SurreyGuy: amitriptyline is my poison ...

[SurreyGuy]

Tapered to 7.5mg about a week ago. So far so good. Let's see how I feel this coming week. 8mg was really challenging. I had to stay there for a good 6 weeks. I'm hoping 7.5mg won't be so difficult/long.

 

Interestingly, my posture is slowly improving, which is great news. It seems the amitriptyline was making the muscles on my right side of my spine weak and tense, making it near impossible for me to stand tall without any pain. I'm now hopeful this condition can be fully reversed in time... All those years of seeing chiropractors for back pain. I even had a chiropractor asking me if I had been in an accident!!! All along it was this bloody drug! I wished I had connected the dots earlier and started my taper years ago. Anyway, the good thing is that I am now on the right path.

[ChessieCat]

7 hours ago, SurreyGuy said:

All along it was this bloody drug! I wished I had connected the dots earlier and started my taper years ago. Anyway, the good thing is that I am now on the right path.

 

Yes, I know how you feel; I and many other members wish we had known this years ago.

 

Glad that you have a positive attitude about it.  That is what acceptance is.  Acknowledging a fact but trying not be emotional about it.  Anger causes stress and stress slows recovery.

 

7 hours ago, SurreyGuy said:

Tapered to 7.5mg about a week ago. So far so good. Let's see how I feel this coming week. 8mg was really challenging. I had to stay there for a good 6 weeks. I'm hoping 7.5mg won't be so difficult/long.

 

Some other members have had difficulty getting past certain doses.  It seems to be a very individual thing so it cannot be said that at "x" dose go a bit slower.

 

I am pleased that you held for 6 weeks.  If it happens again I would suggest making a smaller reduction next time, of course after you are stable.

[Sofie]

Well done! Is it well-known that amitriptyline can make the muscles weak and tense? 

[SurreyGuy]

@Sofie, it is well known and documented that amitriptyline causes constipation (it's a frequent "side" effect along with dry mouth). I'm guessing it does this by impacting neurotransmitter receptors located in the guts, which, in turn, cause the abdominal muscles to contract on a permanent basis. Constipation is a very frequent effect of amitriptyline... 

[Sofie]

Yes, I did know that it causes constipation. But can it make the muscles in the whole body weak? Like the neck muscles for instance? 

[SurreyGuy]

@Sofie, I am not aware of amitriptyline directly affecting other muscles in the body in the way you describe it, but then again, I'm not an expert and I can only go by my own experience which is hardly the way to draw scientific generalisation conclusions... That said I can think of a way where amitriptyline could be the culprit indirectly: each of our bodies works in a state of equilibrium (homeostasis), whether it's biochemical equilibrium (when it comes to neurotransmitters), mechanical equilibrium (when it comes to muscles), etc. If you upset that equilibrium, e.g. by causing abdominal muscles to over-contract chronically, some of your other muscles in the upper back / neck / shoulders may have to work harder that they were intended to in order to compensate, causing all sorts of pain in the long run, etc. A chiropractor might look at you and say you have a posture problem on the assumption that any disruptions to the muscle equilibrium has to be caused by a physical factor (sport injury, accident, etc.) while, in fact, more thorough investigations might demonstrate that it is the medication that is causing the issue. That line of inquiry is particularly relevant to antidepressants such as TCA which are known to affect several types of neurotransmitter receptors located through all your body (quite possibly in muscles too...?). Many psychiatric drugs are known to impact hormones, the cardiovascular system, the GI tract, etc. in addition to the CNS... Pretty scary when you think of it. What puzzles me is that for some patients, those side effects are minimalistic and disappear quickly, while for others like me, the effects take a while to dissipate (but they eventually do)...

 

 

[SurreyGuy]

The reduction to 7.5mg has not been as bad as the reduction to 8mg. I have some rather good days. However, last night, insomnia was rather challenging and I am feeling rather tired today... glad it's Friday...

[SurreyGuy]

Reading that previous post of mind, I find there were too many 'rather' 😄

[SurreyGuy]

Reading that previous post of minE, I find there were too many 'rather' 😄

[SurreyGuy]

It will soon be time to taper again... As I type those words, I do not feel particularly bad but there are is a new symptom bothering me. In spite of a good night sleep, I am tired, deflated, a bit like if my blood pressure was very low. I could easily fall asleep in front of tv. My brain seems unable to perform any serious cognitive task... very frightening. Is this normal. Has it happened to others?

