Amitriptyline and mirtazapine (together?)

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I have been taking amitriptyline for about 3 and half years at a dosage of 100mg. As this has not really done anything for my anxiety I decided to go back to my GP.

The plan was over a 2 week period of dropping down from 100mg to 50mg for the first week, then dropping from 50mg to ZERO. Then at this point I have been given 30mg of mirtazapine. This has been taken for exactly 2 weeks.

Since dropping amitriptyline to ZERO, I have not had a good nights sleep at all, in fact its been insomnia, so today I have gone back to my GP, so now they have said......

Stay on 30mg of mirtazapine as it will take 4 to 6 weeks for it to start working, which I am happy to do as I know it will take time for any medication to work, BUT now my GP is telling me to take 20mg of a mitriptyline alongside the mirtazapine.

The problem I have with this is that 3 other doctors have said that I cannot take the two medications together. On top of that they will not give me any sleeping tablets.

My head and body is all over the place at the moment, not sleeping is exhausting. My body is a mixture of aching and nausia and my head is all over the place........

Anyone on here had similar issues? I am convinced that the problem lies with dropping the Amitriptyline from such a high dose to ZERO in such a short space of time......can anyone offer any advice or help?

Thanks.

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  • Posted

    Hi Mounty,

    I can relate to your suffering and I'm so sorry you are going through this. I came off ami after only being on for several months at 25mg. After dropping to 10mg, I noticed two weeks later that my sleep was becoming fragmented in the later half of the night. Then I dropped to 0mg and basically have stopped sleeping. I sleep now 4 fragmented shallow dream filled hours a night. I wake up every 30-45 minutes and this has been going on for 5.5 months now.

    Your taper was MUCH too quick, especially for being on that long. It's terrible that doctors recommend these type of quick tapers. I wish I had known that mine was too, but figured that since I was on for such a short time it would be no big deal. I would highly recommend going back on a dose in which you can sleep and then tapering off in tiny increments and stabilizing there for several weeks before doing the next taper. If you wait too long to do this, reinistatement does not always take away the withdrawal symptoms. I tried to go back on after a month and it worked the first night, but not the next several nights. I reinstated too late. I also tried Remeron to help with the sleep, but it wouldn't work. From what I've read, the sedating effects of remeron should be immediate. The therapeutic effects for depression/anxiety take 4-6 weeks, but if you aren't sleeping on it now I doubt you will. Typically with withdrawal insomnia, additional medications do not help the withdrawal symptoms.

    I recommend joining the facebook group "amitriptyline takers," and/or "amitriptyline usage & withdrawal." There are some very knowledgeable people on there that can give some advice in how to properly taper this medication and it is a good support network. Another great forum is (survivingantidepressants.org). The moderators of the forum can give you great advice for tapering as well. It's truly unfortunate that so many doctors have no idea of the consequences that can ensue when a taper is done too quickly. Some people can come off of it quickly, but others can not. Wishing you the best of luck and I hope you feel better soon!

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    • Posted

      Thank you for the message Mary. I have joined a group on Facebook to get some real honest answers about amitriptyline. First impressions, I am shocked at a lot of the postings. It appears to be a very nasty drug to come off. I have lost all faith in my GP Surgery and had I known about all of these issues with withdrawal and coming off the meds, I would NEVER have taken them, or certainly for not as long as I have already done so.

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