Amitriptyline – Off and On Again

Amitriptyline is a tricyclic antidepressant that, when taken at a lower dose, can help with the sleep disorder and the pain associated with Fibromyalgia. I had been on it for nearly 10 years, since before I was diagnosed. medicine-thermometer-tablets-pills

Struggling with restless nights (losing 50-70 minutes a night to awake/restless times), I asked my doctor what else may help and he suggested I increase my dosage. But I didn’t want to do this.

I also wanted to be sure it worked, I had a fear of being stuck on it forever, without really knowing it worked. It was also a scary proposition to go off it and not sleep.

I sucked up the fear and started my experiment in November 2015 and tapered off by 5mg at a time. In the reductions from 50mg down to 30mg my sleep actually improved. But the fatigue increased, I became very fatigued and struggled to stay awake during the day.

By the time I got to 10mg at the beginning of January 2016, I was sore, sensitive and (more) exhausted. My sleep was light and it was difficult to get to sleep and back to sleep when woken.

On my first night completely off it, it took a little while to get to sleep, I slept deeply (I think, I didn’t take my Fitbit on holiday) from 12-6.30am and then my son got up. I was exhausted and sore.

As I continued it took longer and longer to get to sleep, except for the few nights when I was so miserable and exhausted I fell asleep fast and slept like the dead.

I tried 5-HTP and SleepDrops and lavender massage oil. I tried keeping the same bedtime routine, hot baths and no caffeine after lunch. I tried meditation, yoga and any pillow set up possible.

I was experiencing more wide spread pain, near constant headaches and worsening fatigue. I wasn’t coping.

I went back onto 25mg of amitriptyline and had a big sleep on the first night. And a normal sleep, albeit with a six hour block on the second night.

Within a week I was back to getting to sleep well, sleeping restlessly (mostly due to pain), but getting (a broken) eight hours. This doesn’t seem like a win, but it’s the same situation as before with half the dose of amitriptyline, which is a win. The headaches have mostly receded and the generalised, all over pain has quietened. The fatigue is more manageable.

I can only conclude that amitriptyline is working for me at the moment and I am happy enough with that. It has a valid place as the base of my wellness plan.

High-Pain Week

My bed is more like Grand Central Station than a rest stop. I go to the bathroom 1-3 times, depending on whether or not I went crazy and drank something other than water after 2pm. My son wakes anywhere between 0-4 times, teething is going on and on! And my husband either gets up or comes home about 5, depending on his shifts.

My Fitbit sleep graph shows many nights that seem like there are more restless and awake periods than asleep periods.

Sleep is the foundation for my day. Broken or less than eight hours sleep makes my day miserable. Eight hours plus helps me to cope.

For whatever reason, perhaps the come down after a very hard three months with a new job that didn’t work out and virus after virus, I’ve had a particularly painful week.

On Wednesday I found my muscle relaxants were prescribed in 2010! My antiinflammatory medicine expired in 2014.

While I couldn’t take these, it was a sign of how well I’ve been doing that they lasted well beyond expiry!

Knowing I had Physio on Thursday, I didn’t make a DR’s appointment. By Friday I wasn’t feeling any better, in fact my back was spasming rather painfully. A call with my DR’s nurse confirmed I shouldn’t take the expired medicine but suggested I try panadol, for back spasms. I was shocked.

Nevertheless I thought I must show some improvement 24 hours after Physio.

On Saturday my back, shoulders, neck and head were so tight I was experiencing stabbing type pains in my skull and spasms in my back. I felt nauseas and miserable. A trip to the chemist proved they had nothing for me. They offered an NSAID which I’d been prescribed previously but I’m pretty sure doesn’t work for me.

Walking back to the car with my husband I expressed my disappointment at not managing  as well as I thought I was. And immediately realised that managing with pain relief is still managing. Just with more side effects.

So I’m hoping my Dr has an appointment early Monday in order to get some help.