[SurreyGuy]

The BBC says: some antidepressants may make heatwave challenging

 

This article explains why I have been avoiding the sun like the plague all those years. As I taper, I start feeling better...

[Sofie]

Yes, same. I've been so sensitive to the sun and very pale, since I started taking amitriptyline. You taper with 0,5 mg every second month? I'm now down to 7 mg from 20 mg - started in May - and I've been getting very heavy, dull headaches, so I guess I should slow down now. 

[SurreyGuy]

@Sofie , that's a rather fast taper you're using! I tend to decrease 0.5mg every calendar month though there have been times (because of work or other health issues) where I have been much slower than that. I had a catastrophic failed cold turkey from 3 drugs 2.5 years ago and my CNS has been sensitised quite a lot since then though things are a lot easier since 2021 Q4. If your symptoms becomes more intense it may well be your body telling you you should slow down... that's what I would do if I were you...? Do you have other symptoms? I have so many....

[Sofie]

Yes, I also have nausea and feel sick/have a slight fever/cold. Wondering if benadryl or another antihistamine could be helpful. 

 

But the headaches scare me the most, as they are very painful. So I should probably also just proceed with 0,5 mg at a time from now on. 

[SurreyGuy]

It's probably wiser. Ideally, the amount of reduction should be such that after your taper, your symptoms flare up, then subside and stabilise after 2 to 4 weeks at which point you know it's time to taper again. If you really want peace of mind re the headaches, you can always request a brain MRI scan. It will most likely show that you have nothing to worry about. Have a good week-end.

[ChessieCat]

@Sofie

 

I suggest that you post in your Introduction topic.  You haven't posted in your own topic since 30 May 2022.

 

The staff do not always see your posts, like the ones you have made above about the issues you are having, so they cannot offer any suggestions about what you might do/try to help with any issues you are having.

[SurreyGuy]

Another day, another taper. This is getting tiresome, a hindrance, which, I guess, is a relative improvement compared to 1 or 2 years ago when every single taper triggered a storm of symptoms, shattering my very core. 

 

I am suffering from bad insomnia at the moment but that doesn't bother me too much. I am just physiologically tired and that's it. Before, insomnia would always go hand in hand with high anxiety. Less so it seems. Again, another improvement.

 

My mood has been down recently. I feel like blasé. A bit like a disillusioned nihilistic teenager. I know it's not me. I know it will be a few days (or weeks) before things improved. I hope I sleep better tonight. 

 

On the plus side, my long-term back problem seems to be gradually resolving by itself. I am pretty confident now that the issue was caused by the medication at higher dose. All those years looking for a solution to that bloody back problem and all that time the solution was right in front of me: stop taking the amitriptyline! 

 

When I look where I am right now and where I was 2 years ago, so much progress has been accomplished. I know it will be worth it, I just need to be patient until I am free of that poison.

 

Courage to all of us still tapering!

[SurreyGuy]

The last taper to 6mg has been challenging. It coincided with prescription renewals and I ended up with amitriptyline hydrochloride pills instead of plain amitriptyline. I am wondering if this has anything to do with how difficult this taper is. That or it could be the manufacturer of the new pills uses less amitriptyline in their pills... I know the pharma industry is regulated and audited... but then again many other industries such as food industry are and it doesn't prevent scandals... would anyone want to comment?

 

[SurreyGuy]

Amitriptyline vs amitriptyline hydrochloride

 

Hello folks,

I wonder if I could tap into your wisdom and knowledge on this one.

I recently tapered from 6.5mg amitriptyline to 6mg 18 days ago.

 

I started going through my usual waves/windows pattern. It was tough but not unusual in any ways.

Then, about 8 days ago, I switched from one amitriptyline generic pill to amitriptyline hydrochloride generic pill. 1 day after the switch, I started developing even worse insomnia, really bad muscle cramps and horrible anxiety. All reminded me of my cold turkey days. 

 

All those things led me to wonder: could the switch in pill manufacturer have caused extra instability on top of the instability from the recent taper? Is amitriptyline hydrochloride any different to plain amitriptyline? Should I insist on going back on old drug?

 

I use a liquid taper with hazelnut milk (hoping the fat in the milk help with the solubility of amitriptyline). Is this adequate for amitriptyline hydrochloride too?

