Fatigue with Amiltryptaline and Solafenicin

My wife started on the SMART trial 2 months ago. To do so, she had to come off her SSRI (as fluoxetine is a studied SSRI in the study) and move onto Amiltryptaline, an ancient TCA for depression. At the same time, unfortunately, she went on to Vesicare (solafenicin ) for bladder problems. She finds it so much harder to wake up at the moment and we wonder if this is because she’s taking two drugs that cause drowsiness. Does anyone have experience of taking both of these drugs, or experience of either one leading to severe fatigue? She’s thinking it may be better to come of the trial and go onto fluoxetine instead of Vesicare. Especially as its one of the studied drugs anyway!


I take amitriptyline for nerve pain. I was prescribed 50mg and told to take it just before bed. This made me very tired the next morning so I started taking it around 6pm. This initially meant that my evenings were pretty sleepy but made me feel better in the mornings!

I have taken vesicare but don’t now and I used to take that in the evenings as well. I can’t remember that making any extra difference though.


I’m only on amitryptaline. Down to 30mg a day now, but the highest does I was on was 70mg. It makes me really drowsy, and seems to have a 12 hour effect, so if I take it at 10:30pm, I still feel drowsy until about 10:30am. I tend to take it at about 9pm now. I work full time, and start at 8:30, so it’s still a struggle getting up and getting to work, but not long before I ‘wake up’. I don’t like taking it too early, as I start to feel drowsy after about half an hour of taking it, and like to enjoy as much of my evenings as I can.

I have taken it for years now, and if I miss a dose because I remember just before going to bed that I haven’t taken it, I can’t get to sleep. Last night was a prime example. Finally drifted off at about 3am, and my alarm goes off at 6:30am. Should have just taken them at 10:30pm when I remembered, as I feel as groggy now as I would have done taking the ami’s late - but at least with the ami’s the groggy feeling would be gone by mid morning.

Thanks for the comments, it seems to me that timing is critical, perhaps its time to adjust when its taken to see if the fatigue peak can be managed somehow…