AMITRIPTYLINE - What you need to know

In this episode of Medication Mondays, join Dr. Syl, a knowledgeable psychiatric registrar, as he delves into the intricacies of Amitriptyline. Learn about its uses, mechanisms of action, potential side effects, and considerations for its safe and effective usage in managing various mental health conditions. Dr. Syl provides valuable insights and answers common questions to help viewers gain a better understanding of this medication and its role in mental health treatment.
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Timestamps
00:00 - Introduction

[@DrSyl]

**Enrol in my 'Dr Syl's Psychotherapy Skills' course today: payhip.com/b/T4gtn First 20 people to use the code 'first20' get 20% off! ** This course is designed for anyone dealing with depression and anxiety, offering you the tools to manage your symptoms through proven techniques from Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT). Course Curriculum: Feelings (45-60 min) Thoughts (45-60 min) Cognitive Distortions (45-60 min) De-stress & Relaxation (45-60 min) Relationships (45-60 min) With about 5 hours of content, this course is perfect to complete over 4-5 weeks at your own pace. You’ll also have access to an interactive workbook and symptom monitoring throughout the course. Why Enroll? Backed by Research: Significant reduction in symptoms of depression and anxiety. Cost-Effective: More affordable than traditional therapy. Flexible Learning: Learn anytime, anywhere with 24/7 access. Take the first step towards better mental health today. Enroll Now and start your journey to a happier, healthier you! #MentalHealth #OnlineTherapy #CBT #IPT #Depression #Anxiety #DrSyl

[@shawnaford5540]

I wish “dry mouth” was expanded to include the warning that a dry mouth causes teeth decay over time.

[@Bethsabee_Sheba_Newrose]

You’re right! It caused $23,000 in dental work for me only a couple years after starting it (I still lived in the U.S.). Prior to that, I’d never had a cavity in my life 😫. And because I have fibromyalgia and my nerves are wonky, I have horrific pain in my teeth to this day. The tooth decay risk really, really should be expressed emphatically so patients can take preventative measures (and those preventative measures should be provided).

[@shawnaford5540]

@@Bethsabee_Sheba_Newrose Yes I remember going for years and years without cavities then very quickly starting to get 3 or four every appointment. Now there are hundreds of medications that cause dry mouth, and sipping water is not going to make up for lack of the saliva. I find going for cleaning 3-4 times a year and xylitol helps.

[@Bethsabee_Sheba_Newrose]

@@shawnaford5540 Yes! Xylitol also can help a bit with the, erm, constipation the meds cause too lol. “Biotène” mouth spray and lozenges are also really helpful.

[@loftyradish6972]

I recommend using dry mouth toothpaste, mouthwashes, mouth sprays and mouth gels, the brand my dentist recommended to me is Oral7, as well as whatever no-sugar breath mints and chewing gum. I too have an epically dry mouth but am very successful with keeping my teeth healthy using these.

[@freelivinghippieshit]

God you’re so right! I’ve been on a medicine for just over two years that causes extreme dry mouth.. I had no idea it could affect my teeth.. so for about 1 1/2 years I just didn’t pay much attention to the dry mouth or even really think it was something that needed to be taken care of. Naive, I realize in hindsight. Fast forward to now, currently I am in so so much pain from all the tooth problems I have I know I’m at the point where I’ve let it get so bad that they are just going to need to be pulled. I’m talking every molar I have is affected. Both sides, top and bottom. I was so unstable and just so happy to be starting a medication that seemed to be working that I didn’t think I needed to look up side effects on google own my own. My doctor never told me about this side effect and its cause of tooth decay. And I just am so mad at myself for not being better informed.

[@rockybadger]

This drug has saved my life. I have CPTSD and have had 2 times in my life that I have been suicidal. This helped me quiet that inner critic telling me to harm myself. No other antidepressant worked for me, and I was on it short term (about a year and a half during both episodes), in conjunction with therapy. It helped me get to a place where I could figure my stuff out and stabilize. I haven't needed it in years now, but I'm so grateful I found it when I did.

[@savejosef]

What dose helped you? How fast did it help?

[@Dave-if5qj]

It can be a great med

[@savejosef]

@@Dave-if5qj For what?

