duvylove: insomnia suddenly stopping 10mg amitriptyline / Elavil

[duvylove]

I developed laryngopharyngeal reflux (LPR) as part of a post surgery complication from transoral robotic surgery for sleep apnea. The pepsin (digestive enzyme) from the reflux was digesting my throat and causing me a horrible burning sensation so i was prescribed Amitriptyline to alleviate the pain. Meanwhile, i  discovered Melatolin and i decided  immediately to stop taking 10mg Amitriptyline after 11days of use. its been 13days now since the stoppage and i have not been able to sleep one bit. 

 

I started using 3mg of Melatolin yesterday and having discovered safer treatments for my LPR, i really do not intend to use Amitriptyline anymore for the throat pain but i am now left with this unbearable insomnia.

 

Has anyone ever experienced this with suddenly stopping Amitriptyline? if so, i would appreciate any useful advise to overcome my insomnia predicament.  

 

Thank you

 

Kind regards  

Edited August 16, 2019 by Shep
updated title with new username

[ChessieCat]

Hi and welcome to SA,

 

Below are some suggestions which you might find helpful.  Please be sure to check out the melatonin topic.  It is best not to take too high a dose of it.

 

Sorry to bombard you with lots of links.  Just work your way through them as you are able to.  Some of the links below may be in the Insomnia topic.  I don't have the brain power at the moment to check which one are there.

 

Please also note that it is best to only start/stop one thing (supplement) at a time and when starting anything new take a small dose to see how you respond:  Keep it Simple, Slow and Stable

 

Tips to help sleep -- so many of us have withdrawal insomnia

 

You might also find this topic helpful:   are-we-there-yet-how-long-is-withdrawal-going-to-take

 

- "Sleep hygiene": Get off computer, tablet, or smartphone in early evening, turn down lights, plan to settle down for some time before bed. Keep bedroom dark and cool, don't do anything else in bedroom but sleep (and sex). Keep regular waking and bedtime hours.
TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime
 
- For those with light sensitivity Light-sensitive? Try blocking out blue light: Your computer may be your problem
 
- Meditation and meditative breathing: Stops "busy brain" and allows the nervous system to settle down for sleep
Easing your way into meditation for a stressed-out nervous system
Non-drug techniques to cope with emotional symptoms
 
- Magnesium, low-dose melatonin, and possibly fish oil before bed
Magnesium, nature's calcium channel blocker
Melatonin for sleep: Many people find it helpful
King of supplements: Omega-3 fatty acids (fish oil)
 
- Blackout curtains and sleep mask to reduce light stimulation causing early-morning waking.
Waking with panic or anxiety -- managing cortisol spike
Sleep problems - that awful withdrawal insomnia
 
White noise devices for sleep
 
Update on milk peptides for sleep: Our friend Lactium again   
 
Glycine for sleep? 
 
Taurine (L-taurine amino acid) for sleep  
 
L-Theanine for anxiety, insomnia

[Jen1234]

Hi Duvylove,

 

How are you doing? I’ve been experiencing insomnia for some time now after coming off amitriptyline. I’m sorry you are experiencing it as well. I was also on short term (2 months), but the insomnia hit after my first drop from 25mg to 10mg, after only being on the 25mg for a little over three weeks. Have things settled down for you? Hope you’re getting some rest.

[duvylove]

Tapering Amitryptiline for Withdrawal Insomnia

 

Hi All,

 

After 3 months of taking 20mg of armitryptiline to suppress burning sensation pain in my throat and ears resulting from Laryngopharyngeal reflux (LPR) , my ENT surgeon advised i stop taking it in order not to exacerbate my sleep apnea. Since i was not feeling the burning pain in my upper respiratory tract anymore as before , i decided to heed his advise by tapering my dosage before stopping. So, i followed the tapering instructions attached to this post by taking 10mg for 28days then 5mg for another 28days before quitting. In short, i took it for 5 months in total (tapering inclusive) with my last 5mg dose on the 1st March. Two weeks after this date, i started waking up at night with panic attacks, slight shivers and unexplainable insomnia. The insomnia got so bad afterwards that i was only able to sleep for roughly 1 hour per night. So i complained to my GP and she advised i try OTC sleep aids but use them only when needed due to my vulnerability to sleep apnea and if they turn out not to work then, i have to re-taper armitryptiline all over.

