# Low dose tryciclic anti-depressants?



## M&M (Jan 20, 2002)

My doctor just put me on a 10 mg dose of Elavil (generic is Amitriptyline) every night. The nurse was so funny, I think she was concerned I thought they were sticking me on an anti-D and wouldn't be happy about it - which I really appreciate (these things make me love my doctor and his staff). She said "it isn't the anti-depressant dosage, it just helps regulate the neuro-transmitters that process pain". I've been having a lot of trouble with migraines lately, so in addition to Fioricet and Compazine he's giving me that to help prevent the pain (hopefully). I'm wondering if any of you are on low dose tryciclic anti-depressants, because I'm really hopeful it might help me with sleep and general pain. I'm just curious if any of you are taking it, and finding it helps in a variety of areas. Thanks!


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## Susan Purry (Nov 6, 2001)

I know someone with SLE who takes low-dose Elavil and she finds it does help with pain and helping her sleep. Hope you find it helpful


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## christywisty (Mar 12, 2002)

I'm on Elavil, which could help any number of things I have -- IBS, IC, endo, fibro, etc. The only side effects I have to speak of are a dry mouth and a lack of appetite. This was quite a surprise as generally the opposite happens. I'm not really complaining, though. I have to stick to a bland, simple diet anyway for the endo, IBS, and IC. Unfortunately, I have a high tolerance to medication, so I'm currently at 150 mg, and I'm sure I could go higher. For some reason, I really don't have the extreme fatigue (aside from CFS, that is ...) that some complain about. All in all, I love Elavil, and it was definitely one of the wisest decisions I've made thusfar. Good luck with it, and I certainly hope it helps you.


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## Feisty (Aug 14, 2000)

Wow, Christy. I'm glad it's working for you. And I'm amazed that you can tolerate such a high dose. I'm also very surprised that you have a diminished appetite. Most of the time a person gets an increase in appetite.I was on it for over 6 years. My Doc kept telling me that it would eventually help the migraine headaches and I also needed help sleeping. It did help me get more sleep, but that's about all. It did not help the migraines at all and it ended up ripping up my stomach--big time. I ended up with stomach ulcers which escalated to GERD and Barretts Esophagitis. I also gained a lot of weight (40 lbs.)I finally refused to take it any longer.The only thing I take now is Neurontin and Flexeril. The Neurontin helps with some of the Fibro pain. Not all, but some. I take the Flexeril at bedtime so that I don't get quite as stiff during the night. Otherwise, I get muscle cramps expecially in my legs and feet.


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## christywisty (Mar 12, 2002)

I'm currently in the weaning process to get off Neurontin. It has wreaked havoc in my life, and I find it to be a terrible drug. It's just so amazing that one person can get so much from one drug, yet another can be nearly destroyed.


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## M&M (Jan 20, 2002)

Feisty,I'm curious - What dosage were you on for those 6 years? I'd hate for this medicine to tear up my stomach as well! I was thinking that since I'm on such a low dosage, I might not suffer from any side effects, or ill effects in general. So far I haven't had any side effects at all.


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## Feisty (Aug 14, 2000)

Mrs. Mason---I started with 10 mg. It was gradually increased up to 30 mg. I know it doesn't sound like that much, and you have to remember that everyone reacts differently. I kept telling my Doc that I had this knawing hunger feeling all the time. Within 30 minutes of eating, I'd want something again. I was also gaining weight and was unable to loose it, even though I tried numerous times of reducing the amount I ate and consuming only "good" foods (protein, veggies and limited amounts of fruit and bread). And all my Doc told me was to exercise more! Dah! If I would have known then what I know now, I would have stopped it as soon as I started showing symptoms of side effects. But, I trusted my Doc.







Christy---Would you be willing to share your reaction to the Neurontin? I want to be sure it is not giving me adverse reactions. Thanks!


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## M&M (Jan 20, 2002)

Thanks Feisty! I really appreciate knowing that. I'll have to pay attention to my body to see how it reacts. My dad also has Barrott's Esophagus (sp?) so I know it's nothing to mess around with. Scary stuff! Hope you're taking something for it that helps you!


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## Feisty (Aug 14, 2000)

Mrs. Mason---I've been on Prevacid for almost 4 years now.Almost 6 weeks ago, I had surgery to repair a huge hiatal hernia and have a Nissen Fundoplication (stomach wrap to make the valve at the bottom of the esophagus tighter---to prevent stomach acid from coming back up the esophagus.) I haven't had any symptoms of GERD since the surgery.







But, I have some problems swallowing and I have painful esophageal spasms; so, tomorrow morning, bright and early, I have to have another Barium Upper GI series to check that out. I may need to have the esophagus dilated (stretched). I should know sometime on Thursday whether I need the stretching done. If all goes well over the next few weeks, I may not have to take Prevacid anymore. Now that would be great!The Gastro told me that the Barrett's looked much better than it did 2 years ago when he checked it. So, at least I know the Prevacid was helping to heal some of it. It won't ever be healed permanently---the damage is done; but hopefully no more damage will occur.It's possible that the Barrett's caused a narrowing of the esophagus and that would explain the difficulty swallowing now. We'll see.


