Elavil (Amitriptyline) for PCS?
 

Hi again!

I wanted to check in with this forum and ask whether anybody has been prescribed Elavil or another type of Amitriptyline for their PCS symptoms?

I’m curious what dosage you are/were on, whether it has helped and whether you developed any symptoms?

Four months after my car accident, I am still dealing with daily headaches/migraines, neck pain, nausea, dizziness and the occasional blurry vision and sensitivity to light (although this has gotten considerably better).

My doctor has prescribed Elavil 10mg for one month, but I’m concerned about the fact that it is an anti-depressant, and not sure whether it will target these symptoms/PCS directly, or if it’s just something that my doctor is giving me because she isn’t taking my symptoms seriously (thinking that I’m being too “worried” about this whole thing and trying to shoo me out of her office with an anti-depressant?)

I would really appreciate any input. Thanks so much…

Welcome to NeuroTalk:

10mg is not an antidepressant dose of this drug. Amitriptyline and Nortriptyline have had recent studies showing they improve nerve damage.

Low dose use of these two drugs does not often impact depression. They are used for all sorts of chronic pain, headache pain and neuropathies. Antidepressant doses start at 50mg a day or more, and often go up to 300mg a day. These drugs are rarely used as antidepressants anymore.

Some actions on serotonin do affect signaling in the brain in the pain loops and low dose antidepessants may help in this area too. Don't expect much subjective antidepressant feelings at 10mg a day however. These drugs are not fast onset either, so expect at least 3 weeks to pass before you notice improvements. You may have side effects first before improvements occur.

Thank you for your response, mrsD.

Is the 10mg dosage something that I would have to continue taking for a long time as long as I still have PCS, or is it something that will help cure up my symptoms so that I can stop taking it after the one month? I am concerned about becoming “dependent” on this drug to feel good.

Also, are there any side-effects to stopping the drug later? (Will my symptoms all of a sudden get worse if my body doesn’t get it when it is used to it?) Thank you.

I’d love to hear from anyone who has had experience with it.

At 10mg there would probably not be a taper needed. Tapers only are needed for longer term use at higher doses.

It is hard to say how you will react to it. Everyone is different.

But I will say, that most diabetics take it, for their peripheral neuropathy issues. We are talking millions of elderly right this very minute!

I have been on 10 mg Elavil for about 2 years. Unfortunately didn't help with my main symptoms (dizziness, headches, fatigue) for me and some things it helped is to make my stomach calm and helped with my smell disorder. As mrsD mentioned nowadays it has been used for number of reasons and for some it helped immensely with PCS.

Each person is different when it comes to how you react to medicine and some has no side effects and for some significant. It made me more dizzy in the beginning then side effects went away. Same goes for quitting. I tried to quit and it affected my sleep, got terrible nausea than normal. I guess I continue for now. according to doctors 10 mg is really a low dosage.

This didn't work for me- please research first
 

I was prescribed this for my headaches at the lower dose as well.


My doctor told me that because it was a small dose it wouldn't be an issue- similar to the opinions posted above.


Everyone is different, but this was awful for me!


The side effects were horrible. Scary!


I became suicidal and have no history of depression, or any other mental issues. I was a perfectly healthy happy 23 year old athlete before my PCS.


Not to mention all the other side effects. I felt like I was ingesting toxins.


It is possible that many people benefit from this but please be an informed consumer!


There is a site online:
http://www.askapatient.com/viewratin...03&name=elavil

People discuss their experience with prescription drugs. Make sure that you look at the right dosage.

I can understand what postconcussion says since that is what happened for me with many other drugs doctors threw at me. (Cymbalta, Neurontin etc.,) With cymbalta I couldn't sleep for 3 nights and about to kill myself. But for some it is a wonder drug. Go figure.

No normal people wants to take meds unless it saves or helps the quality of life. I still wish I quit Elavil if only I don't get these withdrawal effects.

If you don't try these meds then going to doctors is no use since every Neurologist sure wants you to try some meds. I have not seen any neurologist who said don't take any meds.

If you are concerned try with 5 mg instead of 10 and see how you react.

I couldn't take it -- after the first dose I had awful shakes like I had 10 cups of starbucks coffee...and never slept that night!

I had a similar response to Amitriptyline in that I was shaking a lot, and I had an anxiety attack from it. I only took one dosage and I didn't care to keep taking it after that.

Every brain is different. If your doctor prescribes it with a honest comment that it may or may not work for you, it may be worth a try. If you read the fine print and side effects, it says how many suffered each side effect. It is a crap shoot to find the drug that benefits your brain.

If your doctor has actually listened to you and will respond to your comments and concerns, give it a go. If he is disinterested in you, find a different doctor. The disinterested doctors throw meds at you to get you to go away. The interested doctors will want to understand your symptoms before they prescribe meds.

