Lisie: Amitriptyline fast taper - what to do

[Lisie]

Hi, I've been on Amitriptyline for sleep issues for almost 11 years. Started low dose 10mg and worked up to 75mg over the years. Last four years I have been very sick with muscle tentions/pain and chest tightness, making it almost impossible to breath. I was told that my stress/anxitety was the cause, and belived the gp about that.

 

After a bloodtest came back with the result of me having hyperkalemia, I found out that amitriptyline could be the cause of this.

 

I then startet a too fast taper in december. It went okay down to 50mg. But as I got lower, I was having more and more diffeculties with sleep. Last week I have only slept for 2-3 hours most nights. I have tried to reinstate twice, from 36mg-37mg-now40mg. 

 

Should I try to reinstate more at this point? Or hold for a while?

 

Not sleeping being the worst symtom, but also high heartrate and my ears are like I'm in an areoplane.

My heart is starting to beat really fast every night around 5-6 hours after taking Amitriptyline. And after that I have heart/chestpain.

 

By the way I discovered that most og my musclepain and chest tightness got a lot better as I was decreasing the Ami. My muscles makes twiching noises all the time both in my chest and back, and I can breath normally again.

[Frogie]

@Lisie

 

Welcome to SA. We are a volunteer ran site helping members taper off these types of medications, or have tapered off and are not healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

Since you have reinstated, I would hold at this dose for quite a while to allow your body to stabilize before going up or down in doses anymore. We don't suggest more than 10% a month tapering, and a lot got much slower than that.

 

Why taper by 10% of my dosage?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Tips for tapering off mirtazapine (Remeron)

 

What is withdrawal syndrome?

 

The Windows and Waves Pattern of Stabilization

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

A lot of members have a high heart rate when going through withdrawal. I did have it for quite some time.

 

 

You might want to try a little magnesium and omega, they are found to be soothing to some members. Just try one in a small amount, wait a few days before introducing the other.

 

Magnesium

Omega-3 Fish Oil

 

You could also try a small amount of melatonin for your insomnia.

 

Melatonin

 

I hope I've been able to provide you with some useful links. Please reach out with any questions you may have.

 

 

 

[Lisie]

Thank you for your answer Frogi:) 

 

Yes, I think I should hold for some months, until the insomnia is gone.

 

I already take both magnesium and omega fish oil. Will try and put that into my signature. And 0,7mg melatonine.

 

Also, I got a betablocker today because of the high resting heartbeat. It was mostly above 100 yesterday. I'm hoping this could help me from waking up every hour because of the heart racing.

[Frogie]

@Lisie

 

All that sounds very positive.

 

Please keep us posted and let me know if I can answer any other questions you may have.

 

Thank you for updating your signature with this information. It is very helpful to all of us.

[Lisie]

Hi,

 

I really need some advise regarding my sleep problems. It seems to me that amitriptyline doesn't make me sleepy anymore. It's more like they are keeping me awake. I don't think the melatonine is helping much either.

 

The last few nights I have not gotten more than 3-4 hours with sleep. 

 

I take melatonine at 09.00p.m and amitriptyline at 11.00p.m when I go to bed. I then normally fall asleep around 02.00a.m, sleep for one hour and then wake up. Not felling tired at all. My body feels like it's burning og I have the fast heart rate. I will then struggle to get back to sleep, around 05.00a.m I fall asleep and wake up 07.00a.m.

 

My questions are:

 

1. Should I stop taking melatonine?

 

2. Would it be better to take amitriptyline earlier? Or in the morning? How could I do that without upsetting my cns?

 

3. I'm thinking of adding something else to help with sleep. What are the alternatves? I'm considering zoplicone, klonopin, diazepam, zolpidem. 

 

4. I would then have taper of amitriptyline first. And deal with the other one after that.

 

5. Is this a bad idea, would it make my cns more upset? I really dont't want any more bad symtoms, but I have to get some sleep.

 

Thank you so much for taking your time to help

[Lisie]

I have done som more reading, and think adding another drug was a bad idea. The best for now i probably to hold and hope for stabilization. Any idea on how long that might take?

[Altostrata]

Hello, @Lisie

 

It appears you developed withdrawal symptoms as you decreased the amitriptyline lower than 50mg. You restored 40mg only 10 days ago. It takes 6 days or so for a change in amitriptyline dosage to take full effect. How has your symptom pattern changed over the last week?

 

For withdrawal syndrome, 4 hours of sleep isn't too bad. This should get better as withdrawal syndrome slowly fades. You might hold at 40mg and see if your sleep recovers. If this is too frustrating, I might try 45mg. But you will need to be patient, it can take weeks for your nervous system to settle down from withdrawal. 

 

After it does, you might consider a slower taper, see Tips for tapering off amitriptyline

[Lisie]

Alostrata, thank you for your answer🙂

 

My symtoms has not changed much over the past week. Constant earpressure, maybe a bit more pain in the ears. Still not that awfull. The burning inside my body has increased last couple of days. But feeling a lot better today as I got more than 6 hours of sleep🙂 no melatonine last night. Sleep pattern last seven days: 2hr, 3,5hr, 7,5hr, 4hr, 4hr, 3hr, 6,5hr

 

I will hold at 40mg for a while since I don't feel like the increase I made 10 days ago has made things any better

[Altostrata]

8 hours ago, Lisie said:

But feeling a lot better today as I got more than 6 hours of sleep🙂

 

This is an improvement, correct? It's a sign the reinstatement is taking effect. It will take time for your nervous system to settle down with the help of the reinstatement. 

[Lisie]

Yes, the sleep seems to be improving. Had 5,5 hours this night. And the sleep quality feels a lot better. Also my heartrate and stresslevel is getting lower. But both the earpressure and burning sensation are increasing. Trying to eat low histamine to see if that helps with the burning

[Altostrata]

How are you doing, @Lisie

[Lisie]

Thanks for asking Alostrata.

 

Last few days have mostly been better. Hours of sleep: 6,5hr-4,5hr-5hr-6hr-7hr-3hr-4hr. 

Ear pressure is still present. Burning inside my body less so, except for yesterday. Also had increased pain in my back yesterday. But better today. Have some blurred vision, but seems to be decreasing. Sensitive to light and sound.

 

Not stable or ready to taper anytime soon i figure.

[Altostrata]

4 hours ago, Lisie said:

Last few days have mostly been better.

 

This is a good sign. We expect improvement to be slow and frustrating.