My mother, who does not have ME/CFS but suffers from insomnia, finds amitriptyline 10 mg great for sleep, but she says the downside it that it makes her feel depressed for the first few hours after getting up in the morning. Apart from that side effect, it works well for her insomnia, and does not have the tolerance and addiction properties of benzodiazepines or Z-drugs.
I sometimes use amitriptyline or imipramine (imipramine is another tricyclic antidepressant with lower side effects than amitriptyline) for my comorbid depression. It does help a little, but I find it kind of only makes half of my brain happy, and the other half remains depressed. More specifically, I find amitriptyline seems to make the perception part of my mind happy (the part of my mind that processes immediate sensory perception), but the more reflective part of my mind remains depressed. It's hard to describe, but it is not a balanced mood boost, but a skewed one, which feels odd, especially if I take higher doses.
So what I end up doing is just taking very low doses of amitriptyline, typically a quarter or an eighth of a 10 mg tablet.
I have not yet found an antidepressant that works for my comorbid depression.
Note that tricyclic antidepressants may reduce
vitamin B2:
Source:
1.
Taking
vitamin B6 with tricyclic antidepressants may improve their effectiveness:
Source:
1
Taking N-acetyl-cysteine with imipramine improves its effectiveness (so that you can reduce its dose):
Interactive effects of N-acetylcysteine and antidepressants
For sleep purposes, apparently amitriptyline is taken 5 hours before going to bed:
“A Prescription For Sleep”: Sleep Drugs For CFS and FM
I find the supplement
pyrroloquinoline quinone (PQQ) 20 mg before bed effective for deepening sleep, and making sleep more restful, but I find for me PQQ does make my dreams very slightly more vivid / disturbed.
This study found that PQQ helped fatigue, tension-anxiety, depression, anger-hostility and confusion, appetite,
sleep, obsession and pain, with the full effect appearing after 8 weeks supplementing daily with 20 mg of PQQ.