 

Did anybody else experience issue when switching from one manufacturer generic to another? Keen to hear from your experience.

 

Edited September 7, 2022 by ChessieCat
added topic title before merging with intro topic

[manymoretodays]

Well, we even have a couple topics that might help answer your question.

Here you go:

https://www.survivingantidepressants.org/topic/19219-change-in-drug-manufacturer-or-generic-substituted-for-brand-name-drug/

and:

https://www.survivingantidepressants.org/topic/22065-myths-about-your-drugs/

 

Hmmm, I think all amitriptyline is amitriptyline HCL

Could it have just been labeled differently?  And okay, I'm reading a switch in generics.

 

Have the symptoms persisted?

 

I would hope if you are using the same method, same active ingredient (just different fillers) your dilution should be okay.

 

And yes to the below as well.  I guess I was editing.  If you are not adjusting, see if you can get your old brand generic back.

 

 

 

Edited September 7, 2022 by manymoretodays

[ChessieCat]

Yes, other members have reported having issues changing manufacturer.

 

For future reference:  it is suggested to do a cross over which is obviously difficult if you don't have any of the old version left but it is worth noting and in future getting your prescription filled before running out completely:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

My suggestion would be to contact the pharmacy and/or doctor and let them know that you are having issues since changing and try to get the previous type.

 

Edited September 7, 2022 by ChessieCat

[SurreyGuy]

Manymoretodays, I now think the distinction between amitriptyline and amitriptyline HCL was a red herring. I looked at the medication leaflet and what I thought was plain amitriptyline was in fact amitriptyline HCL.

 

So the extra symptoms must have been caused by the difference in manufacturing processes (even though the industry is supposed to be regulated/audited to prevent such differences). Either one manufacturer is using less amitriptyline than the others in their pill or they use a different filler which interfere with the metabolism of amitriptyline...

 

Chessiecat, the concept of crossover is useful. I will make sure to keep some of my old pills when switching to a new brand.

 

Again, thank you for the advice.

[ChessieCat]

3 hours ago, SurreyGuy said:

or they use a different filler which interfere with the metabolism of amitriptyline...

 

This is more likely to be the case.

[SurreyGuy]

I spoke with a GP about my recent experience with crossing over to a different brand of amitriptyline pills. He confirmed that amitriptyline hydrochloride is amitriptyline so that's not the reason behind my symptom flares. He also does not believe the amount of amitriptyline varies enough between brands to explain the symptoms. He believes it's most likely down to the filler and its impact on the solubility of amitriptyline hydrochloride in milk.

 

On the plus side, the symptom flare was over after a day. What a bumpy ride this has been!

 

[SurreyGuy]

Slept relatively well last night, 7h30 I reckon (got up once only at night), yet my mood is very labile today. On the plus side, muscle cramps have eased quite a bit over the past 2 to 3 days. Other symptoms are ok-ish, very touch and go. This is soooooo protracted...

[Erimus]

Hello @SurreyGuy. Thought I would jump in and offer my advice regarding changing of brands. I had a lot of trouble with this when I was in a much more sensitive state earlier this year.

 

You can speak with your doctor and request them to put a note on your prescription saying which brand you would prefer. I did this for a number of months. I also spoke with my local pharmacy in advance of collections to see which brands were available. I did quite a lot of travelling around to ensure I had the same brand each month. I don’t have to worry so much these days.

 

I also created a spreadsheet for mirtazapine with around 4 or 5 different common generics and their ingredients (taken from the patient information leaflet). A couple of the generics I use actually had exactly the same ingredients so no crossover problems. It caused me a lot of stress in the first part of this year but I’m glad to have moved on from that now. I know when you’re suffering you can over-analyse everything to try and work out the issue.

 

Hope your tapering continues to be successful.

[SurreyGuy]

@Erimus, yes I will do that next time I have to renew my prescription, which is every 4 months.

Things are tough at the moment taper-wise. I am supposed to taper soon to 5.5mg but I think I will wait another week or so.

 

[SurreyGuy]

I have a question regarding tapering... Those reading this thread may care to chip in: is tapering 'painful' all the way through or is there a point along the way when the drug loses its stronghold over the patient and things become easier?