I tried 50mg of Nytol (diphenydramine) for 2 nights and i didn't really see any improvements so, my pharmacist suggested Phernegan which is a stronger brand. I took 50mg Phernegan for 3 nights and i had an average sleep of 4 hours per night BUT my sleep apnea started to relapse so, i had to stop it even though it was aiding my sleep.

 

Now, the insomnia persists and yesterday i have resulted to taking supplements instead (500mg of tryptophan and 1500mg of Omega 3 fish oil ) but not seen much improvements so far. Also, due to the corona virus lock down, i have been jogging for 15mins at 8.30pm daily just to wear myself out before bed but it doesn't seem to make much difference to my sleep 

 

In summary, i am torn between the devil and the deep blue see why? My surgeon who operated me for sleep apnea insist i quit armitryptiline as the surgery successfully treated my sleep apnea to a large extent that i no longer require the use of a CPAP machinbe for sleep anymore. Meanwhile phernegan exacerbate my sleep apnea even though it makes me sleep well. 

 

If i have to go back to taking armitryptiline, can anyone suggest a detailed and effective tapering approach or anyway i can resolve this predicament

 

i welcome all your suggestions

 

 

Thank you    

Tapering Strip Instruction For Armitriptyline.pdf

Edited April 7, 2020 by Shep
moved post from new thread and added title

[Shep]

@duvylove Please note I moved your post from the new thread you started and placed it here in your old introduction topic. Please continue to post here in your Intro thread so all of your information is in one place. 

 

On 4/5/2020 at 12:07 PM, duvylove said:

Now, the insomnia persists and yesterday i have resulted to taking supplements instead (500mg of tryptophan and 1500mg of Omega 3 fish oil ) but not seen much improvements so far.

 

Adding in more than one supplement at a time can complicate things. If you experience symptoms, you won't know if it's coming from the tryptophan or the fish oil. Please only add in one supplement at a time. 

 

 

On 4/5/2020 at 12:07 PM, duvylove said:

So, i followed the tapering instructions attached to this post by taking 10mg for 28days then 5mg for another 28days before quitting. In short, i took it for 5 months in total (tapering inclusive) with my last 5mg dose on the 1st March.

 

If you stopped at 5 mg on March 1st, you may benefit from reinstating a very small amount of this drug. Please see:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Are you taking any other drugs? If so, please list them, along with the dose.

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

[duvylove]

Hi Shep,

 

Many thanks for your suggestions and i will definitely consider them. Meanwhile, listed below are my medication timeline in the last 12 Months as requested. 

 

Armitryptyline (10mg Daily) - 22 July 2019 - 01 August 2019; 30 August 2019 - 05 September 2019 & 21 December 2019 - 31 January 2020

Armitryptyline (20mg Daily) - 06 September 2019 - 20 December 2019

Armitryptyline (5mg Daily ) - 01 February 2020 - 29 February 2020

Melatolin (3mg Daily) - 09 August 2019 - 16 August 2019

Vitamin D-3 (10,000 IU Every 3 days) -   30 August 2019 - Till Date

MK-7 Vitamin K-2 (100 mcg 3 days) - 30 August 2019 - Till Date

Omega 3 Fish oil (1500 mg 3 days) - 30 August 2019 - 14 February 2020

Tryptophan (500mg Daily) - 05 Apriil - Till Date

 

My account signature has been updated

 

i look forward to hearing from you

 

Thanks

[manymoretodays]

16 hours ago, Shep said:

This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

Hi duvylove, @duvylove

And welcome back.  Good job on the signature information.  Just use the link to Account Settings ^, and then copy and paste your information, into the signature section.  Be sure and hit SAVE at the end.

 

You may need to remove the actual digital signature to do so.  Can you see below my post, and ChessieCats post above, our signatures?  You can only see them when signed in too.  I was going to insert yours for you, but couldn't get beyond the actual digital signature attachment.  An actual signature!  That's a first, for me.  And an easy interpetation for you to have made. 

 

More about signatures:

Also, please put your medication and tapering history in your signature -- that's the information you see at the bottom of someone's post. This will help people understand your situation no matter where you post on the site. See instructions in this topic:

https://www.survivingantidepressants.org/topic/18343-please-put-your-withdrawal-history-in-your-signature/(Please note that, while your identity is protected by a screen name, your topic can be read by anyone who visits the site, including Google, and do not post sensitive identifying information.)

