I’ve recently started taking a low dose of Amitryptiline for type 2 TN. I am already taking Tegretol , Norco, and a beta blocker. I noticed it is much more difficult to think clearly since starting Amitriptyline. Is that typical? I’m really not liking this medication and I’m debating on whether I should stick with it or not since I'm not functioning well. How long does it take for pain relief to start? What is the therapeutic dose for Amitryptiline? Thanks so much!
Many patients complain that amitryptiline causes "brain fog". Most of the tricyclic antidepressant drugs do. In combination with the other meds you name, I'm not surprised that you observe cognitive deficits.
Drugs.com indicates the following dose range for outpatients:
Usual dose: 75 mg orally per day in divided doses; this may be increased to a total of 150 mg per day if needed
Alternate dose: 40 to 100 mg orally as a single dose at bedtime; this may be increased by 25 or 50 mg as needed at bedtime to a total of 150 mg per day
Maximum dose: 150 mg orally per day
However, it is common for this med to be prescribed at lower than the dose considered therapeutic for depression, and for it to be effective against neuropathic pain at such doses. Generally, if it's going to work at all you should observe some effect within a month of beginning the med. In some people, the cognitive effects also lessen as you get acclimated to the drug.
Regards, Red
Thanks so much Red.
Hello SunnyJ,
Amitriptyline (20mg) along with 300mg gabapentin has given me back the ability to function. I did have foggy thinking and even double vision in the beginning, but after a few weeks, that has subsided. Hang in there.
Rissmal
rissmal said:
Hello SunnyJ,
Amitriptyline (20mg) along with 300mg gabapentin has given me back the ability to function. I did have foggy thinking and even double vision in the beginning, but after a few weeks, that has subsided. Hang in there.
Rissmal
I've been prescribed 20mg amitriptyline at night- it has helped for 8 months but isn't helping now. I did have brain fog but that was down to something else (I had vascular eagles Syndrome causing Intracranial Hypertension, but have had surgery) so now thinking is clearer. I found the amitriptyline helps with sleep though which is great.
Hello, everyone is a little different, of course. For my TN2 pain, trileptal (essentially a different formula of tegretol) and amitriptyline helped quite a bit, but the cognitive side effects from both were rough - brain fog BIG time. I noticed that the amitriptyline dosage at between 30-40mg was actually pretty effective for me. Also, it helped me sleep like a baby and boosted my mood. I remember the pain relief took roughly 10 days or so to kick in. A few others told me it took a couple of weeks. The reasons I couldn't continue were difficulty with urination on the two meds (which caused bladder and kidney infection), pretty significant weight gain, and the brain fog was tough to do my job with. If I didn't have those issues, I still might be taking that combo with successful relief.