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Dr. Bob is Robert Hsiung, MD,
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Posted by ben on March 24, 2002, at 10:39:20
I take only 15 mg amitryptiline (ELAVIL) at night (7 pm) and experience severe dry mouth and sedation in the morning. When I wake up in the morning my head would like to sleep again. This nasty side effects havent disappeared after 2 weeks. I take it as a sleep aid besides Moclobemide (Aurorix) and for neuropathic pain.
The problem is: I dont think that I can go much higher with it (to the range treating neuropathic pain 50-100 mg/d). Should I stick to it or switch to something other ? 2 years ago I was on 100 mg/d trimipramine with similar side effects - but as I can remenber not so strong than amitryptiline (concerning dry mouth and sedation). Do you have experiences between these two tricyclics ? At this time I had no neuropathic pain (developed in the last four months) and I switched to Celexa because of the side effects (sedation, weight gain). Are there any TCAs with lacking anticholinergic side effects ?
Posted by Cmatt on March 25, 2002, at 5:26:01
In reply to amitryptiline versus trimipramine side effects !, posted by ben on March 24, 2002, at 10:39:20
I'm no expert, but I have heard a couple physicians say that trimipramine has a gentler side effect profile than Elavil.
I have also heard that desimpramine or nortriptyline may also be somewhat gentler.
Cmatt
Posted by Chloe on March 25, 2002, at 21:03:02
In reply to amitryptiline versus trimipramine side effects !, posted by ben on March 24, 2002, at 10:39:20
You could give Nortriptyline(TCA) a try. It's a metabolite of amitriptyline, so it's a bit less sedating and anticholinergic. Alot of people tolerate it better.
Can I ask, if you are not having any neuropathic pain, why do you put up with the side effects?
I take 20 mgs amitriptyline each night for neuropathic scalp pain. I am not really bothered by side effects anymore. It took a few weeks to adjust to the S/E's. I would like to increase the dose, but I get very irritable and have mixed agitated states(bp2). So not an option. I have heard that neurontin+amitriptyline is great at wiping out NP pain. But for me, it hasn't been a miracle cure...
Best of luck to you
Chloe
Posted by ben on March 26, 2002, at 5:08:42
In reply to Re: amitryptiline versus trimipramine side effects ! » ben, posted by Chloe on March 25, 2002, at 21:03:02
> You could give Nortriptyline(TCA) a try. It's a metabolite of amitriptyline, so it's a bit less sedating and anticholinergic. Alot of people tolerate it better.
>
> Can I ask, if you are not having any neuropathic pain, why do you put up with the side effects?
>
> I take 20 mgs amitriptyline each night for neuropathic scalp pain. I am not really bothered by side effects anymore. It took a few weeks to adjust to the S/E's. I would like to increase the dose, but I get very irritable and have mixed agitated states(bp2). So not an option. I have heard that neurontin+amitriptyline is great at wiping out NP pain. But for me, it hasn't been a miracle cure...
>
> Best of luck to you
> ChloeI do have peripheral neuropathy and no doc is knowing why ! And you ?
Posted by ben on March 27, 2002, at 7:42:56
In reply to Re: amitryptiline versus trimipramine side effects, posted by ben on March 26, 2002, at 5:08:42
Did you try Neurontin ? And does the Elavil at 20 mg make a difference in your neuropathic pain ? I am afraid that I probably will not bear the side effects of Neurontin. Why do you have neuropathy ?
ben
Posted by Chloe on March 27, 2002, at 9:28:06
In reply to Re: amitryptiline: Chloe, posted by ben on March 27, 2002, at 7:42:56
> Did you try Neurontin ?
Hi Ben,
Yes, I am neurontin 500 mgs now (plus 20 mgs amitrip for the pain). I find neurontin is very useful for joint pain and depressive symptoms. But I don't think it helps with MY type of neuropathic pain. Since some of my pain I think is some really *bizare* side effect of some meds I take.>And does the Elavil at 20 mg make a difference in your neuropathic pain ?
I think a *little*. But mainly because it helps me sleep at night and not think about my burning scalp. I am a very light sleeper, so the small amount of TCA gives me improved sleep without real side effects.
>I am afraid that I probably will not bear the side effects of Neurontin.
I think Neurontin is very easy to tolerate. It is mildly sedating at low doses, and really improves my mood and anxiety level. It makes me "feel" better in general, physically too. If you worked up slowly to 100 mgs three times a day, you find some releif of your pain and anxiety.
>Why do you have neuropathy ?
I wish I knew. But my scalp constantly feels on fire. It burns constantly, and dermatologist and doctors can't find the source. I think it's related to the drying side effects of some of the mood stabilizers like Lithium. But my hair is no longer dry. Just very a painful. Each follicle screams with pain. Though it has improved some with adding 1-2 TBS of Flaxseed oil to my diet...It's all a mystery to me, and I think doctors think I am crazy when I tell them my scalp is sore, but there is no rash or anything!