 

Again, welcome back.  And best.

L, P, H, and G,

mmt

Edited April 8, 2020 by manymoretodays
spelling

[duvylove]

On 10/14/2019 at 3:15 PM, Jen1234 said:

Have things settled down for you?

Hi Jen,

 

its a shame. I understand exactly what you are going through and i empathize with you. Armitryptyline is a very ugly drug to discontinue. For me, i am still not sleeping and if i mange to even get any, its very poor and shallow. 

 

My GP has recommended this free sleeping hygiene course below and i am trying it out to see if it helps. i will encourage you to try it out as well

 

https://www.sleepio.com/

 

I will wait till next week to see how things pan out until i speak with my GP again. Maybe the reinstatement might be the way to go but cutting the tablets to the smallest possible dosage might be a challenge

 

Let just hope for the best in all these

 

Eventually we shall pull through

[manymoretodays]

duvylove,

 

I went ahead and put the information, from the post of yours, into your signature.

Let me know if you can't delete the attachment, and scribbles, and I can try and do that for you.

That way you will have room for further updates in your survivingantidepressants "signature".

Currently, members only get 12 lines.

 

Tips for tapering off amitriptyline

^ has information about getting the small doses you would need for reinstatement

 

Best.

Edited April 8, 2020 by manymoretodays
grammar

[duvylove]

7 hours ago, manymoretodays said:

I went ahead and put the information, from the post of yours, into your signature.

Hi Manymoretodays,

 

Sorry i am just gradually comprehending this site moreover, i am not as sharp as i would normally be as the insomnia is making dull and also affecting my cognition. 

 

thanks for your help and recommendation. Well appreciated! 

[Jen1234]

On 4/7/2020 at 8:50 PM, duvylove said:

Hi Jen,

 

its a shame. I understand exactly what you are going through and i empathize with you. Armitryptyline is a very ugly drug to discontinue. For me, i am still not sleeping and if i mange to even get any, its very poor and shallow. 

 

My GP has recommended this free sleeping hygiene course below and i am trying it out to see if it helps. i will encourage you to try it out as well

 

https://www.sleepio.com/

 

I will wait till next week to see how things pan out until i speak with my GP again. Maybe the reinstatement might be the way to go but cutting the tablets to the smallest possible dosage might be a challenge

 

Let just hope for the best in all these

 

Eventually we shall pull through

Oh CBT-I. I hope this works for you. I’ve been through two CBT-I therapists already. Lots of people have great success with it. But they didnt have a med history or didn’t feel meds were the cause of their insomnia. Insomnia is a tricky thing to understand tho so I’m hopeful this will work for you. Do you feel your insomnia is no longer sleep apnea related? Did you ever have sleep problems like this before amitriptyline. I never had this kind of shallow broken sleep prior to meds. Trying to push through and hold out hope it can get better but after two year I begin to wonder if any healing that was gonna happen already took place. Guess we’ll see. Keep in touch I’m rooting for you 

 

[duvylove]

On 4/7/2020 at 11:42 AM, Shep said:

If you stopped at 5 mg on March 1st, you may benefit from reinstating a very small amount of this drug. Please see

Hi Shep,

 

do you have an idea where i can find the tapering excel spreadsheet calculator on this site?

[Shep]

16 hours ago, duvylove said:

do you have an idea where i can find the tapering excel spreadsheet calculator on this site?

 

Here you go:

 

How to calculate dosages and dilutions? Spreadsheets and calculators

 

Please post if you have any questions. 

[duvylove]

4 hours ago, Shep said:

How to calculate dosages and dilutions? Spreadsheets and calculators

Hi Shep,

 

goodstuff and i really appreciate your help 👍 Meanwhile, as i am kind of new to all these, could you briefly explain to me what the term "HOLD" means in tapering. For example, tapering 10% of  1mg Armitryptiline for 4 weeks then hold for 2 weeks before you reduce the dose further. Does the "hold" mean you stop taking the drug for a period of 2 weeks before you continue dosage reduction?

