Confused (again)

I’ve read on here several posts about taking painkillers for nerve pain that also act as anti-depressants; that is what I am looking for.

I am currently on anti-depressants which are not helping now and need a painkiller for neuropathic pain; I thought it would be logical to take one medication for both things. However, I telephoned MS Nurse on Monday and she said I would probably have to take 2 separate meds as the painkillers would not be at a high enough dose to also be effective as antidepressants - I’m assuming she must know what she is talking about but… is this correct?

If anyone has experience of using neuropathic painkillers in this way I’d be interested to hear from you.

amitryptiline is used for nerve pain and is primarily used to treat anxiety.

talk to your pharmacist, they are the experts.

Amitriptyline is as Carole said, used for certain types of nerve pain. Most frequently the burning, tingling type of pain. It can also be prescribed as an antidepressant. However, the dose used for antidepressant use would be quite high, and were you to take it in the daytime (as most antidepressants are I think), you might end up a bit ‘zombified’.

Most people who take Amitriptyline for nerve pain take it in the evening, so any untoward ‘hangover’ type side effects have worn off by the morning.

For this reason, I doubt that it would do the double job you’re looking for. And I imagine this would be what your MS nurse is talking about.

I don’t know of any other drugs that might work for both MS pain and as an antidepressant. But someone else might.

You might have to start taking a drug for pain, depending on what kind of pain you experience, and then once you’ve got used to the effects of that drug, change antidepressants. Or vice versa, whichever seems more urgent.

Or, of course, as Carole also said, talk to a pharmacist. (My view shouldn’t be taken as absolute truth, it’s what I believe to be true, but check it out with your MS nurse, neurologist or pharmacist.)


MS Nurse mentioned Pregabalin for the neuropathic pain. For some reason I stupidly thought she would be able to write a prescription there and then, but no, I have to see my doctor (to discuss the antidepressants and whether they need tweaking / changing).

Just make an appointment to discuss with your GP what your MS nurse has suggested together with your symptoms and pain. See what s/he says. Probably the best bet would be to start taking a low dose of Pregabalin to see if it helps with the pain, while leaving your antidepressant exactly as it is.

Try keeping a written record of how the drugs are making you feel, effects on pain and any side effects. That way you’ve got something definite to take to a follow up appointment.

MS, and neuropathic pain are an absolute minefield. Any changes you make with drugs should be done one at a time and slowly. Otherwise you don’t have a clue what is doing which job / producing which side effect.

Best of luck.