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[CrispyChick]

Hi ladies.

Bit of a conundrum here. I've been offered amitriptyline so many times over the years for various complaints - ibs etc. But I've never taken it.

I had a lot of anxiety after my babies were born and was put on escitalopram. Been stuck on 5mg for years. Don't think it does anything - too scared to come off it.

Anyway, now I'm having to go back on the mini pill to curb my peri rollercoaster. Which it will. But it'll also give me extreme pms! So I was considering upping the escitalopram in an attempt to fend off the pms. I note it is a ssri that is offered for pms.

The pill also gives me migraines.

Now, being the lucky recipient of yet more
internal pains and randoms - I've been offered
Amitriptyline again.

I know I can't take both at once. So what do I do??? Ideally I'd prefer to stay on escitalopram and up it to cover the pms - but is it at all likely to assist with migraines and pain issues???

Or should I taper whilst trying amitriptyline (scared of side affects) - but would low dose be enough to assist pms mood swings?!?

Any advice - particularly on the ability of the  ssris (like escitalopram) to assist in migraine and pain. Or on amitriptyline to assist with pms.

Many thanks.

[CLKD]

Amitriptyline is basically to ease seizures - it did nowt for me when I had trigenimal neuralgia.  It may work for pain in some cases.

I took it along-side AD meds., I can't remember which it was in the mid-1990s. 

5mg is a maintenance anti-depressant dose.  I use 5mg in the morning and 10mg at night which keeps my depression at bay.  Should my brain be depressed for more than 3 mornings, I add 5mg until I feel better.

[Penguin]

I was offered amitriptyline for overactive bladder about 20 years ago  I said no. I think it can be used for a variety of things, particularly if nerve signals are involved.

I didn't know any of the ssri drugs were used for pain though.

[CrispyChick]

Yeah, I'm not sure the are.

I was hoping they might be  as I'd much rather stay on escitalopram and up it. As hellish as that will be. 

[Penguin]

Couldn't you take something else for the migraines? I'd have thought trialling an increase of escitalopram would be easier on your system than having to taper off and start a new drug?

[CLKD]

If U are taking Escitalopram mayB take 1 dose in the morning the other at night? 

[CrispyChick]

Does that work better clkd?

Yes, good point penguin. I think it is the way I'm leaning. And maybe it will work for migraines.

Not relishing the thought of increasing. I find the start up/increases very hard 

[CLKD]

Which is why I suggest splitting the dose.  5mg really isn't much at all.  MayB keep to your usual time with 5mg and add 5mg every 3rd dose and then alternate days after a couple of weeks.  Allowing the brain to uptake slowly.  Which particular symptom bothers you the most?  4 me when I began it was intense nausea ........ 5 different drugs until we found 1 that actually worked! 

[CrispyChick]

I will increase really slowly clkd.

But even 1/4 of a 5mg tablet will bring me symptoms. I can probably keep the nausea down by taking tiny doses - but it triggers severe anxiety and depression in these first few weeks. Hate it.

But already on this mini pill my mood is slumping. So needs must. 

[Penguin]

I will increase really slowly clkd.

But even 1/4 of a 5mg tablet will bring me symptoms. I can probably keep the nausea down by taking tiny doses - but it triggers severe anxiety and depression in these first few weeks. Hate it.

But already on this mini pill my mood is slumping. So needs must. 

I have recently increased my citalopram for first time successfully, dounled dose from 10mg to 20mg. While I've had physical side effects (sweating, dry mouth mainly), I didn't get the mental side effects I'd anticipated like increased anxiety. Was quite a relief really as the mental side effects were the ones I was dreading the most. Mind you, I hate nausea so would have found that really hard. Crystallised ginger helped me with that first time around.

[CLKD]

CrispyChick - Do check with a pharmacist but in my long experience, cutting 5mg won't make any difference as the body won't get much of the active ingredient.  Most pills/capsules are fillers/packaging  .  Each dose is measured specifically.

Nausea is dreadful.  This thread brought my mind back to when I was on The Pill long-term, how I would look at that tiny tablet for hours B4 daring to swallow 1.  Nothing bad happened but each night was the same    . 

[CrispyChick]

I've done it before clkd. The aim is to increase to 10mg, but I do it slowly, a 1/4 of 5mg at a time. Trust me, it makes a difference to me.

If I add in 5mg in one shot. I won't make it! 

[CrispyChick]

That aside I'm still debating.

I'd much rather stay on escitalopram and increase it. I know if works on my mood.

But I'm getting lots of random symptoms that the amitriptyline would be better for. As recommended to me at least 5 times over my years for my various 'flairs'. Most recent is gut fairs - where all tests are negative. On the pill I'm now getting peripheral neuropathy. Again, amitriptyline can quieten this all down.

But can escitalopram???!!!

[CLKD]

Peripheral neuropathy requires diagnosis by a consultant and on-going support.  MayB ask for your GP 4 a suitable appt. which may mean that you get proper medication overall? 

Both the medications you suggest are for different conditions.  Often medications designed for 1 condition are, by mistake found, to ease symptoms caused by another.  Which is why amitriptyline was prescribed when in the mid-1990s I had trigenimal neuralgia; but it did nowt to ease the sudden, unexpected, stabbing pains in my L face.  Caused by the nerve becoming trapped by the pulsating blood vessel that runs across it, who decided that design might be a good one  .  I would hit the ground when the pain hit, people probably thought that I was drunk when I was walking the dog across the fields  .  The condition went after about 9 months but can be triggered when I have dental work.

[CrispyChick]

Well, that sounds awful. 

I dont mean I actually have peripheral neuropathy. I'm having random things as I'm starting up on the mini pill. It'll calm. In time.

My body reacts. To everything.

I once saw a specialist who described all the randoms as 'your body shining a light on a symptom'. Then it'll calm. Then along comes another. I get episodes - IBS, gastric flairs (no known cause, gastric meds don't work), dizziness, this tingling...other randoms to which amitriptyline is always recommended. Hence me now seriously considering it.