 

I look forward to hearing from you

 

Thanks  

 

  

[duvylove]

On 4/7/2020 at 11:42 AM, Shep said:

If you stopped at 5 mg on March 1st, you may benefit from reinstating a very small amount of this drug. Please see:

ok Shep i fully agree with you as a very good post i read from  @brassmonkeyalso suggested likewise. I have been of 5mg armitryptiline for 41 days now, can reinstate at 1mg?

[manymoretodays]

1 hour ago, duvylove said:

goodstuff and i really appreciate your help 👍 Meanwhile, as i am kind of new to all these, could you briefly explain to me what the term "HOLD" means in tapering. For example, tapering 10% of  1mg Armitryptiline for 4 weeks then hold for 2 weeks before you reduce the dose further. Does the "hold" mean you stop taking the drug for a period of 2 weeks before you continue dosage reduction?

 

Hi duvylove,

Hold means just hold at current dosage. 

 

Besides the cognitive difficulties, and sleep, how are you doing now?  Cognitive or thinking difficulties are really common duvy, early on in WD.

 

I see the tryptophan was just started April 5th.  How have your symptoms changed since then?

And brassmonkey may want to weigh in on that here, @brassmonkey

Here's our topic, as well:

5-HTP(5-hydroxytrytophan) and l-tryptophan

 

It's not really one that we recommend for WD.  More about supplements, etc. below:

Important topics about tests, supplements, treatments, diet

 

Why do you take your D-3 every 3 days?  And when do you take it?  It can be stimulating, so you might want to go with a lower dose daily, and/or if sunshine is available now, try to get it more naturally.  Take it in the morning too.

 

Did you quit the omega 3's then?  And why?

We generally, only recommend 2 supplements.  And then, only start one new thing at a time, and at the lower dosages.  We often become sensitized to things, in WD, and may react differently to things that we might have once tolerated.

And then keep some record, of when you add something new too, or take something away,  so if symptoms change, then you know what is related to what.

 

 

 

BASIC SUPPLEMENT TOOLKIT

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

I think that 0.5 mg to 1 mg, for a reinstatement would be a good place to try.  Do your best reading through the link, on reinstatement that Shep provided you too.

 

Best duvy, L, P, H, and G,

mmt

Edited April 11, 2020 by manymoretodays
minor

[duvylove]

3 hours ago, manymoretodays said:

Hold means just hold at current dosage

oh! meaning two weeks without the drug for the body to stabilize right?

[duvylove]

3 hours ago, manymoretodays said:

Besides the cognitive difficulties, and sleep, how are you doing now?  Cognitive or thinking difficulties are really common duvy, early on in WD.

To be very honest. Not much improvement (i am so alert, making my sleep very horrible ) except the days i use phernegan and i try to use it sparingly

[duvylove]

3 hours ago, manymoretodays said:

I see the tryptophan was just started April 5th.  How have your symptoms changed since then?

Not at all. Only phernegan makes the difference. 

[duvylove]

3 hours ago, manymoretodays said:

Why do you take your D-3 every 3 days?  And when do you take it?  It can be stimulating, so you might want to go with a lower dose daily, and/or if sunshine is available now, try to get it more naturally.

The Vitamins D-3 and K-2 are actually for a long term recovery of my upper esophageal sphincter (UES) that was compromised during my robotic surgery. TBH I actually take it anytime of the day maybe now i would try to take it more in the mornings. Which dose do you recommend? The current does was suggested to be very effective for stiffening and tightening of the UES 

[duvylove]

3 hours ago, manymoretodays said:

Did you quit the omega 3's then?  And why?

TBH i actually ran out. What dose do you suggest and how often?

[manymoretodays]

Have things gotten better or worse since the tryptophan?

And I'm feeling a little uneasy about you reinstating the Amitryptiline, with the trytophan you are taking now, to be honest.  So I'll ask the others what they think.

 

On the "HOLD" question........

It doesn't neccessarily mean that you'll reach full stability in 2 weeks on the same dose, no.  Once WDsyndrome has hit, it's tough to reverse it in any quick way.  In time, things readjust. 

25 minutes ago, duvylove said:

oh! meaning two weeks without the drug for the body to stabilize right?

 

Not really, not quite that simple.  It may take longer for the body to completely stabilize.  Regarding, in general, not just after a small reinstatement.  Or a tapering change.

