Amitryptiline - how long before it works on pain

Hi - can anyone advise on how quickly the drug should act on pain. I have been on it just over a month, originally on a very low dose to help with sleep problems, but now the dose has been increased to help with pain. As it makes me very sleepy I am still taking it only at bedtime and am on a dose of 50 mg for two weeks then I am to increase it to 75mg. My pain is during the day - it used to be just evenings but has gradually started coming on earlier each day and getting more severe. How quickly will the drug start to work - I know for depression they say it can take weeks to notice a difference - is it the same for pain. Must admit I am a bit sceptical that a drug taken once at night can impact day-time pain - but grateful if anyone can reassure me. Thanks

I would have thought that a month was more than enough to know if something was going to work, but I guess it depends on the dose and the level of pain (and the person).

A lot of people find that amitriptyline works really well for them and some of them only take it at night, but (again!) I guess it depends.

It completely knocked me out, which was good because I had bad insomnia and don’t work so it didn’t matter about sleeping in, but I developed side effects quite early on so had to come off it. I’m sure there must be others on here who have a lot more experience with it than me who can tell you more.

If it’s not working for you, it’s probably best to speak to your MS nurse and/or GP. There are plenty of alternatives that might be better for you. I moved onto pregabalin after amitriptyline and although the side effects in the first month weren’t very pleasant, it has worked wonders for me.

Karen x

I am also taking 50mg before bed… does make me a bit sleepy in the mornings… took me about 2 months really before it kicked in… but is working for me… having trouble with passing water, not sure if its the MS or these tablets… I have also put on weight, probably about 10lbs … which not happy about… but it is definitely working for me… my legs are not heavy, i’m not dragging my left leg, not having any pins or needles… Also got my sensations back… Hope it starts working for you soon… my dr was a bit reluctant to give me 50mg because she said it was quite high but my MS nurse said its not high for MS… Good luck

Everyone does react to drugs differently but it might be worthwhile telling your MS nurse that the pain is getting worse and over a longer period. Pregabalin or Gabapentin are often used for neuropathic pain.

I take a high dosage of Gabapentin three times a day plus Amitriptyline in the evening all to diminish the pain. It’s not completely controlled but allows me to live my life, any higher dose and I’d be incapable of doing anything !

Both pregabalin and gabapentin are started off very gradually, like Amitriptyline, and your body adjusts over time. The first couple of days I did feel really spaced out but it was such a relief to be out of pain.

Hope you’re able to get things sorted out for you

Take care,

Lisa x

Hi there,

I was taking it for spasms and codedrymal for pain, but when my pain went after a month of taking it, doc and I decided to use it for pain. The spasms are still there but the pain is a lot better than it was but I have been to the local pain clinic and had additional treatment ie Butrans patches, tai chi and Alexander Technique, all of which I highly recommend.

My MS nurse tells me that any dose higher than around 70ml, will not have a lot of affect on pain. I would go back to your GP and explain that the pain is still there and ask if there is anything else, or a referral to the pain clinic (if you have one).




In my case - never.