300 mg is the depression dose for amitriptyline. It used to be more common in the old days before SSRIs. It carries along with it at that dose QT depressing potential however.

So we don't see those high doses for it anymore.

In the old days, before the link to chronic pain, we rarely dispensed the 10 or 25mg! Now it is the reverse!

Ive been on amitriptyline now for 3 weeks (started at 10mg now at 20mg) I havent had any side effect, it doesnt even make me sleepy. It helps me a lot with pain and calms my anxiety and emotional spikes a lot even at this low dose. I'm surprised, even though its not an SSRI but still an antidepressant, in the past any SSRI id taken really didnt go over well.

Elavil Beware!
 

My wife and I are both extremely sensative to this drug. I took one standard dose, which was supposed to be one of many, etc, etc.

I slept for three days and then "woke up". I could not talk. I could form the words in my head, but could not make my mouth work. It was like being in a dream filled with jello. I cried and cried.

This ONE PILL took a month to wear off. My wife's experience was similar.

25 mg. No i dont take any other meds for PN. I do take vitamins however.

Drug Interactions
 

Good Morning,
Using the drug interaction checker at Drugs.com it showed 227 major drug interactions for amitriptyline. If your using drug cocktails you might want to use this tool, it includes OTC, foods and diseases.

TCA's prolong QT. So it would be listed as interacting with all drugs in the various lists that do that too.

Here is more on QT prolongation:
http://www.azcert.org/
This has evolved into a very nice website complete with
revolving graphic illustrating what the QT interval is.

In the small doses like 10-25mg a day, this is much less an issue than past 50mg or so. 50mg is borderline.

TCAs like Elavil were often a method of suicide in depressed patients, and often was successful. (poor useful interventions for it).

With the advent of SSRIs ...which do not have this deadly potential for overdose...doctors rapidly switched to them, and left TCAs in the dust for high dose use.

Ok, I just re-read this thread, and the article cited about the regenerative potential (which was from 6/09).

I tried the experiment of stopping the R-Lipoic, and the burning began to return, so I got back on it pronto, and so-far, so-good. :Good-Luck: (only emote w/crossed finners....)

I'm getting ready to have a confab with my doc and hit him up for a scrip for amitriptyline. Now since the R-Lipoic is addressing the pain/burning, the main (only) reason I want to add the amitriptyline is for the regenerative potential, and hopefully beat this thing, or at least feel some improvement. So my questions are:

Does anyone have any other links/citations of articles about this topic since 6/09?

Does anyone think it's actually working for them in this manner (i.e. are you getting better/feeling back)?

I was prescribed amitriptyline once before, and stopped it due to side effects, but that was years ago, and I don't recall the dosage. What dosage would I need for just the regen effects (and hopefully avoid the nasty side effects?

Doc

It is possible the lipoic acid is enabling mitochrondrial functions.

This supplement is combined with acetyl carnitine for that purpose in the product Juvenon.

So if that is true for you...and this is only a guess, you may need it daily from this day forward, as your own system is flawed for some reason. (aging is often pointed to for mito decay). Lipoic acid is a natural substance our bodies make, and may decline with age.
http://www.ncbi.nlm.nih.gov/pubmed/15919137

I would continue with what works for you. After a year on the lipoic, you might try stopping it to see what happens.

Do you know for sure you have nerve damage... and not just aging mitochondria? These factors are relatively new, and there would have to be more research in the future to clarify things.

I wouldn't add amitriptyline unless you really need it. Since the lipoic works, you seem okay with that so far.

Maybe I'm not reading it right, but it looks like that link is saying 100 mg/kg bw/day for 30 days (plus 3 x as much carnitine). That's like 11,400 mg/day - a lot of Lipoic acid.

Yep, they tell me from the zap test I gots da nerve damage. Hence I'd like any chance I can to help regrow them. The lipoic is working for now, but since they haven't found a cause (and don't seem to be interested in finding one) if this keeps progressing I can see a time when the lipoic won't work any longer. If I can't reverse it, I'd like to stop it, etc.

Doc

When they do the rats, they always have large doses.
Sometimes the doses on PubMed studies are "strange".

You could contact the doctor... his email is on that abstract.

I think since you have positive results, it doesn't really matter.
Your doses are working for you. That you are feeling better means you needed the lipoic.

The nerve growth factors sound very experimental to me. It is not clear if those were measured on severed nerves in a lab?
Many growth factors are done that way.

The value of the "ami" study is that it was the only TCA with those results. That narrows the field for doctors to choose it.

For you, I'd concentrate on substances that improve mito functions for a while.

Lipoic acid also provides other benefits:
http://www.umm.edu/altmed/articles/a...oic-000285.htm