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[Treatment] Amitriptyline
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Gabby Offline

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Post: #11
RE: Amitriptyline
(01-04-2014 06:29 PM)southernlady Wrote:  I've used both Amytriptyline and Nortriptyline...for pain management. My sleep was fragmented on the nortriptyline...but the amytriptyline didn't have that effect.

READ all prescription med inserts carefully...and even if you've had it before and you are experiencing something weird you can't explain (fragmented sleep is one), then ask your pharmacist for a copy of the side effects of all your prescriptions...look at it carefully. Just because a medication is COMMONLY used for something does not mean it will work that way for 100% of the population. Many of us are Zebras! (Physicians are taught, when you hear hoofbeats think horses not zebras)

Liz
Southern lady, did the Amitriptyline work for the pain? Would be interested to know thanks, as it didn't help with my chronic headaches.

Sleep Tight...
Gabby
01-04-2014 08:03 PM
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Sleepster Offline
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Post: #12
RE: Amitriptyline
(01-04-2014 05:40 PM)DocWils Wrote:  Elavil should not be stopped cold but tapered off.

I knew that. I stopped it a couple years ago when I was taking 100 mg daily. The doctor had me lower it to 50 mg per day for about three days IIRC, and then stop.

Since this time I was at only 25 mg I figured no taper was needed.

As far as I know 25 mg is the smallest dose available, anyway.

What would you have done?

Quote:Other than that, if you don't need it, then great that you can get off of it. It will improve your sleep patterns to be off of it, and some "other" things will improve too.

Glad to hear that it should improve my sleep patterns. I was under the opposite impression. I was prescribed it this time to help with my sleep patterns, so I figured getting off it would make it harder for me to sleep. So far I seem to be right, but I hope that once it gets out of my system what you're saying will be right.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-04-2014 09:39 PM
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Sleepster Offline
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Post: #13
RE: Amitriptyline
(01-04-2014 08:03 PM)Gabby Wrote:  Southern lady, did the Amitriptyline work for the pain? Would be interested to know thanks, as it didn't help with my chronic headaches.

Let me chime in here since it was prescribed for me originally for headaches and it did give me at least some relief. I believe my headaches were muscle tension headaches and the amitriptyline acts as a sedative stopping the patient from flexing the muscles so much. The flexing of the muscles is part of the process of bracing yourself in response to a stressor, the flight or fight response.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-04-2014 09:47 PM
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Gabby Offline

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Post: #14
RE: Amitriptyline
(01-04-2014 09:47 PM)Sleepster Wrote:  
(01-04-2014 08:03 PM)Gabby Wrote:  Southern lady, did the Amitriptyline work for the pain? Would be interested to know thanks, as it didn't help with my chronic headaches.

Let me chime in here since it was prescribed for me originally for headaches and it did give me at least some relief. I believe my headaches were muscle tension headaches and the amitriptyline acts as a sedative stopping the patient from flexing the muscles so much. The flexing of the muscles is part of the process of bracing yourself in response to a stressor, the flight or fight response.
Hi Sleepster, mine were 'Tension type headaches' as well. I am glad you were given some ease with the Amitriptyline, I am sorry to say I wasn't, as I said it did help with depression brought on by headaches and maybe other things but over the years not a lot has helped with my headaches. Did you find you put on weight or had an increased appetite?
I really wish you well coming off them.

Sleep Tight...
Gabby
01-05-2014 12:09 AM
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Sleepster Offline
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Post: #15
RE: Amitriptyline
Yes, I had an increased appetite and weight gain.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-05-2014 04:19 AM
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southernlady Offline

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Post: #16
RE: Amitriptyline
(01-04-2014 08:03 PM)Gabby Wrote:  
(01-04-2014 06:29 PM)southernlady Wrote:  I've used both Amytriptyline and Nortriptyline...for pain management. My sleep was fragmented on the nortriptyline...but the amytriptyline didn't have that effect.

READ all prescription med inserts carefully...and even if you've had it before and you are experiencing something weird you can't explain (fragmented sleep is one), then ask your pharmacist for a copy of the side effects of all your prescriptions...look at it carefully. Just because a medication is COMMONLY used for something does not mean it will work that way for 100% of the population. Many of us are Zebras! (Physicians are taught, when you hear hoofbeats think horses not zebras)

Liz
Southern lady, did the Amitriptyline work for the pain? Would be interested to know thanks, as it didn't help with my chronic headaches.

Mine was neuropathy based pain...I was on a cocktail of meds to help so I can't say if they helped or not.

I was only taking a 25 mg dose of Amytriptyline along with tramadol and celebrex. So which one actually helped? I'm thinking the amatriptyline wasn't.

I know WHY the prescribe Amytriptyline and Nortriptyline...they have long ago gone generic, most insurance plans do not squabble over them and most side effects are known.

Newer drugs may be better but may not be as easily approved or as inexpensive. I know my celebrex was a royal PITA to get but once I did, unless something changed (like insurance companies), I was fine after that. Many want the cheapest drug to handle their problem.

Liz
(This post was last modified: 01-05-2014 08:43 AM by southernlady.)
01-05-2014 08:08 AM
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DocWils Offline

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Post: #17
RE: Amitriptyline
(01-04-2014 09:39 PM)Sleepster Wrote:  
(01-04-2014 05:40 PM)DocWils Wrote:  Elavil should not be stopped cold but tapered off.

