedation reduced over time, still a bit sleepy on waking and sometimes later day fatigue and need a quick late afternoon nap, but can skip that with effort and the fatigue passes.

i started a new threat asking about Amitriptyline experiences because although Remeron has been better for some response and more tolerable side effects than SSRIs, I'm still far from full response.

> I am on Escitalopram 5mg, which is okay. That is 60% SERT occupancy. (I can't stand strong SRIs. Zoloft 50mg, 75mg and 100mg made me a zombie and anorectic)
>
> Now I ve been thinking about adding something with 5HT2 antagonism. I once tried Mirtazapine, but that gave me RLS. Amitriptyline has 5HT2 antagonism and additionally it has some powerful NRI and antimuscarinic action. It seems to be quite a potent med, but sedation frightens me.


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