This explains it:

How psychiatric drugs remodel the brain

 

And then here too, as far as what to expect, and again with WD symptoms in general:

 

[duvylove]

3 hours ago, manymoretodays said:

I think that 0.5 mg to 1 mg, for a reinstatement would be a good place to try.  Do your best reading through the link, on reinstatement that Shep provided you too.

Great, I intend to start with 1mg. So on Monday, i would liaise with my GP to prescribe me a liquid 5mg/5ml of armitryptiline hydrochloride i.e 1mg per 1ml and probably administer with 0.5ml oral syringe 

[manymoretodays]

I know those those links are long, but often the most information is in the first couple of posts.

The links on Omega's and Magnesium.

 

I waited awhile with adding Omega 3's.  And then slowly worked my way up to 1800 mg of EPA/DHA combined, daily.

So I take 3 capsules, twice a day.

Edited April 11, 2020 by manymoretodays

[manymoretodays]

5 minutes ago, manymoretodays said:

Have things gotten better or worse since the tryptophan?

And I'm feeling a little uneasy about you reinstating the Amitryptiline, with the trytophan you are taking now, to be honest.  So I'll ask the others what they think.

 

 

Hopefully, you'll have more input by Monday.  I'm glad you are waiting until then.

[duvylove]

33 minutes ago, manymoretodays said:

Have things gotten better or worse since the tryptophan?

And I'm feeling a little uneasy about you reinstating the Amitryptiline, with the trytophan you are taking now, to be honest.  So I'll ask the others what they think.

TBH I have not seen much difference with the tryptophan yet. The plan is to quit the tryptophan immediately after i reinstate the 1mg armitryptiline. and probably support it with fish oil. I sleep very well once stabilize on armitryptline, the only problem i have with it is "quitting"    

[duvylove]

41 minutes ago, manymoretodays said:

On the "HOLD" question........

It doesn't neccessarily mean that you'll reach full stability in 2 weeks on the same dose, no.  Once WDsyndrome has hit, it's tough to reverse it in any quick way.  In time, things readjust. 

Oh i see. So when you say taper @ 10% 1mg armitryptline for 4 weeks and hold for 2 weeks meaning you i be taking 1mg for a total of 6 weeks, right before reduction? Please correct me if i am wrong as i really want to understand this.  

[manymoretodays]

4 minutes ago, duvylove said:

Oh i see. So when you say taper @ 10% 1mg armitryptline for 4 weeks and hold for 2 weeks meaning you i be taking 1mg for a total of 6 weeks, right before reduction? Please correct me if i am wrong as i really want to understand this.  

 

Okay.  Yes.   With a tapering plan, when you are on a drug, and just beginning a taper, that is often how it goes.  

 

You would be reinstating, a small dose, in hopes of resolving some of the WD syndrome that has set in now.  At least to some degree.

 

With reinstatement though, generally you would just be HOLDing at the reinstatement dose.  You wouldn't neccessarily have to rush into tapering after just 6 weeks.  You might stay on the 1 mg dose for longer.   6 months or more.  

And just stay steady for awhile before even beginning to taper off again. 

 

And so......you don't need to worry so much about beginning a taper now.  I think we're more focused on if you should try a reinstatement dose.  I won't be surprised either, if your doctor wants to do it differently, however.  We run into that a lot.  Reinstatement, is the only medically known way to reduce WD symptoms.  

We tend to go harm reduction here.  Where many doctors will just want to go with a full dose.

Try to just be matter of fact, with what you need or want from the doctor.  I never had much luck convincing them of WD, and cautious tapering, and all. My doctors.  Just glad I got healthier, even without their input. 

 

Anyway, awaiting some other input on the tryptophan that you started.

 

Good questions duvylove. 

 

Okay, happy Easter if you celebrate.

 

L, P, H, and G,

mmt

 

 

[Altostrata]

On 4/5/2020 at 9:07 AM, duvylove said:

So, i followed the tapering instructions attached to this post by taking 10mg for 28days then 5mg for another 28days before quitting. In short, i took it for 5 months in total (tapering inclusive) with my last 5mg dose on the 1st March. Two weeks after this date, i started waking up at night with panic attacks, slight shivers and unexplainable insomnia.

 

duvy, did you have any withdrawal symptoms or sleep problems when you reduced from 20mg to 10mg? From 10mg to 5mg?

