Amitriptyline - experiences, thoughts?
 

I'm over 2 years in. I went to see my primary care for my neck pain and tension because my neuro. was basically ignoring it. I asked for a neck MRI and he said to try amitriptyline first. I guess he is figuring that my symptoms are migraine related even though I don't have a lot of headaches? Is this possible?

The side effects and withdrawl from this drug look to be bad. What have others experienced? What did it help with or what did it make worse?

THanks.

Sounds like classic primary care rhetoric. 'Let's try this' as if he is throwing darts at a board. I doubt a neck MRI will show anything. The subtle neck issues are rarely imageable. At the low dose commonly used for PCS related headaches, amitriptyline is usually not a problem. But, I don't think it is an answer, just another dart to throw.

Do you have access to a Physical Therapist who has gentle upper neck skills. Not the 'let's work on range of motion' type but rather one who can use some gentle traction and manual mobilization to see if you neck will settle down?

Thanks Mark. Yes, I have had a PT treating my neck for some time. He does very gentle techniques of mobilization. It has helped quite a bit as I have gone from having severe upper back and neck tension to it being moderate to light. His work also got rid of the constant pressure feeling in my head. He may have helped with the dizziness some too, but hard to be sure.

The problem is I still have the tension and it feels like a giant knot on the right side of my neck that is causing the occasional headaches. I also sometimes get a very inflamed feeling in my neck that causes my vision and dizziness problems to get worse, and will cause a worse headache - this may be why the doc thought it was migraine related. I cannot figure out a trigger for the inflamed feeling.

Also, I just have this general feeling in my neck like it is very fragile. Like I can't do certain types of exercise or movements without causing it to become tight and inflamed. It is frustrating because I am usually a very active person.

I also saw an Atlas Chiro. for several months, but I did not feel much benefit.

Thanks for your help.

Amitriptyline did help somewhat with my headaches, but it also made me very sleepy and dizzy. In fact, I could not take a high enough dose to eradicate my headaches without getting too dizzy, so I had to discontinue it.

Topamax was the medication that finally got rid of my headaches.

Good luck!

RR,

Our symptoms are so similar! I have knots up and down my right side of the neck that when pressed correlate directly to a spot on my head. I've done acupuncture, PT, and craniosacral, all of which have helped very little, I still have the knots. I also have a ton of pain in my suboccipital region that also gives me headaches. I am going to try medical massage. I am thinking the ten to fifteen minutes my Pt massages my neck is not enough and may need a longer treatment from a massage therapist. Also, another pair of hands may do a better job. Also, I am doing more meditation and yoga to try and stretch my neck and shoulders daily, which helps a little. Being mindful of posture throughout the day is helpful, too. We hold most of our tension and stress in our neck and shoulders. Hoping you get relief. I don't think you have migraines though, just a sore neck.

P.S. I have been working on strengthening my neck as well. Maybe you can try it? you basically just hold one side of your head and gentle push your head into your hand so you feel your neck muscles strengthening. Hold this position for 5 seconds. Do this on each side of the head, back and front for 10x twice a day.

I'm on amitriptyline - 50 mg at night. It's a low enough dose that side effects aren't a problem for me. You'll be super sleepy when you initially take it/after any dosage increase, but that should lessen a lot after the first few days or week or so. I do need a lot of sleep but I don't know whether that's attributable to the med or just my brain doing its thing and wanting to sleep.

I started at 25 mg, which did nothing, but a couple weeks after starting 50 mg, it was evident that it helped and is the only medication I've had that has helped that noticeably. It doesn't get rid of my headaches, but it makes them noticeably lower.

I don't know anything about Amitriptyline, but for neck pain such as you mentioned, I would try seeing a D.O. (Doctor of Osteopathy, I think) or a PT who is a CFMT (Certified Functional Manual Therapists). Either can work on such neck pain.

Good luck, and if you try the amitriptyline, please report back with the results! :)

Jenn
Santa Clara CA