I’m dx RRMS since 2012 and have been on Amytriptyline for all that time moving from 25mg each night to 50 or 75mg. This is particularly for neuropathic pain as I have the hug permanently on the left side of my chest.
I follow Professor G who runs MS Selfie and he’s recently published an article about the dangers of long term Amytriptyline use. Here’s a link to the article Amitriptyline: the neurologist's dirty little secret
So before I raise this with my Neuro, Richard Nicholas, has anyone found a successful alternative for neuropathic pain.
Hi Adam
You’re absolutely right to be questioning the use of Amitriptyline. It was developed for treating migraines and depression - use in MS symptom alleviation doesn’t even get a mention. It has been around for many years and is pretty unsubtle in the way it acts upon the body. Since its introduction there have been many better alternatives but ironically, many neurologists have got into the habit of prescribing it.
For all the reasons Prof G gives in his article, pitch the question straight at your consultant and ask for an alternative. It belongs to a group of drugs such as nortriptyline, imipramine & duloxetine. Perhaps it’s time to try an alternative approach. This PainConcern article is quite informative.
Thanks for your suggestions.
Ive since had a further dose of Ocrevus and whilst there i was able to discuss my concerns with the Doctor, he has contacted my neurologist and theyve now written to my GP.
Initially they propose transitioning to Gabapentin.
Two friends with MS have suggested that Duloxetine is a better alternative.