Amitriptyline caused my neuropathy
 

I have taken Amtriptyline for 20 years started on it for insomnia. I then developed burning skin pain, and no one ever thought it was the Amit. I wouldn't have either, except, I was put on Remeron an other anti-depressant , and first developed numb feet, and the the itching skin and then after a few weeks the burning skin pain. I am no off the Remeron, and the pain is back to the normal level. Now what to do about going off Amit is very scary. It helps the pain, but yet is causing the pain. does that make any sense. Wouldlove to hear from anyone else .

I am not a fan of amitriptyline. I was on it a long time ago, and am no better off for being on it. All my problems started after I took that drug. That doesn't mean it caused it....but, I haven't ruled it out either.

I used to take this drug in the mid-1980's. I think it was prescribed a lot back then... may still be. I was on a hefty dosage of 100 mg.

I agree with Cyclelops statement:

"That doesn't mean it caused it....but, I haven't ruled it out either."

Mere

i take amitriptylene at night. it has helped with the stabbing pains and keeps me asleep once i get asleep. the only side effect i have noticed is its hard to stay awake for a while once i get up.

This drug has some mixed history. It appears on lists from neuropathy sites as a "cause" of axonal neuropathy.

Here is an example:
http://www.wrongdiagnosis.com/t/toxi...line/intro.htm

However, I couldn't quickly find the studies that support this yet.
I'll look later in more detail.

Recently there have been studies showing amitriptyline actually enhances peripheral nerve regeneration.
Here is the link to that article:
http://neurotalk.psychcentral.com/sh...=amitriptyline

This might be dose dependent or a factor in those who do not metabolize this drug well. I do think this is very confusing.

Edit to add:
It appears that amitriptyline is being used as an injected anesthetic in some situations. So I found some neurotoxic in vitro (no in living subjects) on this subject. This would place the drug in high concentration near neurons:

from http://www.ncbi.nlm.nih.gov/pubmed/17437653

and this one :
and this one:
http://www.ncbi.nlm.nih.gov/pubmed/16717317

All involving injection as an anesthetic.

I am still looking for oral studies...

There are studies about SSRIs causing neuronal cell death...these have been around for few years. This paper includes amitriptyline with prozac (which has been most studied so far):
http://www.ncbi.nlm.nih.gov/pubmed/11996893

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 :)

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

This may be a dumb question but how would one know if a med was the cause? Or one never truly does. Also are some bodies just more sensitive cause why would one person not have this reaction and another would?Your apt with your neuro I always suggest this cause I have gotten into apts months in advance is to call every day for a cancelation. Hope you feel better and get some answers

Hi Danielle,

It isn't a numb question at all . The only way of knowing if a med is causing the neuropathy is to stop the med. In my case with Remeron, stoppin git I improoved within a few days. I must start calling to get in earlier, thanks for the good idea.


Janet

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

The following article suggests that "tricyclic antidepressants might deplete the body of coenzyme Q 10 (CoQ 10)." Perhaps a mechanism by which amitriptyline could cause neuropathy. BTW I have been taking it for a few years, mainly 25 mg/day, and it helps with my pain level. If it were slowly making it worse, I might never know. You can find alternatives, there are many drugs used to relieve painful neuropathy. It seems one of the premier ones is gabapentin (Neurontin).

I can't post links yet, so go to **
and search for "Tricyclic Antidepressants"

"Coenzyme Q10(CoQ10)

Preliminary evidence suggests that tricyclic antidepressants might deplete the body of coenzyme Q 10 (CoQ 10), a substance that appears to be important for normal heart function.1,2 Based on this observation, it has been suggested (but not proved) that CoQ 10 supplementation might help prevent the heart-related side effects that can occur with the use of tricyclic antidepressants."

Good luck
BasicPoke

Boy, this has me really PO'd.

I was on amitriptyline 150mg WITH zoloft back in the 90's when that was what they used for pain.....or 'fibro' and its concomittant 'depression'. And those dipsh#ts never took a blood level of the amitrip. I would ask, and they would say....'you don't need it'. This was the same HMO linked clinic that I was with for 11 years and left, only to be diagnosed with neuropathy and SjS. :mad:

I could never prove a case and at this stage, it would not be worth the stress, since litigation is horrible on one's health.

It makes me wonder about the whole thing on drugs...consume at your own risk, I guess.

We must take an active role in our health care. Sometimes we expect too much of doctors. We have to trust them to some degree, but they don't know everything. We can't expect them to know every interaction between all drugs & supplements. And then each person is different too. I sure hope Drs begin to learn more about supplements in medical school.