Thank you for all your responses. I definitely feel that my doctor isn’t taking me seriously and is just throwing medications at me to make me “go away”, which is why I wanted to do the research on this drug before taking it. I am finding that a lot of people report fatigue, shaky feeling, fast heart beats and weight gain with this one, so I’ve decided to wait at least until I get my CT scan done (June) before making a decision. The withdrawal symptoms seem a lot like the symptoms I’m trying to treat in the first place, so I don’t know.

I can tell you that I am dealing with the same thing. I'm seeing a Neurologist who is doing the same thing. I've decided to change Neurologists because I got tired of feeling like he was just throwing medications at me, and he didn't even bother to try and do anything about my neck issues. Even when I was in with him he'd quickly explain what he was doing, why he thought it *MIGHT* work and then would send me out the door and wouldn't really discuss anything with me. So, I feel your pain (literally! :o)... I've been doing the same thing in just going with what I feel right about taking... not what they want me to take.

Elavil at 10 mgs is a very low dose. The withdrawal problems should be minimal.

Waiting for your CT has no value as the CT will not have any value unless you have symptoms beyond those of PCS such as a stroke or other TIA (Transient Ischemic Attack). CT's are just for the comfort and security of doctors and patients. The damage from a concussion that will image with CT or MRI is absorbed by the body starting three days after the concussion. A week later, any small bleeds will be gone.

There is nothing that will show from a concussion except when the patient is in constant debilitating head aches or losing vision or motor control or such extreme situations. The plain garden variety concussion just takes time and then some more time and maybe even more time of rest and low stress.

I would like to suggest that if the migraines are bad that you give this a chance. Its a drug that many doctor's prescribe for this alone.

Also for Neck pain, and even headaches see if you can get a script for
Physical Therapy this will help a lot. If you get a good therapist that
knows how to treat these kind of injuries.

I've just finished a treatment of PT for my neck and shoulder pain from
a car accident that happened in March. I also suffer from migraines.

But they are treated by topamax and other things.

Donna:grouphug:

Thanks to everyone who chimed in.

Mark, I know that the results of the CT scan most likely will not change anything, including how my PCS is treated, but that “comfort and security” would be nice! One of the other reasons I was skeptical about the Elavil is because my doctor has flat-out said that it’s impossible that I have PCS because the neurologist I saw wrote down that concussion symptoms CANNOT develop six weeks following an accident, and that they CANNOT last this long (four months now). As she gave me the prescription for the Elavil, she said “You’re a very nervous person so I’m going to give you something for depression”, despite me not being depressed (but, yes, anxious about my symptoms as anyone would be, I think). I am a pretty small girl as far as body weight goes and usually most medications I take have some sort of symptoms and I couldn’t believe that my doctor would neither consider these nor discuss these with me (or give me any info about how to follow up about the Elavil, when to see her next after the 30 days are up). Just sort of a “take it and go” attitude.

My physiotherapist, an emergency doctor at a hospital and the eye doctor mine had me go see all say it’s PCS, but the neurologist disagreed (saying they are just migraines) so my family doctor looks to him as the overall expert opinion and does not want to send me to another one.

Question about the Elavil: Can the 10mg pills be broken in half, so that if I do decide to take it, I can take a 5mg dose at first?

And Dmom, I absolutely agree about the physio: I don’t know how I would get by without my x2 week visits! The headaches and neck pain usually subside for at least 8-12 hours after I leave.

I bought a pill cutter from Amazon and it did a good job breaking the 10 mg. Close to precise and also based on how the they manufactured the pill. Some are easy to break and some are not.

I still think they should have given me Xanax in the beginning instead of Elavil. My doc. assumed (?) I have sleep issues and headaches. I didn't have any sleep issues and for me headaches are not that bad but pain around my eyes is still bad. As I mentioned before I tried to quit Elavil 10 mg and had terrrible withdrawal symptoms and not sure I try to quit in near future. Even nausea I didn't have and started only after taking Elavil. Elavil can be (E)la(vil).

Having said that some people has no issues being on it or quitting it even with large doses. Only way to know is try it if you want.

I am on my second day of elavil and have no issues other than feeling drowsy. I think I will take only a quarter of a pill tonight. I took half last night. I definitely don't need the 25 mg the doctor prescribed. Somewhere around a quarter to a half of that, the sharp stabbing pain in my head and brain swelling goes away.

amitriptyline/Elavil
 

I have been taking amitriptyline for two years now for post-concussional symptoms, particularly pain in the head.
I started at a dose of 25 mg, which was obviously too much because I was sleepy all the next day. So, I cut the dose down to 12.5mg which seemed to help with headaches, at least it took the sharpness out of the pain of them. It helped a bit with sleep, which was and still is a problem, but didn't make me so zonked the next day that I couldn't function at all.

