Sergey: Quit or taper Amitriptyline after 17 days?

[Sergey]

Hi all,

 

I am new on this forum, but I have been reading people's testimonials and struggles for a few weeks now.

 

My ongoing struggle with gut issues has prompted me to do test after test over the years, which luckily have all come back negative. Earlier this year, my GI doctor finally diagnosed me with Functional Dyspepsia. He wanted me to start on the usual medications for GI issues and, to my surprise, an antidepressant - Amitriptyline.

I am sensitive to medications in general, so the idea of having to take an antidepressant did not sit well with me. So I was reluctant to take it until October this year, when by that time I had seemingly exhausted all other medical possibilities to help with my issues. And  October 2nd was the first day I started tot take Amitriptyline.

 

As I mentioned above, due to sensitivity to medications, I decided to start off by cutting 10mg tablet into four pieces, and take 2.5mg for a few days to see how I would react to it. I took 2.5mg for 4 days. Then I upped the dosage to 5mg for the next two days and... stopped it. After 6 days in total. The fear of taking this drug was - and is - crippling.

I had another appointment with my GI doc a few days after I had stopped taking Ami, and he insisted that I need to give this medication another try. So I did. I reinstated on October 13th at 5mg and increased the dose to 7.5mg on October 15th. I've been taking 7.5 ever since.

The problem, though, is that after reinstating on October 13th, approximately on the 14th to be exact, the UTI like symptoms crept in (burning, frequency, feeling of not completely void) which I had never had before in my life. I went to see a doctor who ruled out UTI but said I need to see an urologist for further evaluation. I think Amitriptyline may be the culprit with the new health issue. Maybe not. But having this terror whether I should or shouldn't continue, especially after reading the horror stories of people fighting to stay sane while they getting off this drug, is not welcome in my life. I've got more than enough issues as is.

 

This is basically my whole story.

 

My question is this: Should I stop it cold turkey after 17 days (4 days - 2.5mg, 4 days - 5mg, 9 days - 7.5 mg for the total of 107.5mg) or would I'd be better off by gradually tapering off?

 

Thank you all in advance. 

[Shep]

Hi, Sergey.

 

Welcome to Surviving Antidepressants. 

 

Have you ever been on a psychiatric drug before? The reason I'm asking is because if this is your one and only psychiatric drug, you may be able to simply rapid taper off it by reducing down to 5 mg, where you were on October 14. If you do okay for a couple of days, reduce down to 2.5 mg and see how you feel. And then you could go to 1.25 for a couple of days. 

 

Please post your thoughts. 

 

Also, is amitriptyline the only drug you're taking? Have you had to take any other drugs for the GI symptoms? 

 

I don't know if the amitriptyline is responsible for the UTI type symptoms or not. Best to follow up with the doctor. Please let us know what you find out. 

 

[Sergey]

2 hours ago, Shep said:

Hi, Sergey.

 

Welcome to Surviving Antidepressants. 

 

Have you ever been on a psychiatric drug before? The reason I'm asking is because if this is your one and only psychiatric drug, you may be able to simply rapid taper off it by reducing down to 5 mg, where you were on October 14. If you do okay for a couple of days, reduce down to 2.5 mg and see how you feel. And then you could go to 1.25 for a couple of days. 

 

Please post your thoughts. 

 

Also, is amitriptyline the only drug you're taking? Have you had to take any other drugs for the GI symptoms? 

 

I don't know if the amitriptyline is responsible for the UTI type symptoms or not. Best to follow up with the doctor. Please let us know what you find out. 

 

I have not been on a psychiatric drug before. I will try to take 5mg for a few days, then decrease down to 2.5mg for a couple of days, and then to 1.25mg. I also take Prilosec as needed. I've also been prescribed Dexilant 60mg but I wanted to start off with Amitriptyline first and see what happens. To take these two potent medications at the same time would confuse me as to which one is causing side effects. And all medications do. This, unfortunately, is the story of my life. Thank you for your suggestion, I truly appreciate it. I hope I'll do well with rapid taper. But if there is anything wrong with me after I stop 1.25mg, what dosage would be the most appropriate to reinstate with? Thanks again. 

[Altostrata]

Hello, @Sergey

 

Amitriptyline is anti-cholinergic and can cause urinary issues. Please review drug adverse effects on drugs.com.

 

23 hours ago, Sergey said:

I will try to take 5mg for a few days, then decrease down to 2.5mg for a couple of days, and then to 1.25mg.

 

This is reasonable. Have you seen any benefit from amitriptyline?