I am so sorry you are suffering, Ben. I really think Neurontin is worth a shot. If you do a google.com search on Neurontin and neuropathy I think you will find alot of useful and positive info.
Hang in there
Chloe
Posted by ben on March 28, 2002, at 3:02:05
In reply to Re: amitryptiline: Chloe » ben, posted by Chloe on March 27, 2002, at 9:28:06
> > Did you try Neurontin ?
>
> Hi Ben,
> Yes, I am neurontin 500 mgs now (plus 20 mgs amitrip for the pain). I find neurontin is very useful for joint pain and depressive symptoms. But I don't think it helps with MY type of neuropathic pain. Since some of my pain I think is some really *bizare* side effect of some meds I take.
>
> >And does the Elavil at 20 mg make a difference in your neuropathic pain ?
>
> I think a *little*. But mainly because it helps me sleep at night and not think about my burning scalp. I am a very light sleeper, so the small amount of TCA gives me improved sleep without real side effects.
>
> >I am afraid that I probably will not bear the side effects of Neurontin.
>
> I think Neurontin is very easy to tolerate. It is mildly sedating at low doses, and really improves my mood and anxiety level. It makes me "feel" better in general, physically too. If you worked up slowly to 100 mgs three times a day, you find some releif of your pain and anxiety.
>
> >Why do you have neuropathy ?
>
> I wish I knew. But my scalp constantly feels on fire. It burns constantly, and dermatologist and doctors can't find the source. I think it's related to the drying side effects of some of the mood stabilizers like Lithium. But my hair is no longer dry. Just very a painful. Each follicle screams with pain. Though it has improved some with adding 1-2 TBS of Flaxseed oil to my diet...It's all a mystery to me, and I think doctors think I am crazy when I tell them my scalp is sore, but there is no rash or anything!
>
> I am so sorry you are suffering, Ben. I really think Neurontin is worth a shot. If you do a google.com search on Neurontin and neuropathy I think you will find alot of useful and positive info.
>
> Hang in there
> ChloeHi Chloe
Neuropathy as aside effect of which meds ? Did you check blood sugar, vitamin B12 and Folate ? Try different oils directly on your skin (olivae oleum, amygdalae oleum...) perhaps you will find one ! What about the antieplileptic Trileptal ?
Did you try Serzone = Nefadozone (or the older drug called Trazodon). They should work for pain as well as Efexor (Venlafaxine).ben
Posted by Chloe on March 28, 2002, at 20:38:09
In reply to Re: amitryptiline: Chloe, posted by ben on March 28, 2002, at 3:02:05
> Hi Chloe
> Neuropathy as aside effect of which meds ? Did you check blood sugar, vitamin B12 and Folate ? Try different oils directly on your skin (olivae oleum, amygdalae oleum...) perhaps you will find one ! What about the antieplileptic Trileptal ?
> Did you try Serzone = Nefadozone (or the older drug called Trazodon). They should work for pain as well as Efexor (Venlafaxine).
>Ben,
Whenever I have labwork done it's always normal! And I do take good vitamins including the B's and extra E.I am not dried out, really, my head just feels like it's on fire at times now, thank god it's not constant anymore. I am not familiar with the oils you speak of. But Flaxseed oil added to my diet has really helped some of my ezcema and evened my mood a slight bit (?).
I think the mood stabilizers are what *cause* this neuropathic burning of my scalp and hair follicles. It started about a year and a half ago when I switched from Tegretol to Trileptal as a mood stabilizer. Well, for me Trileptal was a breeze side effect wise compared to tegretal. I was dizzy, nauseated, constipated and fuzzy even on relatively low amounts of tegretal. The Trileptal worked ok, thoughI did have some insomnia and giddiness, but after a month or so, I developed an awful burning of my scalp. It hurt to brush my hair, wash it, sleep or lie on it. I was miserable.
So I tried Lamictal, Topamax, Lithium and they all made the burning the same or worse. I would be really irresponsible, and go off all meds to try to "fix" my burning scalp, but it would only get slightly better. But my life would be horrible from the deep depressions or rages resulting from not being on a mood stabilizer...
Serzone and trazadone both make me very agitated and sleepy at the same time. I feel awful on those. And effexor is not really an option for me. I can only take 1.5 mgs of an SSRI and 20 mgs of Amitriptyline is pushing the limits of how much AD I can tolerate without getting into mixed states...So I take
100 mgs Lithium CR
500 mgs Neurontin
250 mgs Depakote
10 mgs Diazapam
20 mgs Amitriptyline
1.5 mgs Celexa
A little bit of A LOT of drugs seems to be the best for my emotional and physical pain control.So that is my story. What are you using to treat your pain? Any success with any drugs.
Chloe
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