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Best Tca For Depression & Fibromyalgia?


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9 replies to this topic

#1 Beckett

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Posted 19 March 2012 - 07:12 AM

I'm considering TCA's and nervous about side effects having tried doxepin one time and flexeril (related compound). I have been thinking about Surmontil or Tofranil. I'm concerned that my doc might want to try Elavil because of the heavy side effect profile I have been reading about. I seem to be very medication sensitive. I am attracted to Surmontil because it preserves sleep architecture and to Tofranil for possible energizing effects. I deal with fatigue alongside of pain.

Thank you for any input.
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#2 Nurse Ratched

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Posted 19 March 2012 - 07:22 AM

I found Elavil to be excellent for pain relief but it was pretty sedating.
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Current Meds:  Ambien CR 12.5 mgs

Former meds: Topamax 200 mgs, Seroquel XR 300 mgs, Wellbutrin 300 mgs, Vistaril 50 mgs x4, Klonopin .5 mgs, Paxil, Zoloft, Effexor, Remeron, Elavil, Abilify, Lamictal, Geodon, Zyprexa, BuSpar, Xanax, Depakote, Trazodone, Ambien, Lithium, Risperdal, Doxepin,  Cogentin, Haldol, Saphris, Latuda, Neurontin, Lexapro.


#3 VAL

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Posted 19 March 2012 - 11:29 AM

I tried Elavil in the early 80's first for depression and then at a very small dose for fibromyalgia because I couldn't take the extreme sedation of the anti-depressant dose. I did not find either the higher or lower dose to do anything at all for the fibro pain .....obviously NR had a completely different experience. My own experience with fibro was that once I found good sleep with trazodone, the pain greatly diminished and to this day, as long as i sleep, I can tolerate the pain. It quickly becomes unbearable when I stop sleeping.
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Current Meds: Lamictal 300mg, Wellbutrin XL 450mg, Neurontin 900mg, Klonopin 1.5mg,  Trazodone up to 300mg and Inderal 20mg PRN
Past Meds: Siniquan, Elavil, Imipramine, Zoloft, Seroquel, Abilify, Nardil, Emsam, Rozerem, Celexa and Ambien
Current Non-psych: Soma 350mg PRN, Norco 10mg/325 PRN, Percocet 10mg/325 PRN, Advair, Nasonex, Ventolin PRN, Allegra, Benicar, Dexilant, Levothroxine, Pravachol and Nexium. 


#4 Beckett

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Posted 19 March 2012 - 11:46 AM

Thanks NR and VAL.

VAL, I agree about the relationship between sleep and pain being so critical to fibromyalgia. I have two types of pain which fibromyalgia amplifies, OA/degenerative disc pain and peripheral neuropathy. I wish the Saphris I take was enough to insure my sleep, but it isn't. My sleep is still fragmented, and I have onset difficulties, early awakenings, etc.

The Surmontil which protects sleep archecture might keep me too tired throughout the day. Fatigue nearly tops pain as a symptom. I was checked for chronic fatigue at one point if that illustrates the degree of fatigue I can endure during bad cycles.

Tofranil might disturb my sleep? I don't know.

Thanks to you both. Hope you are doing well.
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#5 Halberd of Hope

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Posted 19 March 2012 - 11:52 AM

Nortriptyline is more activating than amitriptyline/Elavil, and also used for pain.

I have debilitating fatigue from depression, and this has gotten me up off the floor and able to hold a job again.
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#6 Beckett

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Posted 19 March 2012 - 12:07 PM

HOD, which has more NE action, the nortriptyline or Tofranil? I am trying to remember what I read. I am careful about stimulating too much NE. I believe I can be sensitive to it. It's a bit maddening, but too much stimulation, and I go tilt, even though I need it badly.
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--Wilco, "Ashes of American Flags"

#7 Beckett

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Posted 19 March 2012 - 12:14 PM

Nortriptyline is more activating than amitriptyline/Elavil, and also used for pain.

I have debilitating fatigue from depression, and this has gotten me up off the floor and able to hold a job again.


Thanks. I did look this up. It would be energizing. I'm glad it got you up and going. Oh this is so maddening. I see my GP this week and then my pdoc. I am just going to solicit opinions and experience here, ask them, then hope for the very best. I have a dependent child, and I need to be at least halfway together. Oh yikes.
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All my lies are only wishes/
I know I would die if I could come back new.

--Wilco, "Ashes of American Flags"

#8 Beckett

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Posted 21 March 2012 - 06:31 AM

I found Elavil to be excellent for pain relief but it was pretty sedating.


Nurse Ratched, does this sedation mean 24 hrs sedation? Do you feel drowsy during the day, or have you dialed your dose in just right? I see amitriptyline in your signature. I am trying to avoid too much NE action which I imagine might be disruptive. My doc might have another idea.
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--Wilco, "Ashes of American Flags"

#9 Nurse Ratched

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Posted 21 March 2012 - 06:40 AM

If I take it in the afternoon, around 5 or six, I don't experience daytime sedation.
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Current Meds:  Ambien CR 12.5 mgs

Former meds: Topamax 200 mgs, Seroquel XR 300 mgs, Wellbutrin 300 mgs, Vistaril 50 mgs x4, Klonopin .5 mgs, Paxil, Zoloft, Effexor, Remeron, Elavil, Abilify, Lamictal, Geodon, Zyprexa, BuSpar, Xanax, Depakote, Trazodone, Ambien, Lithium, Risperdal, Doxepin,  Cogentin, Haldol, Saphris, Latuda, Neurontin, Lexapro.


#10 Beckett

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Posted 21 March 2012 - 06:51 AM

Thank you. That's important for me to know. Night time sedation is most welcome here.

Edited by Beckett, 21 March 2012 - 07:04 AM.

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All my lies are only wishes/
I know I would die if I could come back new.

--Wilco, "Ashes of American Flags"


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