Experience with amitriptyline / tricyclic antidepressants?

    • Anonymous
      February 13, 2013 at 2:15 pm

      Hello all,


      Do you have experience with amitriptyline / tricyclic antidepressants? My anaesthesiologist prescribed it for me, but I am worried about the side-effects.

      Some background information: I receive IVIG-infusions every three weeks and take 3600 mg gabapentine / neurotine a day. Sometimes I have bad periods in which I cannot tolerate the pain any more. I call them my ‘please cut my hand off days’, you propably understand what I mean.

      I hope to read from you,

      Kind regards,




    • February 13, 2013 at 7:25 pm

      Would more frequent infusions be an option, what is your dosage, perhaps you need more ivig as well as the increased frequency (2g/kg or 1g/kg) Additionally, regarding the amitriptyline, why did the doc pick that group particularly?  I do not know if Cymbalta is in that same category or not, but it too is an antidepressant as well it is used for pain.  Lyrica is specifically used for nerve pain and is not an antidepressant.  Your description of your pain sounds like your inflamatory process is active, maybe you can ask for more ivig?

    • Anonymous
      February 14, 2013 at 9:31 am

      Hello Dawns mom,

      I recently changed from 1 x 4 weeks to 1 x 3 weeks, receiving 0.5 g/kg. We are still looking for the right dosage and frequence.

      A severe complication is that not only the myeline, but the nerval nucleï as well are damaged.

      The doc did not prescribe lyrica because it is almost the same as gabapentine, so she expects it will not help much better.

    • Anonymous
      February 15, 2013 at 5:29 pm


      By all means, have your physician put you on a trial of Lyrica. I was taking 3600 mg of Gabapentin a day, and it did absolutely nothing for my pain. I was place on 450 mg of Lyrica daily, and it worked wonders. While it is true that Gabapentin and Lyrica are both anti-convulsants, they most definitely are not the same. I think insurance companies don’t like to see Lyrica prescribed (as opposed to Gabapentin) because Lyrica is much more expensive, as their is no generic version available at this time. With regard to the amitriptyline, it is a tricyclic anti-depressant which is used for pain. I would try the Lyrica first, and add the amitriptyline if necessary. Also, ask your physician to consider increasing the dosage and/or frequency of your IVIg. It’s all about finding the right combination of factors that help us fight this disease. Best wishes.

    • February 17, 2013 at 4:56 am

      Hello Willem,

      I used nortriptyline, similar to amitriptyline, for my neuropathic pain early on. A 50 mg dose definitely helped the pain. I experienced the usual side effects of sleepiness and feeling a bit slow mentally, but I was adjusting to them. The side effect that made me switch to gabapentin was the loss of the ability to taste “sweet”. I could still taste bitter, salt, sour, and umani, just not sweet. Note that this side effect is rare; my neurologist had never encountered it before.

      If you use the two together, make sure that you have a plane to deal with more sleepiness and minor loss of mental acuity.

      Godspeed in your treatment plan.

    • Anonymous
      February 18, 2013 at 4:40 pm

      Thank you for your responses.

      @Goodney: how did you change from gaba to lyrica? ‘Cold turkey’ or gradually?

      Right at this moment I am feeling rather well, just a little bit of pain after using my feet / fingers too much.

    • Anonymous
      February 19, 2013 at 6:20 pm


      I just switched Cold Turkey. I was desperate at the time due to the pain. I had no noticeable side effects from going off the Gabapentin since Lyrica is also an anti-convulsant. The Lyrica did cause some initial side effects, but it also provided almost immediate pain relief, so I really didn’t care. The side effects wore off after about a month, and have not returned. I am very happy.