I have tried to stop taking it on several occasions but always found that the pain is too much. I am assuming that this is because the drug is having an effect, rather than the pain being caused by withdrawal symptoms. I have been told that the drug isn't very addictive.

I have gradually been going to a lower dose. First I cut down to 10mg and now I am on 7.5 mg nightly.

I haven't been able to cut down any more. I tried only 5mg last night and I have had enough head pain today to make me think that I can't go down to this level.

My doctor told me that the drug does have a long half-life, but I seem to notice the effect of a lower dose within a day or so.

Anyway, everyone is different, but it is good to share experiences just in case it is useful to someone.

CS

I just saw my neurologist today for the first time since my TBI 5 weeks ago. last week my doctor put me on Fiorinal for the headaches and Celexa for help with mood stabilizing and energy level. The neurologist (who is very very good....she works at my hospital where i am an ICU nurse) she said that her post-concussive pts normally do really well with the elavil for headache and symptoms. She is having me start at 10mg for 2 nights, then 20mg for 2 nights, then 30mg for 7 days, then 40 mg after that. I will try and do that regimen to build up the dose slowly in my blood stream and see how i do. If i find that i have too many symptoms as some of you have described, i will cut back slowly to the level i can tolerate but still have less headaches. It is reassuring to read that some of you find headache relief with it. She said the celexa and nortriptyline together should be ok since they are working in different ways in the brain. Here goes a try!

It is odd that she wants you to dose up to 30mgs of Elavil. The usually dose for PCS is just 10 mgs. The caffeine in the Fiorinal is unusual for a PCS patient. The caffeine is usually considered counter to the brain's needs during recovery. The sedative effects of the Butalbital sounds like it would compound the fatigue-like symptoms of PCS. Maybe the caffeine is to counter those effects.

Did you mean to post 'the Celexa and amitryptiline (Elavil)' rather than 'the Celexa and nortriptyline'?

The research says that mixing Elavil and an SSRI like Celexa causes the Elavil to reach a higher blood concentration likely leading to more side-effects from the Elavil.

Is your neurologist taking you off the Celexa as you dose up with the Elavil?

Sounds like quite a cocktail.

My doctor was quite adamant about not combining sedatives and stimulants.

Let us know how you do with this mix.

Sorry....it is celexa and nortriptyline. Celexa at 10mg. Nortriptyline starting at 10 and increasing up to 40mg after 2 weeks. After reading the doses all you guys are on, im going to be very mindful of the side effects and how i feel...if its too much, ill wean myself back down to a dose where headaches subside but dont feel side effects. Im up at 4am...but thats because i was told not to take my sleeping pills until i know how the nortryptiline effects me. Im supposed to stop taking the fioronal once we get my headaches controlled with the nortriptyline. But you are right, it is odd im on 2 antidepressants. I asked my neurologist this as well, and she said to continue with celexa. Im worried i will be kinda manic with 2 diff ones since prior to this i was not depressed and normally a happy talkative woman. We"ll see how it goes.

I gave Elavil another try and it's working wonders. I feel almost 100% but still can't do anything too strenuous of course... otherwise for normal activity, I feel pretty good!

I'm wondering... how much exertion to place on myself since it's the drug making me feel better an not my brain that is healed. It's tough to know what to do.

freezerdoor --- did stimulation from being in conversations with people bother you -- that the elavil has helped?
sending you a Private message

wtrpk - yes and yes. I did have that. I have most of the stuff you have but I have no trouble sleeping. I've never in my life had trouble sleeping except for the first few days of my concussion. I think it was the first three days... and it wasn't "trouble" but i would wake frequently for no reason. That went away in 3 days.

Yes, the elavil has helped tremendously. I'm nervous. Again, is this a help? I don't know.

With Elavil I no longer need naps and I can work 8 - 10 hours on the computer (i'm a web designer) and I can meet and talk with people. NExt to no problem. Not 100% but close enough. I can get through the day just fine. Without elavil? I need naps and talking is limited to a few minutes here and there. It took about 4 -5 days solid of taking elavil to notice the help.

sorry, i've been on the computer since 9am and i'm getting tired so typing is going down the tubes!!

I've been taking 25mg of Elavil (Ametriptyline right?) nightly to help with sleeping. It's been moderately helpful. I still wake up, but less often and I fall back asleep more easily. There was some talk of upping my dose but I'm not interested. It took me weeks to finally cave and try drugs to help me sleep and I'm going to get off it as fast as I can.

It hasn't helped with other symptoms, although if they had improved I would have been left wondering -- was it the magic pill or just time?