And be careful, just because you were taking a particular drug at the time you developed neuropathy, doesn't mean the drug caused the neuropathy. Because two things happen at about the same time does not mean that one caused the other.
Electron

Basically doctors are poorly trained on drugs. They have a short course on them once in college.

They are predominately trained in observation, anatomy and labeling of illness. They then consult therapeutic manuals, many of them way out of date (because they are expensive to buy), on how to treat what they have just diagnosed.
For example methylcobalamin and oral supplements of B12 are typically not in their manuals, and it never occurs to them to look elsewhere for newer information.

I read an interesting critique of medical school in US recently that likened medical training to a cult indoctrination. I can't find that exact article but this one is similar:
http://www.naturalnews.com/021922_ju..._medicine.html

If you Google Is medicine a cult? You will find more.

on the hand if your PN developed while you were taking a drug it would be worthwhile to research it to see if others have been affected the same way, or discontinue it and see what happens after that. I personally dont believe in a great deal of serendipity or concidence. It happens but not that often.

I could never prove I got neuropathy from amitrip. because I have far too many mitigating circumstances. That said, I have always been suspicious of that drug. It never agreed with me. I don't know why that doctor would have denied me a blood level on it....this happened repeatedly.

Likely my case is a combination of factors....

I still think they push amitrip. on people like it is m & m's

Please Use Caution with ALL Meds
 

Hi to All!

I know some of the current participants have never interacted with me at all.
Some of the older members have. I am here off and on throughout many years of neuropathy. Over 25 years now of neuropathy sx.

A brief history: My neuropathies have been diagnosed as sensorimotor in nature in the past, with some autonomic involvement. I now am quite sure of much more autonomic involvement. I have not has NCV/EMGs/SSEPs for about 2 years now. (I have been totally medically disabled for the entirety of the 25+ years.)

I get worsened neuropathy with many drugs used for neuropathy.
In fact, I am reasonably sure this entire situation was made worse by allowing the use of some drugs. Many drugs make the neuropathy so incredibly bad that the docs then start to panic.

I have shown them time and time again, that if/when I agree to amitriptyline, to the SSRIs, SNNRIs, the anticonvulsant drugs, etc. -- I get worse within two weeks. The neuropathy flares up even worse... amping up to being on fire! This quickly ascends up my lower limbs, and now my hands and arms, too.

My last neurologist was openly expressing shock when I had showed him how quickly an anticonvulsant drugs will set me ablaze. (I had demonstrated 2 of them for him. I have tried all of them.) The testing he did had also confirmed this to him. (He is in private practice and is also certified in doing the EMG/NCV studies himself, so he did take the time to prove worsened testing behind what I was reporting.)

Cycleops, I, too, have been repeatedly dosed in high does of so many drugs that have been neurotoxic to me, as a part of my "treatment," only to keep getting worse. For all of these years, if I'd report increased pain, they would prescribe an increased dose; yet, I would never get any reprieve until the drugs were stopped and I was given time to heal the sfn.

When we have stopped the meds, I have had periods of sfn healing, proven with skin punch biopsies, etc.

Then enter another med, for another reason, an antibiotic or something ... and off we go! The nerves start burinng again and everyone wants to start prescribing all of those drugs yet again. Once I was onto this pattern, I found a neurologist willing to listen and also willing to set up a trial whereby he would evaluate the changes. He is convinced I cannot use any of the (many) meds often used for neuropathic pain.

You will see some of these drugs are well-known for med-induced lupus. They set off some kind of an autoimmune reaction for some. I am one of the "some," unfortunately.

Please be very careful and find ways to try to track this with meds. I hope everyone has a doctor as willing to listen as my last one has been. Prior to finding him, I was simply considered non-compliant because I would not take those neurotoxic meds anymore. (This was even though the prior neurologist had seen me willing to try high doses of anything he would prescribe for years.... until I had started to see the patterns by discontinuing the meds and getting sfn healing, etc.)

Please be careful. We may not all react the same way to all meds. However, please be very, very careful.

(I have lots of damage now. I believe the cause(s) of the damage have been mutifactorial and will write more about this another time. However, I am also sure meds have made some aspects much, much worse. I have never had a neuropathic exacerbation in the past without prescribed drugs in my system. Since the drug was not recognized as neurotoxic, they thought there was a separate neuropathy and would introduce yet another neurotoxic drug! Polypharamacy was giving me neuropathy much more than treating neuropathy. It eventually becomes such a mess that it can be very difficult to sort out.)

Take Care!
~DejaVu