[@Maarten_jvr_]

Hi Dr Syl, I've been taking Serlife (sertraline) medication since I was 10 (im 17 now). And your videos have really been helpful in educating myself on al things mental health and teaching me more about the medication I take everyday. And i appreciate what you do so much. Much love from South Africa ❤

[@leslietisdial5753]

He is very great at what he does. Im glad you found a med that works for you

[@leslietisdial5753]

I would be interested in learning more from you about olanzapine. I like how you are more thorough explaining the risks and benefits of the meds than even my pharmacist

[@MelainaMetella]

This medication is so versatile and fascinating! After years of chronic pain I was diagnosed with vulvar vestibulitis syndrome. My doctor perscribed me an Amitriptyline-Ketamine Gel along with pelvic floor physical therapy. At first I thought he was crazy to suggest putting an antidepressant and an anesthetic on my vulva. But it really helped to reduce pain. At least I was able to sleep again; before, it was sometimes so bad that I was crying in pain all night long. Unfortunately, it didn't cure me fully so I had a vestibulectomy two years later. I wish the doctors would have suggested psychotherapy in addition because recently I discovered that I had repressed several traumas (sexual violence / rape) for years. Maybe this played a role in developing this pain syndrome too.

[@aregahailu2487]

Sorry to you

[@Cat-im2hb]

I have taken 10mg for 4 years now. I have had no side effects. But in the future, even if risky, I will not stop taking it. I suffer from chronic nerve pain and FM and I cannot go back to suffering. This medication eases my pain and alouds me to work. It is still challenging but it would be an impossible task without it.

[@ToldatHoe]

😂😂😂 alouds

[@sbitnov]

I have fibromyalgia, mild OCPD, insomnia, adhd, anxiety and depression, hypermobile ehlers danlos, severe bruxism and headache... been on amitriptyline for years and have never had any side effects. I take 20-30mg nightly and learned a lot from this video! Thank you for educating me more, love all your videos!

[@MadonnaGrogan]

Same, no side effects

[@jeanluby4636]

@@MadonnaGrogan same here only need a mint in the morning Helped me through menopausal depression. When stopping the med do it slowly.

[@suzannajames3084]

Thanks so much for this video, I was prescribed amitriptyline a year ago for neuropathic pain but didn't start because of side effect concerns, I've had to start now because of worsening pain levels, just on 10mg for now, and it's already helping, and your advice was far more comprehensive than anything I've been able to access through my doctor's in the UK, who are pretty overloaded, so thank you so much and it's so good to be able to just hear someone talk it through really thoroughly :)

[@TMO870]

I have nerve compression in my back, and got put on amitryptaline to reduce nerve pain. Honest opinion: id rather deal with the nerve pain than feel like a zombie all day. 20mg was enough to make me feel lethargic and mentally dull.

[@Bethsabee_Sheba_Newrose]

I’m jealous of you 😂 My nerve pain is so severe I chose the zombie route.

[@TMO870]

@Bethsabee_Sheba_Newrose It was a tough decision, quick witted and limping or physically fit and drooling. I chose the former 😅

[@doreenmarston6880]

The first night I.took amitripyline it helped me immediately. I slept like a baby and woke up feeling wonderful. Those new antidepressants are worthless. I love amitrimlyne.

[@kymfrancis4612]

I was on amitryptline for 2 years for pain from my Paget’s disease of bone, it really helped my pain & poor sleep (Paget’s night time pain) but the side effects were too severe after 2 years; I developed gastroparesis, impeded urination & the increasing dry mouth was the final straw.

[@spacerdreams]

Hey Dr. Syl, Can you make a video like this but about the medication haloperidol? Best, Christian

[@zubeidamohamed2916]

I threw it all away 2 days ago. So strong. The hospital only prescribes this drug. Very strong.. Dry mouth.. And u feel miserable after u wake up.

[@jeanluby4636]

It helped me through some tough times with menopausal depression. I could function again on 50 mg. before bed no problem with side effects just a mint in the morning fixed it.

