What You Need To Know About Amitriptyline For Fibromyalgia

amitriptyline for fibromyalgia

Different types of pharmaceutical drugs are being prescribed to fibromyalgia patients. They include non-steroidal anti-inflammatory medications, muscle relaxants, sedatives, as well as antidepressants. Amitriptyline, belonging to the oldest type of antidepressants, is a common drug administered by fibromyalgia patients.

What Is Amitriptyline?

Amitriptyline is a type of tricyclic antidepressant (TCA ), mainly used in treating clinical depression. This class of antidepressants has some of the oldest antidepressants still in use. Amitriptyline, sold under the brand Elavil, is believed to be one of the most efficient antidepressants. However, in spite of its effectiveness, newer antidepressants are favored over Amitriptyline due to its side effects and toxicity when over-consumed.

Although approved by the FDA for treating major depressive disorders, Amitriptyline has not been approved by FDA as a fibromyalgia medication. However, it can also help in anxiety disorders and nerve-related pain conditions such as fibromyalgia.

How Does Amitriptyline Work For Fibromyalgia

Amitriptyline works by enhancing the levels of the brain chemicals or the neurotransmitters, norepinephrine and serotonin. This in turn prevents malfunctions in the brain and nervous system. Chronic pain patients, known to show low levels of norepinephrine and serotonin, generally see improvement after administering the drug.

In addition, amitriptyline also acts as muscle relaxant and has effects in increasing endorphins, the body’s natural painkiller. Although it can help treat fibromyalgia symptoms, the side effects of amitriptyline can prevent patients from taking the drug consistently.

Side effects of Amitriptyline for Fibromyalgia

Side effects of Amitriptyline can vary between individuals and are dependent on the dosage. Generally, amitriptyline are more likely to cause weight gain and drowsiness as compared to other tricyclic antidepressants. The other common side effects are:

  • blurred vision
  • confusion
  • headache
  • nausea
  • constipation or diarrhea
  • dry mouth
  • skin rash
  • swelling of face
  • urine retention

Usually, the side effects are mild and would subside in a few weeks. If they are unbearable and persist, talk to your doctor and consider switching medications.

Usage of Amitriptyline for Fibromyalgia

In general, dosage of amitriptyline for fibromyalgia is much lower as compared to the usual dosage used for treating depression. The dosage can start to as low as 10 mg each day and administered at least three hours before sleep. This provides the patient with appropriate sedative effects from the medication without feeling the same effects when they wake up.

Studies On Amitriptyline For Fibromyalgia

In one clinical study, participants administered either 25 mg of amitriptyline or 20 mg of fluoxetine or both. Participants on the combination of both drugs found that its “twice as effective” as compared to taking 1 type of drug alone.

Another study investigated the effectiveness of regular consumption of 50 mg of amitriptyline for fibromyalgia. Participants reported better sleep, morning stiffness and pain threshold. However, tender points remained unchanged.

Later studies suggest that amitriptyline may be administered for neuropathic pain, however, patients may not attain sufficient pain relief.

As mentioned, FDA has not approved amitriptyline as a fibromyalgia medication. However, FDA approved two newer serotonin–norepinephrine reuptake inhibitor (SNRI) antidepressants, duloxetine and milnacipran, for fibromyalgia treatment. Nonetheless, research are still ongoing to substantiate amitriptyline as an effective fibromyalgia treatment.

Have you tried amitriptyline for fibromyalgia? Leave a comment to share your experience below.

15 Comments

  • I tried amitriptyline for my fibromyalgia and depression. I found it eased my tension not so much my pain and eased depression but unfortunately I did gain weight which didn’t help with physical ability which is vital for fibromyalgia and my eyes got very sore and blurred vision. I’m still at a loss with a tablet that can help without side affects. I am very tired all the time and there is not a tablet that helps with fibromyalgia without it making you sleepy.

  • I am no longer allowed amitryptiline as I take citalipram and apparently the two together can cause heart problems. I am desperate to find a replacement for amitriptyline as it was the only drug that effectively eased nerve pain that radiates through my neck, arms, shoulders and chest periodically. This pain becomes excruciating, even inducing vomiting, and amitriptyline took the edge off and helped me relax. I will aske my GP about Duloxetine

  • I am currently taking amitriptyline. I am using it more for sleep, than to help with my pain. I take Savella for my pain, which has helped me tremendously. But, I do understand that not everyone can take Savella. But, the amitriptyline has helped me get more sleep because I had been having a lot of difficulty with my sciatica. And I am also in the middle of my physical therapy.

