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citalopram or amitryptilline
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adreno
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Amitriptyline has more side effects than citalopram, but you might get away with taking a low dose before bed. I would start with 5mg and see how you feel. Many find that only 10mg gives them wonderful sleep. I had the best sleep of my life on amitriptyline. Unfortunately the drug didn't agree with me, and I am now on an SSRI.
Citalopram is not the best SSRI to chose, if you want to take that route. In that case I would recommend escitalopram instead.
PokerPlayer
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I have taken both these drugs. I am much more sensitive now as I have gotten worse and I cannot tolerate either of them anymore.
However, they both helped a lot. Amitriptyline is definitely more gentle. I would say go for that, and start out at half a ten mg tablet per day. Then up it to 10mg, then up it to 20mg. I never could take more than 20mg amitriptyline without getting heart palpitations.
Citalopram could be a good drug, but it doesnt agree well with sensitive people. I would say request 10mg tablets of citalopram, and cut them in fourths to start out at 2.5mg, and up the dosage by 2.5mg every week until you get to 10mg.
Citalopram if tolerated is probably better long term at its highest tolerable dosage (20mg max). It can help gut function.
I would definitely stay away from escitalopram as it is about 3x the strength of citalopram, and it can cause problems for those who are medication sensitive, if I took even 2.5mg escitalopram my body would freak out.
However, they both helped a lot. Amitriptyline is definitely more gentle. I would say go for that, and start out at half a ten mg tablet per day. Then up it to 10mg, then up it to 20mg. I never could take more than 20mg amitriptyline without getting heart palpitations.
Citalopram could be a good drug, but it doesnt agree well with sensitive people. I would say request 10mg tablets of citalopram, and cut them in fourths to start out at 2.5mg, and up the dosage by 2.5mg every week until you get to 10mg.
Citalopram if tolerated is probably better long term at its highest tolerable dosage (20mg max). It can help gut function.
I would definitely stay away from escitalopram as it is about 3x the strength of citalopram, and it can cause problems for those who are medication sensitive, if I took even 2.5mg escitalopram my body would freak out.
thank you both for the info. i tried amitryptilline a couple of years ago but it did make me dizzy on lying down but it sems that is the gentler. will go for the very low dose to start. could itry them both together. ie .2.5mg of cotalopram to help with the appetite etc or is that too much both together?
adreno
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You could combine them, but I really don't see the point. I would definitely try each separately.
heapsreal
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amitriptyline i vote for too, also look into doxepin, similar drug to amitriptyline but i found better for sleep, can give u a hangover at first.
good luck.
good luck.
taniaaust1
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I strongly advise not to start taking them together as if you get a bad reaction you wont know which is doing it.
I had this doctor who believed ME/CFS was all psychological who put me onto citalopram at one point. It caused me bad side effects so my trial only lasted 3 days ... I would of stopped it after the first day had the new boyfriend at that time who then listened to that doctor, had not kept on making me try to take it.
I dont seem to do well at all on any of the SSRI drugs, those who have ME can have a lot of trouble with that drug family and are often better off with other drugs.
I had this doctor who believed ME/CFS was all psychological who put me onto citalopram at one point. It caused me bad side effects so my trial only lasted 3 days ... I would of stopped it after the first day had the new boyfriend at that time who then listened to that doctor, had not kept on making me try to take it.
I dont seem to do well at all on any of the SSRI drugs, those who have ME can have a lot of trouble with that drug family and are often better off with other drugs.
heapsreal
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I would just stay with the amitriptyline, citalopram type antidepressants can actually be stimulating at first and most with cfs/me havent found them helpful. Also what can makes us very stressed is lack of quality sleep, once u get that you will feel alot better, amitriptyline could help improve sleep and therefore handle stress better. Many start with a low dose of 10mg and increase in 10mg increments until it helps with sleep, much lower doses are needed for sleep then for depression though. You might also benefit from a sleeping tablet but first see how u go on amitrip. Also u might be helped by finding an intergrative doctor or another doc who has an interest and proper understanding of cfs/me that way u can get the right treatment to help ease symptoms.
