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Mokum: Weaning off amitriptyline


Mokum

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I have been on and off antidepressants since I was 14 and each time I tried I believed myself to be entirely alone in the effort. I am hugely grateful that I've found this group and have already learned so much reading through these forums.

 

I recently gave birth to the most beautiful little girl in the world. When I learned I was pregnant I tried to go off my wellbutrin and lyrica (for ptsd and chronic pain) cold turkey on the advice of my gynocologist. It was a terrible experience. I completely fell apart and lived in 24/7 panic attack mode. They soon put me back on wellbutrin and replaced lyrica with amitryptoline. I felt so ashamed I couldn't "make it" off meds even for the sake of my unborn child. Now I wonder if it wasn't the withdrawal that had made me feel so terrible? 

 

After the birth, my GP suggested I alternate one day on, one day off wellbutrin to wtihdraw -- I've now learned that was terrible advice! At the same time I was tapering off the amitryptoline. I'm now off wellbutrin completely but am still on the lowest dose of amytriptoline. I'd deeply appreciate any thoughts on how to best go off that final 25mg dose. 

 

Also might anyone know some good alternative treatments for chronic pain, residing mostly in the shoulders, neck and head?

--Mokum

Currently on 25mg of amitriptyline for pain and hoping to taper fully off; had been reducing dosage from original 150mg (prescribed 1.5 yrs ago) too quickly until now. Until a few months ago also on wellbutrin for PTSD, first 150mg then reduced to 75mg then nothing, alas no slow taper. Had been on welbutrin and escitalopram for about ten years both together and separately for PTSD and anxiety. Amitriptyline was originally started fifteen years ago then replaced by lyrica (up to 300mg) for ten years then returned to amitriptyline whilst pregnant. Previous to these have tried quite a gamut in late teens and early twenties - prozac, paxil (which gave me a weirdly permanent dry mouth), effexor, diazepam, lorazepam...

 

 

 

 

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Hi Mokum,

 

Boy, can I relate to you.  I took amitriptyline for 20 years.  I started it after a year of un-diagnosed severe post-partum depression after the birth of my first son.  When I got pregnant with my second son, I had just gone off it for the pregnancy.  I was sicker than a dog for the whole pregnancy, all 42 weeks (he weighed 10 pounds!) and I now attribute that to amitriptyline w/d, not pregnancy.  I breast-fed but got post-partum again so i restarted amitriptyline and felt better immediately.  THEN, unwittingly I got pregnant with my third son.  By the time I knew I was pregnant (was using birth control, so it was a big surprise) I was 10 weeks along.  My psychiatrist and OB/GYN consulted and decided since I was already 10 weeks along, and my baby had been exposed to the drug anyway, it was safer for me to stay on it then to risk another very serious depression.  So I did.  I was nervous that whole pregnancy that something would be wrong with my baby, but guess what?  At age 31, he is by far, the happiest and healthiest of my three kids.  I even breast-fed him while taking amitriptyline.

 

The point here is definitely not to advocate taking any of these drugs, ever, much less while pregnant, but I thought I might assuage any fears you might have about amitriptyline's effect on the baby.  Not seeing your drug history it is hard to say how you would react if you start tapering amitriptyline now, if you are not over the wellbutrin w/d.  25 mg. is indeed a low dose of amitriptyline and it is prescribed, often, for pain.  Again, I am not advocating you stay on it, but I often think my youngest son is the happiest and healthiest (and we are very close) because he wasn't raised by a severely depressed mother.

 

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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  • Moderator Emeritus

Hi, Mokum.

 

Welcome to SA. You'll find plenty of information and friendly support here.  

 

Congratulations on your beautiful baby girl. You did what your doctors told you was best. That's how most of us ended up on this forum, so please be kind to yourself. 

 

We recommend coming off these meds at no more than a 10% reduction. Here are some links to get you started:

 

Tips for tapering off amitriptyline

 

Why taper by 10% of my dosage?

 

And some information on what to expect during withdrawal and recovery:

 

What is withdrawal syndrome? 
 