  • I’ve been on this medicine for over 15 years. It helps with my pain some what but has helped my depression totally. Before nothing seemed to help especially muscle relaxer and other depression medicines. I’m thankful for my results because without this med I don’t think I would have such a great recovery!

  • I take amitriptyline for cvs. I have rheumatoid arthritis. I started taking it 2 years ago. I take 20mg. I think in a higher dose it would help. I have fiends with cvs who take 100my and they find they are in much less pain.

  • If i remember correctly, from over 30 yrs ago when I was finally dx with FM, i started with amitriptline, I was so exhausted waking up in the morning with 3 young kids under 10 yrs, a husband working shift work, I just couldn’t function and had to find something else. I dont remember what it was, but i do remember it taking a lots of trials to find a decent cocktail of meds to help my chronic depression and hypothyroidism that was dx too. Then the B12 defeciency and IBS which are common with FM.

  • Diagnosed 16 years ago, it was the only thing I was offered. I took half s tablet a day for a month, hardly slept in that time, when I did it gave me nightmares. I had flashbacks throughout the days and felt sluggish and drugged all the time. I refused more and didn’t want to try any others so was told I was on my own.

  • I’ve been on amitriptyline since 2009. It was prescribed by my PCP for headaches because I was waking up with daily borderline migraines. I have also have prescribed by my psychiatrist for depression and moods (fluoxitine, welbuteran in past) currently on Cymbalta/ duloxitine since 2012. Tried lyrica but every bad side effect happened so stopped it and am better off without it. My rheumatologist switched me from ibuprofen (was taking max dose Every dose and it ONLY dulled the pain) to indomethasin (much LESS of a dosage and pain relife). My pharmacist and insurance are questioning whether I STILL need the amitriptyline since I am on Cymbalta BUT bloodwork seems to be ok. I am also on Methatrexate arthritis and psoriasis and humerah So complicated healthwise especially since June 2016. Any suggestions on this mix?

  • I take 30mg amitriptyline 4 hours before bed for fibromyalgia. I used to take it just before bed but found my head was very foggy the next day and it took ages to “come to”. Taking the medication long before bedtime has proved very effective. I wake feeling much brighter and my pain is controlled. The advice on when to take my medication came from my chiropractor, not my GP and is the best I’ve received in treating my fibromyalgia.

  • I trotted amitriptyline but got no benefit or relief for pain, depression or insomnia. But what I did get were lots of side effects, groggy, foggy, and what else I don’t recall because out was 1998. My fiance uses it as he has fibromyalgia and myofasial pain syndrome. It helps him fall asleep. Nothing works for the severity of his pain but he hasn’t tried any other antidepressant. He’s been on gabapentin.

  • It seems like every medication I have tried for fibromyalgia causes weight gain and many other side effects. The best treatment plan for me was gentle regular exercise and doing relaxation exercises like biofeedback an hour before bedtime works the best. Harder than popping a pill, but better for you all around.

  • I also have used amitriptylene but keep falling asleep while walking or standing still. This disease is beyond comprehension for most people but i can’t stand it. #iwantmylifeback!!

  • Yes at first it worked for sleep then after a year it didn’t. I was on 25 mg at night. I didn’t want to increase the dose.

  • I was on 40mg AMITITRIPTYLINE for 2 years. It helped with sleep, then stopped hello g me sleep. It helped with nerve pain a lot, but I gained 20 kilos and suffered severe constipation and other bowel problems. I have come off it and pain is back. I’m trying cbd oil now, which helps with sleep but not pain management. I have lost weight 10 kilos in two months since stopping Amitytriptyline and this has improved my overall wellbeing massively. I have to swim, yoga and walk regularly otherwise I completely seize up. I have also tried a self hypnosis audio book for pain management. I want my life back and generally feel better off meds than on. Despite the pain. Hopefully one day, they’ll find something without the horrendous side affects.

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