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Re: Depakote, amitriptyline, pain and sleep » Elizabeth

Posted by Chloe on February 7, 2002, at 18:52:44

In reply to Re: Depakote, amitriptyline, and sleep » Chloe, posted by Elizabeth on February 7, 2002, at 16:02:35

> > I wonder if you know anything about Depakote affecting REM sleep. I started amitriptyline for neuropathic pain and sleep about a month ago.
>
> Yeah, lots of people say amitriptyline helps with sleep, including sleep continuity.
>
> > For the first time in years I was sleeping 8 hours without interuption. It was so great! But my days were filled with agitation and rage (too much AD, caused rapid cycling)..
>
> Unfortunately, TCAs are among the worst ADs for bipolar folks (usually)! They tend to cause a lot of rapid-cycling dysphoric mania or hypomania, not the happy kind.
>
> > So depakote was added. Since the second dose of dep, I have had this dreamy, very light sleep. I sleep for an hour or so and then wake up and have trouble falling back. AND I am still taking the amitrip., but only 10 mgs...
>
> I don't know why Depakote would do that to you. I don't think it's a REM sleep enhancer, and many people find it sedating. Since it's a GABAergic drug, I would expect it to suppress REM sleep if anything. There are many other possible causes of sleep disruptions and fragmented sleep. Unless you're recalling vivid dreams, I doubt that REM increase is to blame.
>
> It sounds to me like you need a different sleep aid, I'm sorry to say! Rapid-cycling and dysphoria are serious side effects, and there are plenty of options for sleep besides amitriptyline.
>
> best,
> -elizabeth

Hi Elizabeth,
Thanks for responding. Normally I would never continue on a TCA, as I have found that extremely small doses are extremely destabilizing to me. But the *primary* reason I was put on amitriptyline was to help with a neuropathic scalp burning. I have developed this while continuely being on mood stabilizers (mainly lithium, trileptal, perhaps neurontin) that have severely dried out my skin and hair. Now my skin and hair gets upset with any mood stabilizer I put in me. Even one's like depakote, where I never had any skin problems with when I took it in the past. I have this constant burning, mostly on my scalp where my hair follicles feel like they are on fire. It is very distracting...And of course I hardly ever brush my hair now, and it hurts to lie down on a pillow. So the added sleep benefit of amitrip was so nice. Because my "aching hair" wouldn't wake me up!

Anyway, my question is, is there any other class of meds, or a "better" AD that can help with neuropathic pain and sleep?

Many thanks
Chloe


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poster:Chloe thread:92585
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