The Windows and Waves Pattern of Stabilization

 

Because these medications can have a "delayed withdrawal" syndrome that may not start for months after coming off, please let us know more about your other meds, such as the doses of Lyrica and Wellbutrin you were on, how you tapered off, and the amount and date of your last dose. 

 

Please also fill out a signature:

 

Please put your withdrawal history in signature

 

This thread is where you can provide updates and ask plenty of questions. 

 

 

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Hi Mokum, welcome! And congratulations on the baby!

I cant suggest you about meds, but I have had a lot of pain in neck and shoulders, due to firstly stress then a minor whiplash. Do you know what causes the pain? If you know what causes the pain it's easier to adress it.

My pain is almost gone now thanks to physiotherapy, CBT therapy and yoga. Maybe something for you?

Current dose: 0! Free!  Quit June 2017.

2017: Last dose zoloft: 17 June 0,00065 mg 18 May 0, 001 mg 14 May 0,002 mg 9 May 0,003 mg 28 April 0,006 mg 19 April 0,009 mg 8 April 0,013 mg 25 March 0,019 mg 22 March 0,039 mg 18 March 0,052 mg 16 March 0,079 mg 4 March 0,086 1 March 0,099 mg 22 February 0,11 mg 15 February 0,13 mg 6 February 0,145 mg 24 January 0,15 mg 19 January 0,19 mg 10 January 0,20 mg 3 January

2016: 0,98 to 0,22 mg; 2015: 2,35 to 1,01 mg; 2014: 4,9 to 2,5 mg; 2013: 9,1 to 5,1 mg; 2012: 15,7 to 9,7 mg; 2011: Started on 25 mg - then 50 mg- dropped to 25- to 12.5 mg - back to 25 mg - after 18.75 mg started tiny tapering to 16.6 mg

Started on 25 mg Zoloft in March 2011 due to stressrelated tinnitus that gave me panicattacks. Had a terrible reaction to Zoloft from start, but was told to "hold on". After four months I was stuck. Therefore the long taper. Crazy, I know... Super sensitive to drops and have dropped by 4-6 % from the previous dose.

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HI Mokum, welcome to SA. You will find lots of great info here. I just finally got off amitryptiline after 35 years of pretty much continuous use. I think you should be able to get off of it fairly easily. I would suggest going down to a half pill (25 mg), hang out there for a while (2 weeks to a month), then cut into quarters and take 6 mg. for a while. I was unable to jump from even that low a dose, and ended up reinstating the first time. At my second attempt, after jumping, I had to reinstate at .5 mg. I figured out that amitryptiline dissolves (suspends) fairly well in water and was able to get small doses that way.

 

The gist of it is that it is easier to drop the larger doses, but as you go lower you will probably need to taper with smaller cuts. I haven't had any bad withdrawal effects, but I do have some uncomfortable bruxism (tooth grinding) that I hope resolves soon. With your usage I'm sure you will do just fine.

 

My only advice on pain is to stay away from pain killers, especially NSAIDS such as ibuprofen and opiates. NSAIDS actually inhibit healing and I was unable to heal chronic pain until I quit them. Opiates actually make pain worse. If you can manage to suffer through, you will heal much faster. Are you under a lot of stress? You might look into massage or acupuncture.

Sarah

1975--first signs of depression

1981--started on imipramine (Tofranil) for IBS and depression

1983-1986--severe depression, rotated through several drugs, on MAOI for one year, eventually back to tricyclics

1986-1994--chronic low grade depression, on tricyclics

1994-96--severe depression, rotated through several drugs inc. Prozax, Effexor, etc..

1996-2013--chronic low grade depression, SAD, on amitryptiline usual dose 12.5-25mg

     flurazepam (Dalmane) as needed for insomnia

2013--developed temazepam (Restoril) dependance for 2 months, tapered off over 1 month

   started bio-identical progesterone 5 mg., depression has lifted completely to this day

March 2016--forced to c/t both amitryptiline and flurazepam, zolpidem not helpful

reinstated small dose (.5 mg) amitryptiline due to stomach issues and tapering w/titration

June 19th--jumped from amitryptiline--drug free!

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