[Erimus]

Always best to listen to your body rather than the calendar. Tapering is meant to reduce in increments so small that your body can make the required adjustments with the least possible symptoms. It’s not going to be symptom free but if you’re having issues with the drops perhaps try a smaller percentage next time. Your next drop from 6mg to 5.5mg is 8.33%, maybe drops in the range of 2-5% would be more appropriate for you. It can take some experimenting to find the best solution, see what some of the other staff members say.

 

When the amount of drug in your bloodstream each day decreases the adverse effects you experience at the so-called ‘therapeutic’ doses should decrease. It can take a lot of time and tapering to reach this point but you’ll probably gradually notice issues fading.

 

Have a read of this is you haven’t already as well:

 

 

 

Edited September 18, 2022 by Erimus

[brassmonkey]

One of the biggest problems with tapering is that it is so unpredictable and affects each person in a different manner. So, we have to make statements that are generalizations and can't be specific to any one person.  In general, as a person tapers, they will experience a gradual improvement in their symptoms. We frequently refer to this as WDnormal, which is a sliding scale based on many months of history. Many people report seeing improvements this month compared to how they felt five or six months ago. It is a slow and subtle process, with a lot of ups and downs in between.

 

If a person's taper has gone smoothly then the last few milligrams of reduction should be pretty painless. Until then it should be variable with improvements along the way. But, again, each person's taper is different.

[SurreyGuy]

Yes, this has been a constant obsession of mine since the beginning of my ordeal: trying to make sense of my symptoms, establishing some cause-and-effect relationships using the most convoluted and nebulous data I can get my hands on. Unfortunately, I have not been able to establish any reliable patterns...

 

Am I better now than when I started my taper? The answer is an emphatic yes. But now and then along the way, I get terrible waves and I doubt. Today is one of those wavy day. For all I know, I could feel better tomorrow. If so, I'm sure I will think I was a fool to worry so much. Or tomorrow could be the continuation of the wave...?

 

It's fair to say that my last taper to 6mg has been more difficult than the previous ones. Perhaps it's telling me I need to slow down as @Erimus pointed out. If true, this is depressing news as I probably have a few more years of taper to go through (I thought I would be over by Xmas 2023) before I can be free...

[Erimus]

Excuse the cliche but it’s a marathon not a sprint. Given how long you’ve been taking amitriptyline it is going to be an arduous and challenging journey to become drug free. I’d say you’re doing pretty well given your cold turkey attempt in Dec 2019, followed by the reinstatement and slower taper. It’s pretty impressive that you’re down to just 6mg now. Try and look at the positives. Eventually tapering will just become something you have to do, but your life will so full that it is just background noise.

[ChessieCat]

2 hours ago, SurreyGuy said:

Yes, this has been a constant obsession of mine since the beginning of my ordeal: trying to make sense of my symptoms, establishing some cause-and-effect relationships using the most convoluted and nebulous data I can get my hands on. Unfortunately, I have not been able to establish any reliable patterns...

 

When I got symptoms I would try (without spending too much time or effort on it) to work out what non-WD issue might have caused it, thinking back of the recent past of what might be the cause.  Sometimes it might have been something simple like I hadn't been sleeping as well, or I was a bit stressed over something.  If I couldn't think anything non-WD then I would just think matter of factly that oh it's probably withdrawal.  So long as it wasn't unbearable I would just try to accept it as being a part of the process of getting off the drug and try not to worry about it and cope as best I could with non drug coping techniques.

[SurreyGuy]

Still stuck on "6mg". Main symptom is crippling insomnia... I survive on 4h of sleep per night... ugh... it's hard to remain functional in a professional capacity. I used the double quotation mark around 6mg as I am not sure this is the actual dose I get with my tapering technique.

 

At the moment I feel "bipolar". When I sleep well I am almost maniac, hyper. Then I have insomnia for a few nights in a row and I crash completely... it's so hard... sorry for the moan, I just need an outlet to vent my frustration and desperation I guess.

[ChessieCat]

Looks like it might be time to start maker smaller reductions.

 

On 8/16/2011 at 12:20 PM, Altostrata said:

Making your own liquid suspension of amitriptyline

A liquid preparation of Amitriptyline could be made simply by dissolving the tablets in a specific volume of water. (It is also soluble in ethanol, see below.) 

 

[Altostrata]

1 hour ago, SurreyGuy said:

Still stuck on "6mg". Main symptom is crippling insomnia... I survive on 4h of sleep per night.

 

Might be time to take a long vacation from tapering, let your nervous system accommodate to the lower dose.