I knew that. I stopped it a couple years ago when I was taking 100 mg daily. The doctor had me lower it to 50 mg per day for about three days IIRC, and then stop.

Since this time I was at only 25 mg I figured no taper was needed.

As far as I know 25 mg is the smallest dose available, anyway.

What would you have done?

Taken it every other day for two weeks, tapering it to every three days in the end. This is just because you have been on this a long time now, and the body needs time to adjust to even the smallest loss of dosage. Or even just for one week, thrice every two days.

Quote:Other than that, if you don't need it, then great that you can get off of it. It will improve your sleep patterns to be off of it, and some "other" things will improve too.

Quote:Glad to hear that it should improve my sleep patterns. I was under the opposite impression. I was prescribed it this time to help with my sleep patterns, so I figured getting off it would make it harder for me to sleep. So far I seem to be right, but I hope that once it gets out of my system what you're saying will be right.

It depends on why you had the problem in the first place, but in general, you are probably better off now. Part of your problem before has now been dealt with by the CPAP, and the rest by the therapy and by time. It will take a few weeks for your sleep patterns to be restored, normally there is an adjustment period of around six to eight weeks post drug for anti-depressants, until the brain chemistry rights itself and the brain learns to get along without it. And then you have to relearn good sleep patterns - it takes a bit of time, so don't expect things to right themselves in one go. Some changes in diet will also help it along - drop salt as much as possible, no booze (depressant), try to keep to simple carbs and easy proteins like tofu, and as much exercise as possible (and reasonable - don't hurt yourself or give yourself a heart attack). One thing a study in Edinburgh has shown is that doing hard exercise on a stationary bike for 90 seconds, revving your heart to 80% of capacity, with a 140 second break between, three times, every two days, for three weeks, will also benefit you greatly by lowering the lipids in your blood stream and evacuating any toxins built up as a result of the stoppage of the medication (the body rebounds and searches for natural ways to get the same stuff, and this builds up gunk). BTW this is a case of more is not better - the method is as described - three repetitions, every two days. Don't think that if you do it twice a day, or do six repetitions it will be twice as beneficial. It won't.
01-05-2014 08:51 AM
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Sleepster Offline
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Post: #18
RE: Amitriptyline
Thanks for the awesome advice, DocWils. Last night would have been the 4th night without it, but I finally had to take one to get to sleep. And it was like my body had received what it was craving. Within a few minutes I could feel myself melting. Got out of my reading chair, staggered to bed, and slept a straight 7 hours. I feel like crap today.

Another part of the problem is stress. I think it's time for me to go back to the therapist for round 3. Deal with these stressors, and then maybe try again.

Your advice is more helpful than you can know.

This kind of interaction is one of the many fantastic benefits of this forum.

Do you think that amitriptyline can be taken on an "as-needed" basis. That is, take it on nights when I feel I really need it and try to skip it on other nights?

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-05-2014 12:42 PM
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DocWils Offline

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Post: #19
RE: Amitriptyline
(01-05-2014 12:42 PM)Sleepster Wrote:  Do you think that amitriptyline can be taken on an "as-needed" basis. That is, take it on nights when I feel I really need it and try to skip it on other nights?

I don't really know. Normally this needs time to build up in the blood stream for it to be really effective - I suspect you will have some positive effect from occasional use, but these types of drugs are not designed for that, and I cannot guess if it is dangerous or not to use as needed. I also would suspect that sooner or later you would start to build up a psychological dependence on Elavil rather than the physiological one you have now. You are better off, once tapered off, to find other ways to get to sleep. I imagine my self on a journey to Mars, in extreme detail, and let me tell you, it is sooooo boring that you nod off real fast.

Better to get to understand and embrace your stressors, so you can be rid of it for good. For muscle tension cycles causing headaches, I recommend, if you can handle it, Robax Platinum with a side of diovol.
The Robax combines a muscle relaxant and a pain killer, so the tension cycle is broken and the diovol keeps the acid down to a minimum. Much better than taking an anti-depressant. If you are on a cocktail of meds, clear any of this with your pharmacist.
(This post was last modified: 01-05-2014 05:57 PM by DocWils.)
01-05-2014 05:54 PM
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Sleepster Offline
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Post: #20
RE: Amitriptyline
Ever since I started CPAP therapy a bit over two years ago my headaches have gone from chronic to occasional. I'm thinking it was the episodes of apnea that provided the underlying cause for the headaches.

I agree that dealing with the stressors directly is a good step, which is why I plan to start up with a therapist again.

When I meet with my PCP next week for my annual physical I will discuss this issue. It is he who put me on the amitriptyline this last time specifically for improving my sleep as I wrestled with the then-new CPAP therapy.

My sleep patterns have improved a lot. The side effects of the amitriptyline are certainly tolerable, and as you've told us so many times drugs are a cost-benefit balance. Do the benefits outweigh the costs? It used to be that when I had untreated sleep apnea the benefits did outweigh the costs. At that time I was willing to put up with the negative side effects because of the positive benefits. Now that CPAP therapy has improved the quality of my life the negative side effects may no longer outweigh the benefits.

In other words, I was willing to put up with a bit of daytime grogginess, and occasional blurred vision and sexual side effects when they were giving me relief from headaches and anxiety. Now that the CPAP therapy has dealt successfully (to a large extent at least) with the headaches and anxiety, I'm not so willing to put up with those side effects. In other words, I'm getting spoiled. Smile

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-05-2014 06:10 PM
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