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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Ginny on March 14, 2000, at 14:43:44
My doctor prescribed amitriptlyne for my headaches and it worked good at the 10 mg a day for a while and made me feel mentally better. Then came time to up the dosage to 20 mg a day. After a few days I noticed I was having heart palpitations every evening for hours on end. Only in the evenings though at first. It took several days to realize it must be the medication. At first I didn't know what was going on. So the Dr. took me off that and put me on Nortriptlyne. That didn't help my migraines and didn't give me the benefit of "perking me up". So, I tried the Amitr. again at 10 mg. again but with verapamil a high blood pressure med. I started having heart palpitations again. I've started taking topomax for the headaches. It's only been about 2 weeks so I can't really say if it's working for me yet or not. But I though that the amitriptlyne worked pretty good for my head and hate that I can't take it any more. And it was dirt cheap too. I MISS IT! Darn it. Has anyone else had this side effect? What did you do?
Posted by Cam W. on March 14, 2000, at 15:13:19
In reply to amitriptlyne heart palpitations, posted by Ginny on March 14, 2000, at 14:43:44
Ginny - Some people are sensitive to the cardiac side effects of amitriptyline. I have seen quite a few people have to stop it because of palpitations. This may be due to the amitriptyline blocking muscarinic/cholinergic receptors or alpha-1-adrenergic receptors. Give the Topamax a week or two more. Topamax has worked for a number of people on this board who suffer from migraines. If it doesn't work for you, maybe ask your doctor about low doses of propranolol. This has worked wonders in my mother-inlaw and one lady at my store who started to lose the feeling in her fingers and toes because of overuse of ergotamine-like antimigraine medication. It too is dirt cheap, but is not for everyone. Good luck - Cam W.
Posted by Scott L. Schofield on March 14, 2000, at 16:08:44
In reply to amitriptlyne heart palpitations, posted by Ginny on March 14, 2000, at 14:43:44
> My doctor prescribed amitriptlyne for my headaches and it worked good at the 10 mg a day for a while and made me feel mentally better. Then came time to up the dosage to 20 mg a day. After a few days I noticed I was having heart palpitations every evening for hours on end. Only in the evenings though at first. It took several days to realize it must be the medication. At first I didn't know what was going on. So the Dr. took me off that and put me on Nortriptlyne. That didn't help my migraines and didn't give me the benefit of "perking me up". So, I tried the Amitr. again at 10 mg. again but with verapamil a high blood pressure med. I started having heart palpitations again. I've started taking topomax for the headaches. It's only been about 2 weeks so I can't really say if it's working for me yet or not. But I though that the amitriptlyne worked pretty good for my head and hate that I can't take it any more. And it was dirt cheap too. I MISS IT! Darn it. Has anyone else had this side effect? What did you do?
I would not be so afraid of heart palpitations. They do not necessarily reflect a disturbance of heart function. 20mg is a very small dose. The palpitations may simply be the result of temporary changes in the balance of the “fight or flight” nervous system (dysautonomia). In otherwise healthy people, heart palpitations are commonly experienced in states of fear, anxiety, or panic.Do you suffer from depression in addition to the migraines? Does the fact that amitriptyline was “perking you up” indicate that it was acting as an antidepressant?
Some doctors have their patients take EKG tests when they are being treated with a tricyclic antidepressant (amitriptyline and nortriptyline). I think you should have one done while you are taking the 20mg to see if there are any abnormalities. If there are none, you may actually see them disappear at a higher dosage. In depression, the “fight or flight” stuff sometimes becomes exaggerated at a dosage that produces only a partial response - when you are sort of stuck in the middle. At least, this has been my experience.
Please be advised that any MD appearing after my name would stand for Manic Depressive, not Medical Doctor. You should judge this post accordingly.
Good luck. I’d be curious to know what happens.
Sincerely,
Scott
Posted by Sam on March 17, 2000, at 1:18:38
In reply to Re: amitriptlyne heart palpitations, posted by Scott L. Schofield on March 14, 2000, at 16:08:44
I had very troubling heart palpitations on tofranil. The palpitations made it difficult to do anything. My EKG came back abnormal. I discontinued the tofranil but the palpitations lingered on for a good while. If you use caffeine you should consider not using it. Also watch mixing your meds with alcohol, cold medications, etc.. Years later I tried Aventyl, another tricyclic, and didn't have problems with it. I have also noticed markedly different responses to AD's over time and in combinations with different medications. Maybe a different tricyclic would help your headaches, I am not familiar with this usage, Aventyl or Sinequan perhaps? I know palpitations can be quite distressing. Good luck.
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