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Re: Switch from amitrip to noritrip due to poop out? Jaxter99

Posted by ed_uk2010 on March 4, 2018, at 2:32:05

In reply to Re: Switch from amitrip to noritrip due to poop out? ed_uk2010, posted by Jaxter99 on March 4, 2018, at 1:33:39

>Hydroxyzine hydrochloride (Atarax)
>Which cause drowsiness but I guess I could take if I stopped the amitriptyline.

True, a few antihistamines have been tried in IC, but mainly hydroxyzine. Also, among its many other actions in the body, amitriptyline is an antihistamine. Amitriptyline does a lot of different things!

Would you rather stop amitriptyline or take something alongside it?

It is (now) not recommended to take hydroxyzine with amitriptyline due to occasional effects on the heart rhythm (if the QT interval is prolonged), so it would be something to take instead rather than together. I think that's particularly relevant to you because you already take a medication which can increase amitriptyline levels (paroxetine).

In general, if someone has become used to taking one drug with a sedative antihistamine effect, like amitriptyline, other potentially sedating antihistamine such as hydroxyzine do not cause much drowsiness. This is because the brain adapts to the effects of histamine receptors being blocked. Because amitriptyline can causes drowsiness through multiple mechanisms, rather than just blocking histamine, I would expect hydroxyzine to cause you milder drowsiness than amitriptyline.

One thing you could take in combination with amitriptyline is a non-sedating antihistamine. Cetirizine (eg. Zyrtec) was suggested in an article I looked at.

Treatment Approaches for Interstitial Cystitis: Multimodality Therapy
Robert J Evans, MD

'In patients who cannot tolerate a sedating antihistamine, cetirizine hydrochloride may be a reasonable alternative.'

Cetirizine was discovered because it is the main metabolite of hydroxyzine (ie. hydroxyzine is converted to cetirizine by the liver). In contrast to hydroxyzine, cetirizine causes much less drowsiness and does not affect the heart. As a result of its improved safety, cetirizine is available as a non-prescription medication in most countries, for allergies etc.

>I've heard of Gabapentin as well - but I read something about that it could cause depression which would be terrible for me?

Like other epilepsy medications, gabapentin comes with a depression warning. I would not say it's a common side effect though.

When used to treat chronic pain, gabapentin can be used with or without amitriptyline. There isn't any specific interaction, but taking them together may cause more drowsiness than alone.

Gabapentin has also been used as a treatment for anxiety, for which it is something effective.

If it's necessary to stop treatment with gabapentin, it should be done gradually to avoid unpleasant symptoms.

> I've heard of Gabapentin as well - but I read something about that it could cause depression which would be terrible for me?
> And botox! But obviously that's injected :)




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