[Sergey]

14 hours ago, Altostrata said:

Hello, @Sergey

 

Amitriptyline is anti-cholinergic and can cause urinary issues. Please review drug adverse effects on drugs.com.

 

 

This is reasonable. Have you seen any benefit from amitriptyline?

Hello, @Altostrata

I have not seen the full benefit of Amitriptyline simply because I haven't been on it for long. It sort of dulled my pain a little, but otherwise nothing exceptional. If it had not been for urinary issues, which my urologist said are most likely due to the drug, I might have continued taking it. But, to be honest, I was and I am terrified at the prospect of taking antidepressants. Even short-term.

Yesterday was the third day of taking 5mg. I was suggested to take it for a couple of days and then decrease down to 2.5. I decided to take it for three days instead of a couple and then decrease. But last night was a little bizarre. After taking 5mg at my usual time, I felt lightheadedness and slight dizziness. Couldn't fall asleep until 3AM. Slept until 7.30AM and that was it. Are these withdrawal symptoms? Should I keep on taking 5mg for a few more days before trying to decrease the dosage? I'd hoped before last night that after taking Ami for such a short period of time and at pretty low doses, I'd get away with doing as fast a taper as possible. Maybe I was wrong. 

[Shep]

9 hours ago, Sergey said:

After taking 5mg at my usual time, I felt lightheadedness and slight dizziness. Couldn't fall asleep until 3AM. Slept until 7.30AM and that was it. Are these withdrawal symptoms? Should I keep on taking 5mg for a few more days before trying to decrease the dosage?

 

Yes, please stick with the 5 mg for another night. 

 

Did you have insomnia or dizziness before taking amitriptyline or is this something new? When you stopped this drug on October 8 - October 12, did you have any of these symptoms? 

[Sergey]

1 hour ago, Shep said:

 

Yes, please stick with the 5 mg for another night. 

 

Did you have insomnia or dizziness before taking amitriptyline or is this something new? When you stopped this drug on October 8 - October 12, did you have any of these symptoms? 

Hello, @Shep

 

Well, I've had occasional (rare) sleepless nights like most people have, but never dizziness. Except, of course, for some days when I was only starting or upping the dosage. 

 

I wouldn't say I was wobbly last night, but still felt like I'd had a few beers. Please pardon my comparison, but I cannot come up with a better description right now. And it started not long after taking 5mg at 9PM. It's my usual time.

 

Today, however, I was functional, without any signs of symptoms for the most part. Of course, I felt a little bit tired, but that is to be expected with only a few ours of sleep last night.

When I quit on October 12, none of these symptoms were present. 

[Shep]

9 hours ago, Sergey said:

I wouldn't say I was wobbly last night, but still felt like I'd had a few beers. Please pardon my comparison, but I cannot come up with a better description right now. And it started not long after taking 5mg at 9PM. It's my usual time.

 

Since it happened after you took the drug, that may have been a side effect more than a withdrawal effect. Even though you reduced the dose, amitriptyline has a very unpredictable half-life, so there may be some drug build-up in your system (for more on amitriptyline, see Tips for tapering off amitriptyline). 

 

Even though you took it at the same time, did anything else change? Any changes in supplements or diet? Do you usually take amitriptyline with food and if so, did you do so last night? 

 

Please let us know how you slept last night and how you're feeling today.

[Sergey]

7 hours ago, Shep said:

 

Since it happened after you took the drug, that may have been a side effect more than a withdrawal effect. Even though you reduced the dose, amitriptyline has a very unpredictable half-life, so there may be some drug build-up in your system (for more on amitriptyline, see Tips for tapering off amitriptyline). 

 

Even though you took it at the same time, did anything else change? Any changes in supplements or diet? Do you usually take amitriptyline with food and if so, did you do so last night? 

 

Please let us know how you slept last night and how you're feeling today.

Hello, @Shep

 

No, nothing else changed. My diet has been the same for almost a year: low carbohydrate, no coffee, no chocolate, no alcohol. I don't use any supplements. And I don't take amitriptyline with food because my last meal is around 5 o'clock. I take Ami at 9pm. 

 

I was feeling better last night. I slept without waking up once. Since I started Ami, I usually feel sleepy in the morning but that changes back to normal quite quickly. Sometimes I feel a little bit tired during the day, but this has been the case since I started Ami.

 

So the question now is whether I should try 2.5 tonight or stay on 5mg. 

 

Thanks for being so helpful and patient with me. 

[Shep]

@SergeyThat's a great update, Sergey. Very glad you slept last night. 

