Is there another tricyclic for pain besides Elavil?

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Alcie
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Date Joined Oct 2009
Total Posts : 5012
   Posted 4/5/2012 9:28 AM (GMT -6)   
Is there a tricyclic antidepressant anyone is using that works for pain like Elavil but doesn't last as long?
 
I'm getting good pain relief for back muscle spasms and other pain at night with Elavil 5 mg (amitriptyline), a very tiny dose.  The problem is it lasts about 12 hours for me, which means waking up with a hangover and tiredness until the morning tramadol kicks in.  Hangover's not too bad if I take Elavil at 5PM, but pain relief wears off about 3AM. 
 
There are no muscle relaxants I can take.  Either they don't work or they give me bad side effects.  I've been trying everything over 3-4 years.  My TENS unit doesn't stop the spasms anymore.  I'm back to Elavil in desperation.  Yesterday I had to stop driving 3 times because the pain was just too bad to get home from the oncologist's office.  I had the TENS on and was crying with the pain.  My back brace helps with spine pain but does nothing for muscle spasms.  Vicodin and Percocet don't work at all.  I take tramadol during the day for fibro, torn rotator cuff, spine pain, but it doesn't stop back muscle spasms.  I can't take it at night because it wakes me up.
 
The only other solutions I have come up with are cutting the Elavil down more, which will probably cut down effectiveness.  I have to babysit for 3 (5,4,2) today and the spasms are already hitting above hip level.  I don't have time to lie around on the heating pad.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16396
   Posted 4/5/2012 10:39 AM (GMT -6)   
Hi Alcie, I did a quick google search for this and found several, all I did was type in trycyclic antidepressants and found the list. One that stuck out for me was Nortriptilene not sure on the spelling, but I am pretty close,lol. That is one I have seen others here take. Hope this helps......Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Acheybody
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Date Joined Nov 2008
Total Posts : 5994
   Posted 4/5/2012 7:42 PM (GMT -6)   
Alcie,

I take Nortriptyline, have for almost 20 years. My doctor says it's something like 1 molecule different from Amitriptyline - less sedating. Maybe that would work better for you, the same pain relief with less hangover feeling....

Debbie
fibromyalgia, herniated disc L4-5, (with recent discectomy), bulging disc L5-S1, other assorted spinal deterioration, scoliosis, Hashimoto's, IBS, migraines, tachycardia, hearing loss (probably from Menieres Disease)

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5012
   Posted 4/6/2012 4:33 PM (GMT -6)   
Debbie -
 
Do you take a low dose, once a day?  Do you have any idea how it works for you?  I'm trying to find the "duration of action," i.e. how long the drug works.  It's not the same as "half life," could be several hours more or less.  My main problem with amitrip is that it lasts 12 hours.  I read that nortrip is a metabolite of amitrip.  That might indicate it doesn't work as long.
 
Tricyclics seem to work very well for neurological pain, according to technical books I have read.  My rheumy put me on Elavil (amitriptyline) a few years ago, but it gave me thoughts of suicide, so I stopped it.  On trying it again, it's not doing anything like that and is giving me good pain relief at just half the smallest dose available.  
 
A problem with nortriptyline is that it comes in capsules.  I'd have to open them and throw away half a dose to start, or get some empty shells and put in half a dose.  Of course, I'd only do this with doctor's OK.
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