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Amitriptyline and fluoxetine (prozac) treatment

Discussion in 'General Treatment' started by cosmo, May 22, 2013.

  1. cosmo

    cosmo

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    Hi.

    I was wondering if anyone is using/has used this combo of drugs to treat their cfs/me.

    I have seen it suggested in my ongoing research but wondered if anyone had first hand experience.
  2. xks201

    xks201 Senior Member

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    Amytryptaline maybe in a low dose like 10-25 mgs. Not sure if it is the end all be all though. Prozac and the SSRIs are just fatiguing in my experience. TCAs are more broad acting on more than just serotonin - which is why they are probably a better choice. Even the SNRIs I found sedating.
  3. Lotus97

    Lotus97 Senior Member

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    I used to be able to take Prozac and other SSRIs at bed time and it didn't interfere with my sleep. For the past few years, SSRIs have had a very stimulating effect on me. Anxiety/insomnia is not that uncommon as one would think as far as SSRIs go (especially Prozac). I've read accounts of people with bipolar disorder for whom Prozac has triggered manic episodes.

    Amitriptyline/Elavil isn't that great of an antidepressant by itself. It's mostly used as a sleep aid. Coincidentally, I'm taking Prozac for depression and Elavil for sleep at the moment. I could see Elavil being used for anxiety during the daytime or even augment another antidepressant, but it would be likely to cause drowsiness for some people. Amitriptyline does have SNRI qualities and I've heard of it causing a stimulating effect with some people.
  4. snowathlete

    snowathlete

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    I take Amitriptyline for sleep as well. For me it made a huge difference to my sleep. Huge. But the first couple of weeks are rough going and it doesnt work for everyone.
  5. Lotus97

    Lotus97 Senior Member

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    I was taking amitrityline and Risperdal for over a year. I slept at least 10-11 hours a night and made one of my biggest recoveries during that period. I gained 30 lbs and high cholesterol during that period due to the Risperdal so I wouldn't necessarily recommend that combo, but it does show how big a factor sleep is in treating this illness (at least for some people).
    snowathlete likes this.
  6. ukxmrv

    ukxmrv Senior Member

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    Amitrip gave me severe gut problems. I didn't help my sleep or pain. In the mornings I was like a zombie and as time went on it just got worse and worse. We tried different doses but at the end I was far worse off than when I started. Prozac left me feeling poisoned and also fuzzyheaded. On both my blood pressure went lower and I had more POTS / fainting.

    Thought that there has been some research showing high serotonin in PWCFS but I've not been able to find it again.

    What research have you seen that would indicate that this combo would be helpful?
  7. Valentijn

    Valentijn Activity Level: 3

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    Might be a very bad idea. Both Amitryptyline and prozac are capable of contributing to Serotonin Syndrome.
  8. cosmo

    cosmo

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    One or two specialists use this combo and it was suggested I start it.

    I am weary as I have severe stomach trouble anyway and I feel very dizzy and groggy on meds such as these.

    I also get urinary trouble, which I hear can be made worse on ami.
  9. taniaaust1

    taniaaust1 Senior Member

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    There is one person at this website who ended up with a permanent damaged bladder due to Amitrip (frozen bladder where they no longer can go naturally), there are two people at this website who have permanent gut/stomach issues after Amitrip (we recently were talking about it on another thread). That drug taking just a short term, low dose trial of it in my case permanently damaged my bowel (prolapsed it to the point in which I almost needed surgery). One of the physiological effects of this drug is it slows down bowel peristalsis so affects muscle function in that area.. I assume that's what it did also to the one who got her bladder permanently damaged from it).

    All of us who got these permanent issues from this drug were those who have ME (rather then general CFS). If I had to say what is the most dangerous drug for a ME person I'd say this drug as it can be permanent and doctors cant fix the issues it leaves. If you fit Canadian defined CFS or the international consensus ME defination.. Id say certainly avoid it, its shown too much risk.. there would be safer drugs around which you could try.

    This is the only drug which has given me permanent damage.
  10. Lotus97

    Lotus97 Senior Member

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    I think a higher dose of Prozac is more likely to cause problems than a lower dose of Prozac combined with amitriptyline. I don't have any studies to back this up, but I don't think there's any studies suggesting otherwise either. SSRIs are much more of a heavy hitter compared to TCAs (in my opinion).
  11. cosmo

    cosmo

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    Oh god, that sounds awful. I'm so sorry.

    I really am weary of this drug as I don't like some of the effects.

    Do you have a link for where it was discussed before please? Thanks.
  12. cosmo

    cosmo

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    Also how do you know if you have cfs (canadian) or me?
    Thanks.
  13. Lotus97

    Lotus97 Senior Member

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  14. taniaaust1

    taniaaust1 Senior Member

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  15. taniaaust1

    taniaaust1 Senior Member

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    http://sacfs.asn.au/download/consensus_overview_me_cfs.pdf That is the Canadian consensus document overview which has the diagnostic criteria in it. (scroll down, several pages or so till you get to the page heading (it stands out) "Clinical working case definition of ME/CFS". If you fit this you probably will fit the international ME defintion as they are quite similar..
  16. Hip

    Hip Senior Member

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    If you want to try a tricyclic antidepressant (TCA), you may want to consider imipramine rather than amitriptyline. Both are TCAs, but imipramine is better tolerated and has a lower incidence of side effects.

    I used to take imipramine on days or weeks when I had depression. However, now I use the drug amisulpride off label as an antidepressant, and I find it is excellent. Amisulpride gives me a more natural feeling mood boost (I find the TCA antidepressant effects a bit of an artificial feeling). I take just 12.5 mg of amisulpride daily. Amisulpride also noticeably improves the sound sensitivity symptoms of ME/CFS, which is a great boon.
  17. Lotus97

    Lotus97 Senior Member

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    Wikipedia says amisulpride isn't approved by the FDA in the United States.
  18. Hip

    Hip Senior Member

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    It isn't, but you can legally buy it from the usual overseas pharmacies, like this one, where I get mine.

    You can read my musings on this nice ittle drug here:

    Amisulpride — A Multipurpose Drug for ME/CFS
  19. ukxmrv

    ukxmrv Senior Member

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    Cosmo, personally I would be worried about your doctor(s) if all they were offering to prescribe was a combo of antidepressants.
  20. cosmo

    cosmo

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    Thank you, tbh I am.

    The thing is, is that if I disagree it will seem as though I think I know better then a 'specialist' in the area.
    However I am really worried for the rest of my body as I already have severe bowel problems and uti's.

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