Now what do I do. Is there a doctor some place that knows about this link. I am decreasing the Remeron, and the depression is increasing, but the burning pain is less. This is such a catch 22 situation.


Janet

Typically amitriptyline is used in small doses for PN. It may be long term high dose for depression is more problematic. That is just my take on it.

I would not expect a regular doctor to know the details about this drug. Perhaps some neurologist or anesthesiologist might if they work in a teaching hospital.

Most doctors don't know that amitriptyline is on neuropathy lists as "toxic".

When I try to decrease it even by 10 mg the burning gets worse. I take 85 mg at night. I always new when I went higher my skin would burn more, and when I took 75mg my skin would burn more. 85 mg seemed to be the right dose for me.


Janet

You know Brian here, used it in I think 100mg and he didn't have any problem.

I don't know how often he visits now, that he is so much improved.

I see you are a new member with a low post count, so your PM privileges are not active yet. I'll PM him to come to this thread.

How's that?

Thank you , you are so kind

I tried to get an appt with my neurologist who I haven't seen in 8 years, and I need a new referral and he is booking into October. Is 85 mg considered a small dose, maybe I wouldn't have to go off of it ?


Sincerely,
Janet

Well small would be different for different people.

Typical PN doses start at 10 or 25mg. Some go to 50 etc.

The antidepressant doses are much higher, all over 150mg daily typically. I used to see 450mg sometimes in the old days even.
Getting really high with this drug is problematic because it prolongs QT in the heart. ODs are typically fatal therefore with amitriptyline, (whereas SSRIs are very much less so). Mixing high dose with other drugs that also affect the heart leads to possible problems too.

At your dose QT issues are not likely unless you have a genetic marker for it.
Here is my post on QT for you to read. The link to the University of Arizona that is on it, is very good and explains it well:
http://neurotalk.psychcentral.com/post15298-4.html

I was on 150 mg Endep at night, plus 25 mg in the morning for a few years, it was the only med I found that helped the burning the most, I stopped using it when I got better, so it definatly did not cause any nerve damage to me only helped a great deal.

good luck
Brian

Thanks I am glad you are feeling better though sorry for what this has caused. I have just started this med again. I am going to talk to my doctor about this. I believe that these things can happen from meds or what ever I just get confused on why one body it happens to and another it does not. I guess one person is more prone then another. Before this condition I was on meds for depression and anxiety and I never looked up side effects. The doc rx it and I took it. Now with each new med I research and don't feel as trusting. There was this comic on tv an was making fun of the prescription ads and how a person goes into the doctor asking for a certain med and it was so funny cause it was so true. I have tried many different meds by asking my doc after I read on here. The doctor is like sure we can try it. Anyhow sorry to get off track. Hope you get continued relief

Hi


My doctor said going off the Amitriptyline would increase the pain for sure, but she also said if the nerves improoved it would take months. I was also told to take B6 to help regenerate the nerves possible destroyed by Amitriptyline. Is there anything else I should be taking in supplements? I take a B /C complex , omega 3 fish oil .


Janet

The drug reference I use for drugs that have studies behind them showing interference with nutrients only lists.

CoQ-10 and
Riboflavin B2.

Riboflavin is the cofactor for activating B6 in the body. Without it,
B6 doesn't work, unless you get the active form called P5P.

This is a chart made from the reference I use:
http://www.chiro.org/nutrition/ABSTR...rapeutic.shtml