Dont stress just take the amitrip an hour before u want to go to sleep. reassess everything after a good nights sleep.
take care,
cheers!!!
snowathlete
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I have taken both of these drugs.
Before i was diagnosed with ME/CFS i was working fully time, living full time and went to my doctor struggling to cope all the demands (in hindsight - not surprising) she prescribed 20mg of Citalopram, which over the next year went up to 40mg.
It did work, to some degree. It made me feel quite emotionally numb. This brings its own problems, but it did help me.
Then after being diagnosed with ME/CFS and having a sleep study, the sleep doctor listed three drugs to try to improve my sleep. All she said, worked well with people with ME.
The first she suggested was Amitryptaline and starting at 10mg and rising to 20mg later. It came with a warning. That was that in the first instance, the first two weeks i would feel awful on it, and that most people discard the drug in this period thinking that it doesnt work for them but makes them worse.
She explained that this was normal, and you should presevere because after two weeks the side effects disappear and then you get the benefit.
She was spot on.
The first week was dreadful, i spent all of it on the sofa. I would have given up had she not prepared me first. The second week was also not good. After that though, the side effects vanished. The only thing that i am left with is a slightly dry mouth, and a fast beating heart (i.e. 100 at rest) and its a little punchy five minutes after taking the tablets at night. This is all minor though, especially when balanced against the benefit.
I now sleep REALLY well. I wish i knew about this drug a decade ago. Maybe then i wouldnt have got ME/CFS as im sure this contributed to wearing me down.
Personally, i cannot recomend the drug enough for sleep. Doseage wise, for depression alot more is given, and high doses are also given to children and its widely used...so i figure that its pretty safe.
Two months ago i decided to come off the citalopram, firstly because i wanted to take less pills, second because of the cost (although on prescription, the additional 7.40 every other month is hard to find right now), thirdly because i read about long term use of SSRIs being nto good for you, and fourthly because i felt ready to deal with coming off it. I did it VERY slowly, and finished coming off it about three weeks ago. I feel no different - no worse - so thats a result.
So both are widely used, and can benefit you, especially the amitryptaline, in my experience. Both can be taken together so long dosage is set properly, but i agree with other posters that its best to start one at a time. They both effectively increase the seratonin in your brain, Citalopram by stopping the seratonin you produce naturally, from being broken down, instead it is taken back up (this probably isnt the best explaination, you might want your doctor to explain it better) and Amitryptaline works in a different way that i dont remember as well.
Personally, I would recomend Amytriptaline for EVERYONE with ME/CFS who has sleep problems. Of course, some people with ME/CFS dont tollerate any drugs well, but if you are going to try any, i would try this for two weeks if you possibly can, as the side effect to benefit ratio is hugely in favour of the benefit in most people who take the drug.
Hope that helps.
Before i was diagnosed with ME/CFS i was working fully time, living full time and went to my doctor struggling to cope all the demands (in hindsight - not surprising) she prescribed 20mg of Citalopram, which over the next year went up to 40mg.
It did work, to some degree. It made me feel quite emotionally numb. This brings its own problems, but it did help me.
Then after being diagnosed with ME/CFS and having a sleep study, the sleep doctor listed three drugs to try to improve my sleep. All she said, worked well with people with ME.
The first she suggested was Amitryptaline and starting at 10mg and rising to 20mg later. It came with a warning. That was that in the first instance, the first two weeks i would feel awful on it, and that most people discard the drug in this period thinking that it doesnt work for them but makes them worse.
She explained that this was normal, and you should presevere because after two weeks the side effects disappear and then you get the benefit.
She was spot on.
The first week was dreadful, i spent all of it on the sofa. I would have given up had she not prepared me first. The second week was also not good. After that though, the side effects vanished. The only thing that i am left with is a slightly dry mouth, and a fast beating heart (i.e. 100 at rest) and its a little punchy five minutes after taking the tablets at night. This is all minor though, especially when balanced against the benefit.
