In that case, why not skip the first two and just go for the gold?

Doc

[QUOTE=Dr. Smith;1018727]In that case, why not skip the first two and just go for the gold?


Hi Doc
Does the Amitriptyline your taking help with neuropathic pain? Or do you take it only for sleeping and depression?
I take 300 mgs of Lyrica for SFN , it doesn't do much (as far as I know), I still have bad pain and unpleasant symptoms. My Neurologist recently added 10 mgs. of Amitriptyline. I started very slowly taking 5 mgs (split pill), so far it helps me to sleep. I'm hoping I will get some pain relief with only 10 mgs like you. I do get some "angina-like" pains in my chest and arm, but my cardiologist said it was ok for me to take it. (I have micro-vascular angina, its the tiny vessels that constrict and cause me pain, my large arteries are clear). I'm a bit concerned (alto the Doc said it was OK) about increasing it (Ami) , due to "heart -related" problems I've often read about. Do you get skipped beats on Ami? I hope this note finds you well. Thanks
Marie

Hi Marie,

I do not take amitriptyline for depression; this dose (10 mg) is allegedly too low for that anyway (I think any change in my mood is due simply to getting better/more sleep).

How to Take Elavil (Amitriptyline) for Chronic Back Pain

I couldn't say for sure that it's helping any neuropathic pain because 1.) I'm asleep while it's working, and 2.) my burning pain from PN is alleviated entirely by taking RLA (100 mg) daily.

As I mentioned in post #8 ADDENDUM, I tolerate this dose of amitriptyline very well—with no side effects whatsoever.

If you haven't discussed it with your doctors already, you might ask/suggest them about switching from Lyrica (pregabalin) & Elavil (amitriptyline) to gabapentin & nortriptyline.

Study finds that the combination gabapentin plus nortriptyline reduces neuropathic pain more than either drug alone

I believe (not certain) that this may be the referenced study:

Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial.
Nortriptyline is a 2nd generation tricyclic antidepressant, while amitriptyline is 1st generation. As such, nortriptyline is generally better tolerated with a lower side effect profile.

I looked briefly for any similar study using Lyrica and amitriptyline, but did not find any (doesn't mean there isn't one—I just didn't find any).

Hope this helps, & Best Wishes,

Doc