 

Yes, I would go ahead and decrease down to 2.5 mg. Please let us know how you do. 

[Sergey]

20 hours ago, Shep said:

@SergeyThat's a great update, Sergey. Very glad you slept last night. 

 

Yes, I would go ahead and decrease down to 2.5 mg. Please let us know how you do. 

Hello, @Shep

 

So far so good. However, I am aware that withdrawal symptoms could punch one in the gut in a few days or even weeks. That being sad, I hope it's not going to happen to me. Fingers crossed!

 

I'll be updating how I do. 

 

Thanks again for guiding me through this. 

[Shep]

On 10/29/2021 at 3:22 PM, Sergey said:

So far so good. However, I am aware that withdrawal symptoms could punch one in the gut in a few days or even weeks. That being sad, I hope it's not going to happen to me. Fingers crossed!

 

True, this is a very unpredictable journey.  But getting hit with delayed withdrawal generally happens with people who've been on the drug long enough to become dependent. You're at the very edge of dependency right now and any dependency that may develop is going to be at the very low end of the dose. So let's hope for a smooth exit. 

 

How are you feeling? How is your sleep? 

[Sergey]

13 hours ago, Shep said:

How are you feeling? How is your sleep? 

Hello, @Shep

 

So far, I haven't been able to detect much of a difference between the last couple of days, when I started taking 2.5, and earlier when I was on a relatively higher dose. One thing in common, however, is that  I feel a little bit tired at around 3-4pm. It feels like a need a nap, but can't take one because of work.

 

I go to bed at 11.30 and sleep pretty good until 6.30 or 7.00 o'clock in the morning. It's now been three days since I decreased the dosage down to 2.5. How long, in your opinion, should I stay on 2.5 before decreasing to 1.25?

 

Thank you. 

[Shep]

6 hours ago, Sergey said:

How long, in your opinion, should I stay on 2.5 before decreasing to 1.25?

 

You're doing great, Sergey. I would go ahead and decrease.

 

The goal is to get off the drug as close to the one month mark as you possibly can. Since you're sleeping well and feeling okay, aside from some late afternoon fatigue, I think you'll be okay to continue your rapid taper.

 

Perhaps fix a healthy protein snack to eat before 3 PM to give you a nice boost of energy to help with the afternoon fatigue.

 

Please let us know how you do. 

[Sergey]

On 10/31/2021 at 4:17 PM, Shep said:

Please let us know how you do.

Hello, @Shep

 

Update. Started 1.25mg on October 31st. It's now been three days since then. The first two nights I didn't sleep well. The third night was a lot better. It's worth mentioning that in my estimation the first two bad nights were due to severe stress from a doctor's visit (nowadays doctors make me feel lost, devastated and there is a sense that I am on my own confronting health issues), as well as my pain - so-called functional dyspepsia - is coming back. Amitriptyline did dull my pain to a degree, as I mentioned earlier, but still didn't make me feel like my old self. Originally my doc wanted me to gradually up the dosage to 30mg, even 50mg or some such. Having said that, I could only manage to work my way up to 7.5mg when urinary issues appeared.

Other than that, there are no symptoms of withdrawal. At least as of today. Do I need to continue taking 1.25 for a few more days, or is it OK to quit it once and for all?

 

Thank you. 

 

 

[Shep]

16 hours ago, Sergey said:

It's worth mentioning that in my estimation the first two bad nights were due to severe stress from a doctor's visit (nowadays doctors make me feel lost, devastated and there is a sense that I am on my own confronting health issues), as well as my pain - so-called functional dyspepsia - is coming back.

 

I'm not familiar with functional dyspepsia and it's not something we can help you with on this forum, but you may want to research holistic doctors in your area and see if there are any natural, non-drug ways of healing from this. Taking drugs to mask pain can prevent you from finding out what your body is trying to tell you. I wish there were more options for holistic care, especially holistic care that's covered by insurance, but definitely worth researching what's available in your area. 

 

16 hours ago, Sergey said:

Other than that, there are no symptoms of withdrawal. At least as of today. Do I need to continue taking 1.25 for a few more days, or is it OK to quit it once and for all?

 

I think you'd be safe to go ahead and stop it. Very glad to read that outside of external stressors hurting your sleep, you're doing well. 

 

If you're uncomfortable stopping it too soon, you could half the 1.25 mg and half tonight and half tomorrow and then stop. 

 

Please let us know how you do. 

[Sergey]

7 hours ago, Shep said:

I'm not familiar with functional dyspepsia and it's not something we can help you with on this forum, but you may want to research holistic doctors in your area

I was venting. Prone to do that once in a while. Sorry for that. 