 

Sleeplessness is a very common antidepressant withdrawal symptom.

 

12 hours ago, duvylove said:

I have been of 5mg armitryptiline for 41 days now, can reinstate at 1mg?

 

This seems a good idea. You might ask your GP for a prescription for liquid amitriptyline, so you can take this small amount. Please let us know how you're doing.

 

What time of day do you take 500mg tryptophan? What effect do you feel from it? You've been taking it less than a week, correct? If you don't feel any benefit, I would stop it.

 

Are you taking any other drugs?

[duvylove]

14 hours ago, Altostrata said:

duvy, did you have any withdrawal symptoms or sleep problems when you reduced from 20mg to 10mg? From 10mg to 5mg?

Hi Altostrata...........not at all. every thing was perfectly okay all through these tapering period until March 12 which was 2 weeks after my last dose of 5mg 

[duvylove]

14 hours ago, Altostrata said:

This seems a good idea. You might ask your GP for a prescription for liquid amitryptiline, so you can take this small amount. Please let us know how you're doing.

Sure Altostrata. its like you were reading my mind. i have spoken to my local pharmacy and they have confirmed to me they have  5ml/5mg Armitryptiline hydrochloride (liquid) in their database. I just need to convince my GP to make its prescription and i will administer with 0.5ml oral syringe 

[duvylove]

14 hours ago, Altostrata said:

What time of day do you take 500mg tryptophan? What effect do you feel from it? You've been taking it less than a week, correct? If you don't feel any benefit, I would stop it.

 

Are you taking any other drugs?

I take 500mg Tryptophan at bedtime. Not much difference TBH but the plan is to stop it immediately i begin the reinstatement.

 

Meanwhile,  something funny happened to me yesterday night. After 1 hour of sleep,  I woke up around 3am as usual and couldn't go back to sleep and feeling hot. So, i went into the shower, had a 10mins warm bath, made a cup of chamomile tea, went to stand in the balcony for about 10mins while sipping this hot chamomile tea in the cold of the night. Then, i went to sleep in the guest room instead of my usual master bedroom and behold i was able to sleep for another 4 hours. I was only able to achieve this length of sleep with phernegan before now. So i was surprised that changing rooms could make a difference so i intend to continue the testing for another 2 days and i would let you know how it goes.

 

Thank you very much for all your suggestions.      

[Altostrata]

Sounds like you found a way to break whatever internal biochemical reaction was causing a wave. Humans sleep better in cool bedrooms, you may want to turn off the heat at night.

[duvylove]

On 4/11/2020 at 8:42 PM, manymoretodays said:

I know those those links are long, but often the most information is in the first couple of posts.

The links on Omega's and Magnesium.

 

I waited a while with adding Omega 3's.  And then slowly worked my way up to 1800 mg of EPA/DHA combined, daily.

So I take 3 capsules, twice a day.

Hi mmt,

 

Thanks so much for your wishes and hope you also tried to make the most of the Easter with your family. Meanwhile, if you don't mind me asking, while did you have to wait a while after reinstatement before adding the fish oil? I want to purchase one but not sure now of the concentration to buy as the link below suggests  2,000-3,000 mg EPA + DHA a day.

 

Also, i spoke to the GP this morning and she confirmed to me 5ml/5mg armitryptiline hydrochloride (liquid) is not available for prescription on their system meanwhile my local pharmacy has confirmed to me they can supply it on special prescription. Do you have any ideas on how i can get around special prescriptions? I am a bit lost right now  

 

 

 

     

[manymoretodays]

3 hours ago, duvylove said:

Thanks so much for your wishes and hope you also tried to make the most of the Easter with your family. Meanwhile, if you don't mind me asking, while did you have to wait a while after reinstatement before adding the fish oil? I want to purchase one but not sure now of the concentration to buy as the link below suggests  2,000-3,000 mg EPA + DHA a day.

 

Also, i spoke to the GP this morning and she confirmed to me 5ml/5mg armitryptiline hydrochloride (liquid) is not available for prescription on their system meanwhile my local pharmacy has confirmed to me they can supply it on special prescription. Do you have any ideas on how i can get around special prescriptions? I am a bit lost right now  

 

Hi duvy,

I had tried the omega 3's, while on hefty doses of all kinds of medication/drugs.  I found that, at the 3,000 mg, I bruised easily and also had some GI effects from it.  The GI effects, mostly "fish farts", and excuse my language, when I did restart it, were gone.  I keep mine in the freezer too, and I think that makes a difference.

