Amitriptyline Downregulates Chronic Inflammatory Response to Biomaterial in Mice, 2020, Scheuermann et al

[InitialConditions]

Most doctors do tell you that a TCA taken for pain or sleep isn't supposed to be an antidepressant. It is in some of the NICE guidelines, e.g., neuropathic pain, IIRC.

Yes - usually given at low doses (10–25 mg) as oppossed to 50–250 mg for depression. Within the NHS, this is often the first medication given when presenting with ME/CFS or fibromyalgia. As with most of the recommendations, the evidence base is slim to non-existent.

 

[Invisible Woman]

Most doctors do tell you that a TCA taken for pain or sleep isn't supposed to be an antidepressant. It is in some of the NICE guidelines, e.g., neuropathic pain, IIRC.

Yes. This is what I've been told but I've heard doctors that ME patients won't take them because they're described as an anti depressant. Ignoring that it's the side effects from taking them that are the issue.

Mind you, I also had one doctor who wanted me to try an SSRI (can't remember which one now) but it was a whacking great dose. The sort of dose someone with primary depression would build up to & not appropriate for an ME patient. That kind of ignorance in prescribing doesn't help matters.

I have family members who suffer from a well understood & very painful condition who have been prescribed amitriptyline for pain relief.

 

[Arnie Pye]

I know some people are very anti-this type of drug

I actually did well on low-dose (20mcg per night if I remember correctly) Amitriptyline for a short time. It reduced pain and improved my sleeping. Unfortunately, within a few weeks my heart rate shot up to 150 beats per minute. Tachycardia is a known side-effect of the drug which is listed in the Patient Information Leaflet.

A few years later a doctor at a Pain Clinic I was referred to assured me that far fewer people got side effects from Nortriptyline than Amitriptyline and against my better judgement I tried it. Well, it turned out to be a slight improvement - my heart rate only rose to 135 beats per minute.

I don't recall any other adverse effects, and it did reduce my pain, so I was quite miffed that I couldn't keep taking it.

 

[Wits_End]

Surmontil being trimipramine, in case anyone's getting confused Been there, done that, got the T-shirt ...

 

[Sisyphus]

My GP had me on them around the late 90s.

When I missed an appointment, made to inform her of the zombieism they caused, because I was so sedated I couldn't get out of the chair (couldn't see the point of it), I was told off, told I should no longer make appointments and only use the morning emergency surgery, and had my dosage increased from 75mg to 125mg.

This was/is the only GP appointment I have ever missed.

I still have enough to tranquilise a small to medium sized herd of elephants, as I stopped taking them after that, and she kept prescribing.

For me they can be useful, occasionally, at much lower doses.

ETA - AFAIK everything else I've ever been prescribed for sleep makes me itch, which keeps me awake.

Who the &^$ is your MD? If an Rx is obviously harming the patient, you don’t prescribe it. This is rather obvious.

 

[adambeyoncelowe]

I actually did well on low-dose (20mcg per night if I remember correctly) Amitriptyline for a short time. It reduced pain and improved my sleeping. Unfortunately, within a few weeks my heart rate shot up to 150 beats per minute. Tachycardia is a known side-effect of the drug which is listed in the Patient Information Leaflet.

A few years later a doctor at a Pain Clinic I was referred to assured me that far fewer people got side effects from Nortriptyline than Amitriptyline and against my better judgement I tried it. Well, it turned out to be a slight improvement - my heart rate only rose to 135 beats per minute.

I don't recall any other adverse effects, and it did reduce my pain, so I was quite miffed that I couldn't keep taking it.

I wonder if it's better for those with low heart rates in the first place, then?

I've also noticed that it warms me up a bit. I'm often sub-36 degrees Celsius, but I've noticed that rises immediately after taking amitriptyline to around 36.3.

 

[Arnie Pye]

I wonder if it's better for those with low heart rates in the first place, then?

I've also noticed that it warms me up a bit. I'm often sub-36 degrees Celsius, but I've noticed that rises immediately after taking amitriptyline to around 36.3.

Interesting idea. My heart rate has been quite high for years - at least the last 10 - 12 years I would say. It isn't that uncommon for me to have a heart rate over 90, but these days I take a small dose of a beta blocker if it goes too high. For me, life with a high heart rate (100+) is absolutely exhausting and makes it impossible to sleep. So, if I was to take a drug like amitriptyline, and it raises the heart rate, then I would be a prime candidate for my HR ending up much too fast.