[@Bamsougher]

Pharmacist always a good place for interactions :) thanks prof

[@DorianBrightMusic]

Thank you so much for this video - it’s always fantastic being able to learn more about this stuff. One of the important things with psych meds is always how differently they affect different people - I’m on 25mg amitriptyline for chronic pain, and get basically no unwanted side-effects aside from increased lightheadedness (but not postural hypertension), while I know some people get a massive panel of adverse effects from this drug. (My form of chronic pain makes the anticholinergic effects useful, while some folks might find them more debilitating.) Personally, I find it’s helpful for reducing baseline pain and flare intensity, but it doesn’t really prevent flares at all. The first couple of nights after titrating up bring sedation, but then, the adjustment happens pretty quickly. Others might find this *far* more sedating, though, so ymmv, I’m afraid.

[@danyellea.m.]

This was super helpful. Please do Vyvanse next!!! There’s a major shortage of it and I’d like to know if I should really consider coming off of it.

[@aaronkeane3130]

Hi Dr Syl, could you do a video on Lyrica or Pregabalin and it's array of uses and effects!?

[@CanuckInNZ]

I was on Nortriptyline, which I think is a similar class of med, for a few years. It really helped with anxiety/depression, insomnia and I had a lot fewer issues with headaches/migraines. Unfortunately, I was diagnosed with an ASD, and the med was causing some cardiac issues, so had to stop taking it. On a different, but related topic: it's very tricky to get to see a specialist regarding mental heatlh here in NZ. It really does sound like things are better in Australia. Basically, I'm being managed by my GP who is great, but who is overrun with patients. Maybe it's better in the larger cities, but we are in one of the regions. Honestly, it's grim here.

[@jasond626]

Very good video.. thank you so much.

[@Dave-if5qj]

I believe tricycles can be one of the most effective for hard to treat depressive disorders Especially amitriptyline If you can deal with the side effects and underutilized

[@loftyradish6972]

Oh man, I f*cking love my amytryptaline. I use it for my fibromyalgia, that drug changed my life overnight. I hadn't realised how bad I felt, until I woke up the morning after taking it and felt good for the first time in about 15 years. I also take cymbalta now and I'm one of those terrifyingly active people where even I wonder how I manage to pack so much into my weeks and still get 8 hours of sleep a night.

[@Turtledove72]

I take it for chronic functional abdominal pain. It’s the only thing that ever worked

[@MadonnaGrogan]

Excellent at blocking pain for me

[@coraldell3091]

Yes , when risk outweighs to gain... It can get confusing 🤔

[@petergordon2712]

Does anyone ever mention the absolutely mental dreams when you take it.

[@brandonbarley315]

I’m only on day 4 and my dreams are already getting vivid

[@Tomi_1808]

You didn’t really talk much about anxiety in this video. I was prescribed amitriptyline a week ago because I get so anxious to communicate with people. So i was diagnosed for social anxiety disorder and I’ve been using amitriptyline for a week and a day and I still feel extremely anxious to communicate in English, even tho I understand and can speak English but it’s hard communicating due to extreme anxiety.

[@queeng5925]

ermmmm watching this b4 im about to take mine (or not)

[@iluvsox12]

I had been on this for years for my migraines was the only thing that worked! And on the plus side it helped with my sleep and anxiety 😂.

[@KieraCameron514]

Kava is great for anxiety.

[@Ehecatl1111]

THIRD!! FINALLY!

Hi Dr Syl, just wondering if you could do a video on Antisocial Personality Disorder? I have a sibling with this condition, and I'm at my wits end trying to deal with him. Any help would be greatly appreciated, thank you!

[@RubyHolden-j6z]

This drug gives me the most wildest dreams ever... lol 😅 Always a dream to experience every night.

[@gjh9299]

my first I had audio hallucinations I was 22 long term bpd it gave me anxiety and Id lay awake

[@m0hibullahdawoodzai139]

I have ibs diarrhea for more than 4 years it ruined my life i can't work and travel iam always at home my gastroenterologist told me the only medicine can help you is amitriptyline 75 mg it worked 50% however my ibs still bothering me and the side effects of this medicine is dry mouth and fatigue

[@bencebukta6370]

my dad takes it for migrane attacks and depression

[@savejosef]

What dose help him?

[@bencebukta6370]

@@savejosef the lowest, 25mg

[@savejosef]

@@bencebukta6370 You know how fast it worked and how bad depression he had?