 

And I don't know why, but for me if the EPA/DHA ratio is too high.......I felt like it was over stimulating.  So I settled in, when I restarted the omega's on a more balanced EPA/DHA ratio for my omega 3's.  It doesn't make a lot of sense, as the EPA converts to DHA, but I do think some others may have had a similar problem.  I had thought Dr. Andrew Weil, had written something about this too, but could not find the reference.  He's an integrative doctor, who has written books, and has much online as well, and is into more natural healing for sure, than some.

 

And oh, shoot, on getting the pharmacy brand liquid.  It's probably a cost factor.  NHS may not want to cover it.  Rather than get an exclusion, which could take some time, why don't you go with making your own.  If the doctor will prescribe a 5 mg tablet(you may have to get a 10 mg, if that is the lowest dose tablet) that would be all you would need, as well as syringes for measuring, and a mixing container.  It's really not as complex as one might think.  You can often get what you need, equipment wise from Amazon.  I did it, and just used syringes from the pharmacy, and some that I had from the vet, and a covered urine specimen cup.  I remixed every 3 days and kept the container in the fridge in a brown paper bag.  See what you think though.

 

  

On 8/15/2011 at 8:20 PM, Altostrata said:

Dissolving amitriptyline in water to make a liquid

About basic amitriptyline in tablets: Manzo 2006 Biowaiver Monographs for Immediate Release Solid Oral Dosage Forms: Amitriptyline Hydrochloride http://www.fip.org/files/fip/BPS/BCS/Monographs/Manzo%202006.pdf

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Amitriptyline hydrochloride is soluble 1:1 in water.11 The USP and the Ph. Eur. report this API to be ‘‘freely soluble in water’’.

 

How stable is this solution of amitriptyline in water? See Buckles 2008 The stability of amitriptyline hydrochloride in aqueous solution http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2710.1976.tb00052.x/abstract

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The present work, using thin layer chromatography and polarography, reports that solutions of amitriptyline hydrochloride in purified water at room temperature are stable for at least 8 weeks if protected from light.

 

Theoretically, you should be able to make a solution of amitriptyline in water, and use an oral syringe for precise dosing. See How to make a liquid from tablets or capsules

 

I haven't personally done this and I don't know of anyone who has, so if you do it, please post your experience in this topic.

 

And then maybe you can find out the whys or why not on the prescription liquid.  I wouldn't spend too much time on that though, as reinstatements work best early on.......and right now you are in a good time frame to give it a try.

 

Okay duvylove, and please ask.......anything, okay?  You are doing great.

 

L, P, H, and G,

mmt

Edited April 13, 2020 by manymoretodays
purple

[duvylove]

3 hours ago, manymoretodays said:

nd oh, shoot, on getting the pharmacy brand liquid.  It's probably a cost factor.  NHS may not want to cover it.  Rather than get an exclusion, which could take some time, why don't you go with making your own.  If the doctor will prescribe a 5 mg tablet(you may have to get a 10 mg, if that is the lowest dose tablet) that would be all you would need, as well as syringes for measuring, and a mixing container.  It's really not as complex as one might think.  You can often get what you need, equipment wise from Amazon.  I did it, and just used syringes from the pharmacy, and some that I had from the vet, and a covered urine specimen cup.  I remixed every 3 days and kept the container in the fridge in a brown paper bag.  See what you think though

Hi mmt,

 

wooow!......this is a revelation, interesting. I have been so stressed up all day as i want to reinstate asap and time is just passing. I have a leftover of 84 tablets 10mg Armitriptyline from the last prescription. As the link you sent me above is confirming Armitriptyline is soluble 1:1 in water, does this mean if i dissolve a 10mg tablet in 10ml of water (any specific type/s of water?) mix then drink, it would have the same potency as just taking a pure 10mg tablet on its own?

 

Could you just SIMPLY give me a brief step-by-step on how i can use a 10mg tablet (this will last me 10 days at 1mg/day) to make a soluble armitriptyline hydrochloride. please keep it simple and stupid for now until my cognition improves

 

Thanks