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## christywisty (Mar 12, 2002)

Feisty,It only took a couple of days for me to get used to the Neurontin. I remember the first morning I went to get out of bed, and I fell to the ground. It was like I was drunk, and I kept running into things and whatnot. Getting dressed was no walk in the park either. That can be expected.Once we went past 3200 mg per day, I started showing signs of "damage". I couldn't think. I stuttered after never having a problem. I couldn't speak well, which was a real shame because I enjoyed public speaking. As time went on, more and more things happened. I would walk downstairs to get something, and by the time I got down there, I had no clue what I was doing. One day I looked at a wooden door, and it was green. Another day I was walking through a parking lot, and the shadows from the cars were red. I heard and saw things. My memory was shot, which was the hardest to deal with. I went from being a Dean's list student to a failing college senior. Now I have disability services at school on my side. They require my professors to meet with me, to give me extra time on exams, and to let me take my exam by myself if I choose. I have gotten used to the changes -- not being able to remember, having mental blocks, and having rapid eye movements when I try to focus and read -- but there is no reason for me to stay on the Neurontin. It doesn't do anything but harm for me.Now the long-term problems are setting in, despite the fact that I dropped down to a much lower dose several months ago. I felt badly about losing control of my body (legs or arms fall out under me and I am on the ground before I ever knew what happened), but not as badly as I do now.I have blackout periods where I have no control over my body for up to thirty minutes or more. The problem is that I am semi-functional. I've balanced a checkbook, taken a shower, taken notes in class, etc. while in this "state". Once I feel it coming on, I can't stop it. It's like I'm screaming in my head for it to stop, but the lights go out. I have no control from there. I've taken some strange notes and made even stranger drawings while in this state. I've been in the weaning process for close to 20 days now, but coming down off the Neurontin has given me terrible headaches -- moreso than what I'm used to. I'm also having the dizzy spells again.Christy


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## Feisty (Aug 14, 2000)

OMG Christy. That's terrible. What amazes me is that the Doc put you on such a high dose. That is a lot of Neurontin to have in your body at one time.When my Doc started me on Neurontin (about a year ago now), he said he has some patients on as high a dose as 1800 mg. and that was as high a dose as he would give anyone. My Doc started me out slow---100 mg. at bedtime. After two weeks, it was increased to 100 mg. twice a day. After another two weeks, he increased it to 100 mg. three times a day. There was no improvement with the migraines, so he increased it again to 300 mg. morning and evening. After another 4 weeks at that dosage, it was increased to 300 mg. three times a day. A month later, he had me try 600 mg. at bedtime and 300 mg. in the morning and midafternoon. I couldn't function on that. I was so tired and had that "drugged" feeling. I couldn't concentrate in the computer class I was taking at that time---I was falling asleep!So, I stopped the midafternoon dose entirely and cut back the evening dose to 300 mg. again. When I talked to my Doc and told him I had cut it back and why, he said that was alright to do. I am now on 100 mg. in the a.m. and 300 mg. at bedtime. I still get just as many migraines---it doesn't help that at all. But, it does seem to help with the Fibro pain. I can press on the muscles in my arms, etc. and they don't feel quite as sore.I'm really concerned, though, about long-term effects even though my dose is a lot lower than yours. I am ultra sensitive to most meds, so I am better off with small doses or none at all.The Neurontin was tried because I suffer from daily migraines. It's twenty years of living with it and I am at my wits end. I use so much Imitrex because it is the only thing that will cut the headache for a while; but my Doc doesn't want me to use it as much as I have to. It's just a vicious cycle all the time.I wish you the best, Christy. I hope you can get off of the Neurontin and I sincerely hope some of your symptoms can return to normal.


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## christywisty (Mar 12, 2002)

Feisty,It's difficult to weigh the pros and the cons for each medication. I peaked this summer when I was taking over 20 pills a day. Now I'm down to five prescriptions. I'll be weaned off the Neurontin just in time for my December 23 surgery. In most cases, the most a doctor will prescribe is 3600 mg per day, but they can go up to 6 grams. I was only able to maintain 3200 mg for a month or so. They wanted to increase it even more, but I refused. I dropped down to 1800 mg, which helped with some things, but like I said, the long-term damage is becoming much more evident now.I was on a high dose of Celebrex for my fibro pain. I didn't think it helped me, but when I went off it, I realized just how much it did help. I don't have a habit of responding very well to medications. I would love to have my Celebrex back, but I decided to stay off it until I could get switched over to the new insurance. I figured it would allow me to get used to not having it until the new insurance kicks in. My fibro is the worst after my periods and when it's cold or rainy. We have an ice storm headed this way. Great, a combination of the two.







I can't believe the Elavil (or a combination of Elavil with my other medications) actually decreased my appetite. I've lost over 20 pounds without even trying. I can barely tolerate much of anything right now, but it's going to be that much more difficult while recovering from surgery. Nothing like morphine to really turn your stomach ... That's with the anti-nausea medication, too.I wish you the best!


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## Feisty (Aug 14, 2000)

Christy---You have to have surgery two days before Christmas? That's a bummer, huh?







Will it be outpatient or in hospital surgery? May I ask what kind of surgery?


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## christywisty (Mar 12, 2002)

I'll be bed-bound for Christmas, birthday, and New Years! Talk about a holiday season ... I'm having surgery for my endometriosis. I'm having a laparoscopy, a hysteroscopy, a d&c, a presacral neurectomy, and laser/excision as needed. I have to come home with a Foley catheter, too.


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