[@berniezhang8678]

I'm on 50 mg , split dosage 25 in thw morning & 25 in the evening. It's my not give a f$@k medication. Bonny and blithe most of the day. And spaced out. Good sleep which is a cornerstone of mind health. Only downside is the munchies. Once you know you don't care one bit about what's happenin' in the middle east , then you're on the right alchemical concoction.

[@highlightshadow]

I cannot tolerate SSRI's due to bruxism and mirtazapine was no better and caused bad sleep ... so i'm on Ami now but i feel it doesn't do anything worthwhile other than letting me sleep, albeit dreamless sleep. They don't do any pre-checks in UK -- just "take another pill". Definitely didn't ask about ideation which i do have but still on Ami plus my weight has been horrendous for most of my adult life .... GP's in uk just don't care

[@alexd1274]

Can you discuss why during my period my adhd medication feels less effective?

[@miguelacosta7564]

Dr Syl, mention that its a tricyclic ,,,,,,,

[@jaywilson2018]

Have you done one on Mertazapine ?

[@Tattersayl]

There's a persistent buzzing in the background of your video, I'm not sure what your mic is picking up (a fan maybe?) but it's very difficult to pay attention to what you're saying over the buzzing, as someone with sensory issues.

[@ladybaabaa3294]

I can't hear any buzzing at all...

[@DrSyl]

Thanks for the feedback. I’ll look into it.

[@Bethsabee_Sheba_Newrose]

I didn’t hear a buzzing sound either (and I can’t even tolerate sounds of things like a lamp or a device being charged make, so I know it’s frustrating when someone says you’re not hearing what you know you are definitely hearing). I’m definitely not saying you aren’t hearing a buzzing sound 😊 I hope that made sense.

[@Tattersayl]

After hearing feedback, I did clear my browser cache and refresh everything, still experiencing the buzzing. It's also not happening on any other youtube videos I'm trying. So there's definitely a frequency I'm catching that perhaps others aren't. Also went and checked the previous upload and it's not present on that video either.

[@ila9063]

I hear it too. It’s definitely there!

[@dionysusapollo]

Can you do olanzapine? I was on amitriptyline until it made me manic,but it was great for sleep and pain. It's got some concerning associations with dementia though.

[@KomradeKlonopin]

SSRIs show higher dementia risk than TCAs so it's a class wide issue sadly not to mention untreated severe depression is awful for neurological diseases as well

[@vwvqr]

Newcastle subscriber here - You didn't say 'Nortriptyline' once! Not even a pearl 😅

[@Bethsabee_Sheba_Newrose]

Yeah! 😂

[@50Hz]

Can you please do 'Rexulti'? I've just started on it while im still on Olanzapine

[@50Hz]

@TheDaniel0258 telling me. I've put on 7kg in just over a week. Didn't realise now i have to watch what i eat.

[@noahcd36]

FIRST

[@nobodyimportant7804]

I was on this for about a year. I have depression, anxiety, lower back pain, neuropathic pain, migraines, and severe insomnia. It was exactly like taking nothing. If it is still being used 100 years from now, that would mean psychiatry hasn't yet figured out the causes of MI. Ketamine infusions need to be a first-line treatment for depression. The long-term risks are much lower than these garbage pills.

[@Bethsabee_Sheba_Newrose]

Please forgive my ignorance, what is MI?

[@nobodyimportant7804]

@@Bethsabee_Sheba_Newrose Mental illness, sorry for being lazy and not spelling it out.

[@Bethsabee_Sheba_Newrose]

@@nobodyimportant7804 Ah! Thank you, it seems obvious now lol. Yeah, if we’re still at this level in 100 years then we’ll pathetically still be in The Dark Ages of treating mental illness and pain, and that’s a grim thought indeed.

[@BrokePencil]

I did not enjoy amitriptyline.

[@emmajackson661]

Oh endep gave me bad manic episode

[@DaxtonKnight]

My ex took it. Worst thing ive seen

[@aidanm7225]

This stuff is pure poison , got off it after 3 mouths and have never felt better

[@JohnMark-bx1ks]

amitriptyline is only good if u take it not more than 25mg otherwise makes u very sleepy all day ..works great as pain relief..... i take it together with high dose st. john wort, what a great combo, covering both the low mood and anxiety, it might need another meds for the nervousness like alprazolam