 

7 hours ago, Shep said:

I think you'd be safe to go ahead and stop it.

 

That's what I did yesterday. I stopped it. The first day off this drug. Hopefully, there won't be any problems down the road. 

7 hours ago, Shep said:

Please let us know how you do

I will. 

 

Thank you for your replies. 

[Shep]

On 11/4/2021 at 12:56 PM, Sergey said:

I was venting. Prone to do that once in a while. Sorry for that. 

 

Nothing wrong with what you wrote, Sergey. No apologies needed! I only mentioned checking out holistic doctors because you seem to be medication sensitive, which in the long run, may lead you to seek healthier options. A lot of pharmaceuticals do come with a lot of risks and doctors aren't educated in the risks of these drugs. 

 

How are you doing this weekend? How is your sleep? 

[DinaDina]

Hi Sergey. I have the almost same story. I was diagnosed with Functional Dyspepsia and a doctor prescribed me Zoloft. And after that I have bladder/pelvic issues. I think people like us shouldn't take any AD. I hope you will be better soon.

[Sergey]

On 11/7/2021 at 11:16 AM, Shep said:

I only mentioned checking out holistic doctors

Hello @Shep,

 

Last week, I set out to find one, and I did. I have an appointment next week. She said, that we'd make some sort of a plan to try to help me with my issues. I have no other choice so I guess it's worth a try. 

 

On 11/7/2021 at 11:16 AM, Shep said:

How are you doing this weekend? How is your sleep?

Well, I am doing pretty decent, considering that I just recently stopped Amitriptyline (it's now been 5 days off the drug) and am also tapering Prilosec, which has done absolutely nothing for me. 

 

There is some low grade nausea that comes and goes during the day, a bit of fatigue, but all this could be due either to my original problem (it did roar back, unfortunately), Prilosec, or withdrawal from Ami.

 

I sleep well, no headaches or mood swings so far. I am hoping for the best, but at the same time closely monitoring every symptom or change every single day. I wish I'd gotten scot-free from this Amitriptyline debacle, but nobody can guarantee that. That's how I am right now.

 

Again, thank you for asking. I appreciate it. 

[Sergey]

21 hours ago, DinaDina said:

Hi Sergey. I have the almost same story. I was diagnosed with Functional Dyspepsia and a doctor prescribed me Zoloft. And after that I have bladder/pelvic issues. I think people like us shouldn't take any AD. I hope you will be better soon.

Functional Dyspepsia is no picnic, that's for sure. I've tried so many things to help myself but nothing has worked out so far. So now I am off to try holistic approach. Maybe that will eventually sort this nagging issue out.

 

I also hope that you will be able to find what's best for you in terms of getting rid of this issue. Good luck! 

[Shep]

On 10/25/2021 at 8:58 PM, Sergey said:

I also take Prilosec as needed.

 

19 hours ago, Sergey said:

Well, I am doing pretty decent, considering that I just recently stopped Amitriptyline (it's now been 5 days off the drug) and am also tapering Prilosec, which has done absolutely nothing for me. 

 

There is some low grade nausea that comes and goes during the day, a bit of fatigue, but all this could be due either to my original problem (it did roar back, unfortunately), Prilosec, or withdrawal from Ami.

 

I'm glad you're doing okay so far. 

 

How often were you taking Prilosec? You mentioned "as needed," but since you're tapering, do you think you developed a dependency? 

 

You may have already seen this thread, but just in case, I'll leave a link:

 

Tips for tapering off stomach acid blockers or PPIs...

 

We recommend people hold for awhile after coming off one drug before tapering the next. You may want to stop tapering the Prilosec to see if the nausea and fatigue resolve. Just a thought, especially if these symptoms are particularly troublesome. It could be a sign that your nervous system is asking for a rest. 

[Sergey]

On 11/9/2021 at 7:43 AM, Shep said:

How often were you taking Prilosec? You mentioned "as needed," but since you're tapering, do you think you developed a dependency? 

Well, I started taking Prilosec on as needed basis for a few weeks in the beginning of October and everyday at the end of October (about two weeks) when I started tapering. I am just playing it safe, tbh, not quitting it cold turkey even after taking it for such a short period of time. As I wrote before, my doc wanted me on a much more potent PPI, which, I am happy to report, I refused to take. 

 

The last few days nausea is all but gone. It is really common with Functional Dyspepsia to have all kinds of symptoms including, much to my chagrin, nausea. But I am monitoring any changes that might occur in the future. 