I now sleep REALLY well. I wish i knew about this drug a decade ago. Maybe then i wouldnt have got ME/CFS as im sure this contributed to wearing me down.
Personally, i cannot recomend the drug enough for sleep. Doseage wise, for depression alot more is given, and high doses are also given to children and its widely used...so i figure that its pretty safe.
Two months ago i decided to come off the citalopram, firstly because i wanted to take less pills, second because of the cost (although on prescription, the additional 7.40 every other month is hard to find right now), thirdly because i read about long term use of SSRIs being nto good for you, and fourthly because i felt ready to deal with coming off it. I did it VERY slowly, and finished coming off it about three weeks ago. I feel no different - no worse - so thats a result.
So both are widely used, and can benefit you, especially the amitryptaline, in my experience. Both can be taken together so long dosage is set properly, but i agree with other posters that its best to start one at a time. They both effectively increase the seratonin in your brain, Citalopram by stopping the seratonin you produce naturally, from being broken down, instead it is taken back up (this probably isnt the best explaination, you might want your doctor to explain it better) and Amitryptaline works in a different way that i dont remember as well.
Personally, I would recomend Amytriptaline for EVERYONE with ME/CFS who has sleep problems. Of course, some people with ME/CFS dont tollerate any drugs well, but if you are going to try any, i would try this for two weeks if you possibly can, as the side effect to benefit ratio is hugely in favour of the benefit in most people who take the drug.
Hope that helps.
Hi, of cpourse these are just our own anecdotal experiences, but just to add mine to the pot. I had a VERY severe reaction to citlaporam after only one dose - severe confusion, severe agitation, unable to be alone, couldnt understand where i was or what was happening to me. My doctor convinced me to take the 2nd dose, which was a big mistake - it made me suicidal (i had been fine up to this point, judst a bit anxious) i didnt take any more but it threw me into a hellish state of severe anxiety and suicidal ideation, agitation , couldnt sleep, severe hypoglcaemia, almsot a complete disolving of my self which took me over a year to even begin to recover from. The agitation and anxiety that it cause took me two years to heal from fully.
I would never touch another SSRI again as long as i live, even though i had taken them in the past with no problems at all.
I know a lot of people who take Amitryptiline for pain and sleep at very low doses and it seems to help them. I have to agree with the poster who said it might be a good idea to find an integrative doctor - that has helped me the most - supplements, pacing, help with sleep etc from someone more holistic an dunderstanding of M.E than a regular GP (i see Dr Myhill in the U.K who has a great website that you can check out with lots of info about CFS/M.E)
Take care, Justy.
I would never touch another SSRI again as long as i live, even though i had taken them in the past with no problems at all.
I know a lot of people who take Amitryptiline for pain and sleep at very low doses and it seems to help them. I have to agree with the poster who said it might be a good idea to find an integrative doctor - that has helped me the most - supplements, pacing, help with sleep etc from someone more holistic an dunderstanding of M.E than a regular GP (i see Dr Myhill in the U.K who has a great website that you can check out with lots of info about CFS/M.E)
Take care, Justy.
oh that was so helpful. i started exaclty the same way as you, im trying the citalopram first, i/4 to start. a low dose. unfortunately i have been lumped in the `it pschological basket~but ive decide to go with the flow and try anyhting now as the cfs is very bad.
many thanks for explaining it so well
many thanks for explaining it so well
Hi. I agree about Dr Myhill. I am a brit living in NZ and so wish i was back home as the medics here thinkk cfs is all inyour mind. many drs have made me cry over this approach as mine started with campylobacter. i was perfectly well til then. Dr Myhill e mailed her book.my dr has convinced me to tryt 1/4 citalopram to start as i have had a bad reactio to amiytrp in the past. I had the same reaction as you when i took prozac 5 years ago out of desperation. i do think tho that anyone who has along trn illness like cfs or any other for that matter will eventually have to succumb to some intervention as it does wea r you down emotionally however strong you were to start with and i dont want to fight with my emotions anymore really as its not helping.
take care
take care