Amitriptyline for neuropathic pain

Please note this information should be read alongside any patient information provided by the manufacturer of the medication.

Amitriptyline for neuropathic pain

Amitriptyline belongs to a group of medicines used to treat neuropathic pain (pain caused by nerves not working normally.) Studies have shown that when prescribed at a low dose it can help relieve long term pain (chronic pain), particularly pain caused by irritation or inflammation of the nerves. In the past amitriptyline has been used to treat depression, but in higher doses.

How does amitriptyline work?

Amitriptyline works by changing the way the nerves send messages to the brain. When nerves are damaged or become irritated they are unable to transmit correct messages to the brain. Often nothing can be seen, but amitriptyline helps reduce and stabilize the number of faulty messages that the nerves are sending to the brain which results in reduced pain sensations.

These scrambled or altered messages to the brain can also affect your sleep and mood.

How long will it take to work?

It is important to remember that nerve pain often escalates or ‘winds up’ over time: it may take time for the nerves to reverse or ‘unwind’. You may need to continue treatment for several weeks before the benefits are felt.

When and how much amitriptyline should I take?

Your doctor will prescribe a suitable dose for you; the starting dose will be small and then increase over time to a beneficial amount. This helps the body get used to the medication. It is important to follow these instructions and take them regularly as this type of medication dose not work when taken on an as and when basis.

Why did I have an ECG (heart trace) before starting amitriptyline?

If you have an underlying heart condition amitriptyline may cause problems. By taking a trace of your heart (an ECG), we can tell amitriptyline will be safe for you.

What if I forget a dose?

If you miss a dose, take it as soon as you remember unless it is close to your next dose.

Do not double dose.

Are there any possible side effects?

Medicines are used to make you feel better, but sometimes they cause problems that we don’t want – side effects.

You may get some side effects when you first start taking amitriptyline. These usually settle down within a few days or so, as the body gets used to the medication.

The most common side effect is drowsiness. Often patients are less aware of this if they take the medication at night and it can be a welcomed side effect for some people, as many people who live with chronic pain have difficulty sleeping.

Other side effects include:

• Dry mouth
• Dizziness
• Nausea (feeling sick)
• Constipation

If you experience any side effects that worry you let your doctor or pain nurse know.

Can other common medications be given with amitriptyline?

Yes, you can take regular analgesics (pain killers), unless your doctor has told you otherwise.

Remember it is important to tell your doctor what medication you are taking including those bought without a prescription or herbal medicine. We will tell your GP that you have started this medication and of any changes to the dose.

Is there anything else I need to know?

Do not suddenly stop taking amitriptyline. Even though it is not addictive, if stopped suddenly you may experience some withdrawal symptoms.

Do not change the dose without getting advice from your doctor or pain nurse.

Make sure you have enough medicine. Order a new prescription from your GP at least 2 weeks before you run out.

Amitriptyline may make your skin more sensitive to sunlight, therefore wear sunscreen of a high factor, wear protective clothes and avoid direct sunlight.