 

On 11/9/2021 at 7:43 AM, Shep said:

You may have already seen this thread, but just in case, I'll leave a link:

 

Tips for tapering off stomach acid blockers or PPIs...

Yes, it's a very important thread for me. 

 

On 11/9/2021 at 7:43 AM, Shep said:

We recommend people hold for awhile after coming off one drug before tapering the next. You may want to stop tapering the Prilosec to see if the nausea and fatigue resolve. Just a thought, especially if these symptoms are particularly troublesome. It could be a sign that your nervous system is asking for a rest. 

Thank you for this advice. I'll try to update in a few days. 

[Shep]

How are you feeling, Sergey? 

[Sergey]

7 hours ago, Shep said:

How are you feeling, Sergey? 

Hello, @Shep

 

I've been feeling all right lately. I do not detect any withdrawal type of symptoms at this time. No headaches, no body aches, no dizziness, and no insomnia. Also, I noticed that the brain fog (or rather lightheadedness) that I had while taking the drug seems to have lifted. Despite all of this, there's a lingering feeling that I can still get hit later. Therefore, I am very interested in how I should proceed from here on out.

 

I am going to see a holistic doctor next week. When I spoke to her on the phone, she said that we'd work out a supplements plan to address my issues . From what I've gathered on this forum, it is advised not to take supplements at the time of withdrawal from ADs, with the exception of Magnesium and Omega-3. Hence a few questions: would it be prudent for me to start with her plan right away, meaning sometime next week, or should I wait a bit longer without taking anything? If I need to wait more, how long should it be? I've been off the drug for eleven days now. 

 

Thank you for continually helping me. 

[Shep]

2 hours ago, Sergey said:

Despite all of this, there's a lingering feeling that I can still get hit later. Therefore, I am very interested in how I should proceed from here on out.

 

I wouldn't worry too much about getting hit later. It's possible, but with the sedating antidepressants, many people stop sleeping. The fact that your sleep is good is a great sign that you likely will do okay. I would hold onto those kinds of thoughts, while at the same time, treating your nervous system like fine crystal and doing as much self care as possible. You did a great job of carefully coming off with a rapid taper after short term use. 

 

But with Covid circulating as endemic, it's important that we all take very good care of ourselves, whether we're dealing with withdrawal or not. So living healthy as a lifestyle will serve us all well, even after we heal from withdrawal. 

 

2 hours ago, Sergey said:

I am going to see a holistic doctor next week. When I spoke to her on the phone, she said that we'd work out a supplements plan to address my issues . From what I've gathered on this forum, it is advised not to take supplements at the time of withdrawal from ADs, with the exception of Magnesium and Omega-3. Hence a few questions: would it be prudent for me to start with her plan right away, meaning sometime next week, or should I wait a bit longer without taking anything? If I need to wait more, how long should it be? I've been off the drug for eleven days now. 

 

Be careful the holistic doctor isn't using supplements the way a lot of allopathic doctors use prescription drugs. For example, using St. John's Wort to raise serotonin for depression. Hopefully you won't run into that since your medical condition is physical. Perhaps let her know you have medication sensitivities and try to target certain foods and exercises as your medicine before adding in supplements. 

 

If you do add in a supplement, we advise only adding in one supplement at a time and at a low dose. You may want to keep a symptoms journal to track your progress as you bring in a supplement or holistic treatment. And definitely research anything and everything. Hopefully what you've learned here about psych drugs will translate into other areas of medicine and you'll get some much needed and much deserved healing without getting harmed in the process. 

[Sergey]

22 hours ago, Shep said:

I wouldn't worry too much about getting hit later. It's possible, but with the sedating antidepressants, many people stop sleeping. The fact that your sleep is good is a great sign that you likely will do okay. I would hold onto those kinds of thoughts, while at the same time, treating your nervous system like fine crystal and doing as much self care as possible. You did a great job of carefully coming off with a rapid taper after short term use. 

 

Thanks. Your words have calming effect on me. 

 

22 hours ago, Shep said:

Be careful the holistic doctor isn't using supplements the way a lot of allopathic doctors use prescription drugs. For example, using St. John's Wort to raise serotonin for depression. Hopefully you won't run into that since your medical condition is physical. Perhaps let her know you have medication sensitivities and try to target certain foods and exercises as your medicine before adding in supplements. 

 

If you do add in a supplement, we advise only adding in one supplement at a time and at a low dose.

The first thing I said to this doctor was that I am very sensitive to everything these days. I will definitely make sure to tell her that I need to start off with one thing at a time and at a low dose.

 

Thanks for the heads up!