TRICYCLIC ANTIDEPRESSANTS FOR CHRONIC PAIN…

The obvious use for antidepressants is for depression but now tricyclic antidepressants are used widely for back pain. They have been proven to treat some cases of chronic pain.

After my first visit to a pain clinic, I was put on a low dose of tricyclic antidepressants to treat my pain. At first, I was a little apprehensive about being labeled ‘depressed’ but then when I looked into the drugs I was being prescribed I understood the difference in them being used for pain rather than depression. The main difference was the strength of the drugs as for pain you are only given a low dosage but for depression, you are given a much larger dose.

Amitriptyline is one of the widely used tricyclic antidepressants used for the treatment of chronic back pain which I take at night as I find it helps me sleep. They explained to me that it works as a muscle relaxant for my pain and although I was initially prescribed 10mg I was told I could more than double the amount if I needed it. I now take 30mg every night.  If the medication is ineffective, your dose can be gradually increased. This approach will help to lower the risk of side effects.

The British Pain Society say Amitriptyline works by increasing the number of specific nerve transmitters in the nervous system, reducing pain messages arriving in the brain.

Obviously, you have to expect side effects from constipation, sweating, blurred vision or drowsiness as well as dry mouth. I actually find the dry mouth the most inconvenient side effect in the mornings as I need a drink nearby to carry on a conversation but it’s short-lived. They do say that if you experience drowsiness or blurred vision, you should avoid driving or operating heavy machinery. This is why I take them at night rather than in the morning.

It also says to avoid drinking alcohol while you are taking amitriptyline as the combined effects can make you feel very drowsy. All in all, I do think that they are one of the best drugs for relaxing your muscles and helping you sleep. Arthritis Research UK has a great article on Amitriptyline for anyone thinking of asking for this drug, as does The British Pain Society.

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