How effective is amitriptyline for neuropathy?

Those taking amitriptyline may experience extreme drowsiness for the first few weeks.

Amitriptyline is an effective treatment for peripheral neuropathy, especially diabetic and post-herpetic neuropathy. The most common treatment is to prescribe a tricyclic antidepressant (TCA) such as amitriptyline for neuropathy, as it has been proven in several studies to be effective in relieving pain in at least 75% of treated patients. Although amitriptyline is considered a TCA, it is prescribed for many conditions other than depression, including chronic pain relief because of its analgesic effects.

Amitriptyline is also marketed and sold under the brand name Elavil.

Neuropathy refers to a disorder or misfire of the nerves, often leading to painful symptoms. Many diseases and conditions can cause neuropathy, including diabetes, shingles, and cancer drug therapy. Some other causes of neuropathy include autoimmune diseases, vitamin deficiencies, and acquired immunodeficiency syndrome (AIDS). Since some types of neuropathic pain do not indicate actual tissue damage, only malfunctioning nerves, the doctor’s primary concern is to treat and relieve the patient’s pain. This can be done through the use of antidepressants, opiates, or anticonvulsant medications.

Weight gain may cause some patients to stop taking amitriptyline for neuropathy.

Doctors prescribe TCA amitriptyline for neuropathy because it acts as a noradrenergic and serotonergic reuptake inhibitor. Simply put, amitriptyline stops certain “nice” neurotransmitters in the brain from being reabsorbed into cells. This causes blood levels of neurotransmitters to remain higher than they would otherwise, resulting in an elevation of mood and cessation of pain.

Amitriptyline is a tricyclic antidepressant.

Some patients have problems with side effects when taking amitriptyline for neuropathy. Some of the more common side effects include extreme drowsiness, dry mouth, and weight gain. Although some side effects, such as drowsiness, subside over time, weight gain and ongoing problems with concentration or memory sometimes cause patients to stop taking their medication. In cases where the side effects are very severe, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may be substituted by the doctor. SSRIs and other medications can help relieve pain, but they may not be as effective as amitriptyline for neuropathy, although their side effects may be better tolerated.

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SSRIs, often prescribed for depression, can be used to treat neuropathy.

Other TCAs work as well as amitriptyline for neuropathy but have similar side effects because they use similar mechanisms to relieve pain. Some of the side effects of amitriptyline can be beneficial for the patient, especially if he is suffering from insomnia, anxiety, or headaches. This medication is an effective treatment for all these conditions.

Some doctors may increase the effectiveness of amitriptyline by prescribing complementary therapies such as transcutaneous electrical nerve stimulation (TENS), biofeedback, and acupuncture. While most complementary therapies have not been studied specifically for neuropathy relief, one study has shown that TENS helps relieve neuropathic pain in up to 80% of patients. When used in conjunction with amitriptyline, this percentage increases slightly to 85%.

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