Amitriptyline is the medication I am asked about most often.
I am not a medical professional and everything in this article is my own opinion. Please discuss your medication with your own doctor if you have any queries.
Although unlicensed for trigeminal neuralgia, this antidepressant is often prescribed as pain relief. I was told by the pain management clinic that it works best for type 2 pain, especially the crawling sensation I get in my cheek. I was on amitriptyline for around two years in total.
I’ve previously written about how to come off pain medication and how to prepare beforehand, but I’ve never actually spoke about how difficult it was to start taking amitriptyline. I found it more difficult than any medication I’d started on before. At the time, I didn’t think anything of it, because I was so desperate for the pain to stop, but looking back, I really put my body through a lot, all because of one tiny pill, in the hope it would end my pain.
I read about the side effects online and took absolutely nothing in, because I was so excited at the thought of the crawling feeling in my face stopping. Now, looking back over the side effects, I feel like some of them were definitely more prominent than others for me.
Amitriptyline can take around a month to start working, but the side effects can start straight away. Sometimes, it gets worse before it gets better. It can be really disheartening to start taking a drug, to feel absolutely none of the benefits and to get all of the side effects, but this is a really strong little medication.
You have to build up to a suitable dose. I didn’t feel any kind of pain relief from taking a lower dose. I increased my medication from 10mg, to 20mg, to 30mg and eventually settled on 40mg after several long weeks. Most people settle somewhere between 40mg and 70mg for trigeminal neuralgia.
Amitriptyline makes you really really tired. You are usually advised to take your dose before bedtime and getting the timings right was a skill I was very slow to pick up on. If you take it too early, you’ll be struggling to keep your eyes open during dinner, but if you take it too late your body might not know how to fall asleep without it (absolutely happened to me) and, more importantly, you won’t be able to get out of bed the next morning!
Amitriptyline can affect your vision. I remember taking my first 30mg dose and trying to focus my eyes on my boyfriend (now husband). I could see three of him and he took me straight to the walk in centre for a check over, at around 9pm one evening. It was a combination of the strength of the medication and also how tired I was from the increased dose.
You will feel hungry all the time. I gained what felt like a bottomless stomach. I could eat and eat. If I didn’t eat for a couple of hours, I’d feel sick with hunger.
You will probably gain weight. I gained about a stone and a half, which I found to be especially unfortunate as I am only 4’10.
Your mouth will be incredibly dry. I feel like I’m always talking about how to cope with the dry mouth side effect, but I think it was probably the worst side effect I’ve ever struggled with from a medication. It was so uncomfortable and I couldn’t forget it for a second.
Everything will be dry. Your eyes will feel dry. Your skin will feel dry. I dabbed my forehead with my towel after a bath and my skin actually bled.
You may be struggle to go to the toilet. I didn’t have this problem personally, but my body is completely adjusted to taking codeine, which commonly makes people quite constipated. However, amitriptyline can also cause difficulty urinating, so you should contact your doctor immediately if you can’t use the bathroom at all.
You will feel dizzy. I felt ridicously drunk whilst taking amitriptyline and this was the reason I eventually stopped taking it. I couldn’t speak properly, I knew I was slurring and I was ‘losing’ words. This really knocked my confidence.
Amitriptyline is one of the only medications that has actually worked for my pain, so despite all the bad bits, it’s a medication I stand behind and will go back to when I need relief.
The Pain Corner 
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