Use of 200mg of amitriptyline alone as a drug in this country is practically non-existant, due to risks to fatal heart side effects.

Combined with high dose Methadone? Well Methadone itself is risky in certain patients...so when used with high dose amitriptyline?

You can read more here:
http://www.drugs.com/drug-interactio...ne_d00146.html

I would not recommend 200mg of Elavil for anything.
There are other safer therapeutic choices today that do not have the cardiac warnings.

Thank you for your response!!

I have wondered for some time now if there would be long term adverse side effects from the high dose of Elavil i am on. Coming off it is almost frightening to think of, due to the onslaught of migraines and sleepless nights that will follow. Regardless i will definitely be bringing this up to my Doctors.

It's all most comical that over the years, when a situation came up where i had to see a ER doc or Walk-in Doc that they would argue with me why i was on such a high dose. It was always the same argument, you must be on it as a anti-depressant. This dose would never be prescribed for sleep.

Any suggestions for A replacement for the Elavil? Please take into consideration that my tolerance to just about any drug is through the roof. This is not something i'm trying to boast about, but it is a fact. I have no prescription coverage so "new" & expensive meds are not a option.

Thank you again, This is a great forum! I will post again after i see my doctor(s)

ckfisher

Just so you understand clearly.... Interaction with Elavil is seriously aggravated by Methadone.
This website explains it clearly...
http://www.azcert.org/medical-pros/d...drug-lists.cfm

If you should become dehydrated, low in potassium and magnesium, you could slip into a long QT event, even if you are not genetically primed for it.

You should have a screening EKG before starting the Methadone, and while on it combined with Elavil.

Unfortunately people on certain insurances or state aid, are often given the least expensive drug to treat illnesses. As time passes, new data are often ignored, and cost is the main criteria for many.

I have seen many people with migraine get by with much lower doses of Elavil. 200mg is way out there!
Other drugs used to help with migraine prophylaxis are
verapamil
or
beta blockers (like nadalol)

You'll just have to find a doctor willing to evaluate you safely.

Good luck, there!