Coming off of Amitriptyline

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I have been taking Amitriptyline 50mg for severe migraine and Escitalopram 20mg for the past 5 years.  My GP has decided this combination is not a good idea because of heart risks and I have been told to come off of the Amitriptyline.  Over the last month I have cut my dose of Amitriptyline from 50mg to 40mg and bang 2 very severe migraines.  Am at a loss of what to do as Amitriptyline is the only med that has ever helped my migraines has been marvellous and almost stopping them (of course there is the weight gain, fatigue etc). I am reticient to go back to 50mg because now I have the worry of QT wave heart effects from this combination of drugs.

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9 Replies

  • Posted

    Hello lorraine. Are you currently having any side effects from the combined medication? This happens occasionally when two drugs are prescribed but sometimes it's just a case of the GP carefully monitoring the patient. 
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    • Posted

      Hi Matron I have been having the usual side effects associated with Amitriptyline ie weight gain over 5 years, fatigue etc but have lived with these as life has been so much better for me with this combination.  However the GP suggested I came off of Amitriptyline because both Amitriptyline and Escitalopram have the capacity to interfer with QT waves on an ECG resulting rarely in sudden death.  In 2011 they found this was the case with Escitalopram apparently and the advice was to lower doses of Escitalopram if possible. 

      So in essence I am on 2 drugs with the rare potential of heart block and feel I cannot continue on both.  The GP and her pharmacist said there are no studies to show how dangerous this is but I could lower the doses. I am afraid they have no idea what they are doing and what level would be considered dangerous.  They have never monitored me and I am cross that they have had this knowledge in recent years and 2 surgeries have failed to tell me as apparently warnings would appear when they go to print off the prescriptions.

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    • Posted

      Yes it's really naughty of them not to tell you. Doctors in particular have a duty to discuss anything like this with you. Sounds though they are working in the dark and don't have the knowledge on how to manage it. Like the other posts mention, I would ask for a referral.
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  • Posted

    I would ask for a neurology referral - to come off Amitrityline (with good reason) you need something which can offer a similar level of cover. Obviously your gp will need to consider this.
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    • Posted

      Hi Liz,I have been under a Neurologist before had hormones, anti histamines, anti epiletic meds, tripans, Topamax etc and they did not work.  I actually came across the Amitriptyline by accident as I was prescribed Escitalopram for anxiety and found I woke every morning in the early hours and was given 50mg to counteract this and bingo it helped my migraines.
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    • Posted

      Hi Lorraine

      It soulds like you have had a wide range of treatments covering a variety of possible causes.  I am pleased you have found something which is of benefit.  You don't say how long you have been suffering.  There seems to be a vast  array of symptoms, lengths of suffering etc. reading all the blogs.   I don't much care what I have to take if it works.

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  • Posted

    Hi Lorraine

    It must be very frustrating for you!  When my migraine and vertigo became unbearable, 5 years ago, I was initially prescribed Imigran (nasal spray), Betahistamine Hydrochloride and Prochlorperazine Maleate.  These did not help with my symptoms and I was taken off them and put on Amitriptyline, this did not work either and I was prescribed Almotriptan.

    I've been on Almotriptan now for about 3 years.  Almotriptan is taken at the onset of a migraine.  I am only prescribed 6 tablets at any one time as it is dangerous to exceed the dose.  I have found that these do help with the migraine on most occasions but I still continue to be troubled with migraine.  I have regular chiropractic treatment, which helps a little with my symptoms.

    Do go back to your GP as to see what alternative treatment would be best suited to you.  I hope you will get the help you need. Good luck.

     

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  • Posted

    Hello, I read your post and I felt like I'd reply as I'm also in your shoes. I took nortriptyline which is a sister drug to amitriptyline nd my heart rate went up to 150 constantly. I'm now having a load of heart tests to check its not a underlying condition with my heart. Ive actually had less migraines whilst weaning myself off but increasingly dizzy sad 
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  • Posted

    Hi, Am even more confused today as my GP contacted a Psychiatrist (as of course both Amitriptyline and Escitalopram are antidepressants) to check out the dangers of the combination and the Psychiatrist said there is no problem with taking these 2 drugs together.  However, I checked on Gov.uk and they are indeed contraindicated together.

     

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