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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by g_g_g_unit on July 15, 2009, at 22:20:47
hey, i was given amitriptyline 10mg to help with sleep. i was just wondering if a) it has any positive effects on sleep architecture, and b) are anti-cholinergic s/e's present at such a low dose?
(i've tried nortriptyline for sleep, but it has absolutely no benefit in that respect).
Posted by Phillipa on July 15, 2009, at 23:41:18
In reply to TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 15, 2009, at 22:20:47
Pamelor l0mg with benzos slept and couldn't wake up the next day till 2pm. So it did affect mine. Phillipa
Posted by X-ray on July 16, 2009, at 4:02:15
In reply to TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 15, 2009, at 22:20:47
Hi,
Amitriptyline is a very good sleep-aid.
But 10 mg is an extremely low dosage.The normal dose would be 30-70 mg for sleep.
You can't get away from the bad side effects.Best regards,
X-rayP.S. I'm on amitriptyline and buspirone.
Posted by g_g_g_unit on July 16, 2009, at 5:21:40
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by X-ray on July 16, 2009, at 4:02:15
> Hi,
>
> Amitriptyline is a very good sleep-aid.
> But 10 mg is an extremely low dosage.
>
> The normal dose would be 30-70 mg for sleep.
> You can't get away from the bad side effects.
>
> Best regards,
> X-ray
>i took 10mg to sleep as a teen and it was almost too much. my doc said the ideal dose is that which presents *no* hangover effect. he said you can even go as low as 5mg. maybe i'm just sensitive?
anyway, since i'm having problems with getting deep sleep (not necessarily falling asleep) i'm curious about whether amitriptyline can assist that, or if it's just a sedative ..
> P.S. I'm on amitriptyline and buspirone.
Posted by SLS on July 16, 2009, at 6:02:00
In reply to TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 15, 2009, at 22:20:47
> hey, i was given amitriptyline 10mg to help with sleep. i was just wondering if a) it has any positive effects on sleep architecture, and b) are anti-cholinergic s/e's present at such a low dose?
>
> (i've tried nortriptyline for sleep, but it has absolutely no benefit in that respect).I never thought nortriptyline was good for sleep, except for the first few days perhaps. It can increase REM sleep latency as well as suppress REM later in sleep. Interestingly, people who are depressed often have reduced REM latency and increased REM sleep overall - just the opposite of the illness.
Trimipramine (Surmontil) is an interesting TCA. It actually improves sleep architecture. It is often given for more anxious depressions and sometimes as a sleep aid. Trimipramine isn't used very often. It is sort of the black sheep of TCAs. It doesn't inhibit the reuptake of norepinephrine or serotonin.
I don't think it helped me sleep. As far as side effects are concerned, I didn't find it as bad as imipramine and about the same as nortriptyline.
- Scott
Posted by SLS on July 16, 2009, at 6:17:13
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e » g_g_g_unit, posted by SLS on July 16, 2009, at 6:02:00
> I never thought nortriptyline was good for sleep, except for the first few days perhaps. It can increase REM sleep latency as well as suppress REM later in sleep. Interestingly, people who are depressed often have reduced REM latency and increased REM sleep overall - just the opposite of the illness.
I meant to say TCAs affect REM sleep in a way that is opposite to that seen in the illness.Some have proposed that this is one mechanism that can promote an antidepressant effect. In addition, it was once thought that anticholinergic activity was therapeutically important because it might help balance out the antagonistic relationship between dopamine and acetylcholine. I haven't seen these things mentioned much anymore.
- Scott
Posted by X-ray on July 16, 2009, at 6:31:44
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 16, 2009, at 5:21:40
Hi,
Amitriptyline will probably give you deep sleep.
I've been on mirtazapine for six months recently,
but now I have switched back to amitriptyline.I'm getting better quality of sleep on amitriptyline.
Why don't you try 30 mg?
Take the pills two hours before bedtime!Best regards,
X-ray
Posted by SLS on July 16, 2009, at 6:54:54
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by X-ray on July 16, 2009, at 6:31:44
> Hi,
>
> Amitriptyline will probably give you deep sleep.
>
> I've been on mirtazapine for six months recently,
> but now I have switched back to amitriptyline.I was very sensitive to the sedating effects of amitriptyline. It made me feel disgusting all day long. I was taking higher dosages that were targeting depression, though. I find it amazing that so many people report feeling okay during the day given my experience.
- Scott
Posted by X-ray on July 16, 2009, at 7:31:43
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by SLS on July 16, 2009, at 6:54:54
To Scott
I've hated this drug since 1973,
but I sleep well.X-ray
Posted by ColoradoSnowflake on July 16, 2009, at 13:39:04
In reply to Re: TCA's - sleep architecture / SLS, posted by X-ray on July 16, 2009, at 7:31:43
I take 12 1/2mg amytriptyline at night and I sleep really well! I am tired during the day but don't know if its that or the Parnate. I have no insomnia on 50mg/day Parnate and 200mg Provigil, but who knows? I do think only 12 1/2mg amytriptyline gives me a good quality sleep. (I take that amount because I halve a 25mg pill).My pdoc would really like me to take 25mg, but I don't need it. gayle
Posted by g_g_g_unit on July 17, 2009, at 0:25:39
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by SLS on July 16, 2009, at 6:54:54
since it was 6 years ago, i can't recall how it effected my daytime performance. i just don't want to take something that might increase sleep duration, but necessarily quality/depth. i might give 5/10mg a go and see how i fair. i don't see any reason to go higher than that since, like i say, 10mg reliably knocked me out in the past.
Posted by ColoradoSnowflake on July 17, 2009, at 9:31:04
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 17, 2009, at 0:25:39
I'd like to know how that works for you. Would you keep me posted.
Good luck. gayle
Posted by viper1431 on July 18, 2009, at 0:23:09
In reply to TCA's - sleep architecture / anti-cholinergic s/e, posted by g_g_g_unit on July 15, 2009, at 22:20:47
I was just given amitriptyline a couple days ago, i took the 10mg dose and slept for 12 hours (twice as long as i usually sleep) and then felt horrible for the rest of the day, i just didn't want to get out of bed.
I've gone back to clomipramine now, it's meant to be a lot less sedating acording to the chart my pdoc has but for some reason it actually knowcks me out to sleep faster than the amitriptyline and i only sleep about 8 hours with no hangover effects (i just about bounce out of bed when it's time to wake up)
Posted by ColoradoSnowflake on July 20, 2009, at 10:04:12
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by viper1431 on July 18, 2009, at 0:23:09
Hi viper:
Wow, that sounds like the kind of sleep I dream of!
Maybe it is the amytriptyline that is making me so tired every day.
I'm going to ask my pdoc about changing to another TCA, which is tricky on the Parnate. I'll ask about clomipramine as well as nortriptyline. He has never mentioned clomipramine as a choice?
Thanks for the info!
Gayle
Posted by SLS on July 20, 2009, at 12:03:20
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by ColoradoSnowflake on July 20, 2009, at 10:04:12
> Hi viper:
> Wow, that sounds like the kind of sleep I dream of!
> Maybe it is the amytriptyline that is making me so tired every day.
> I'm going to ask my pdoc about changing to another TCA, which is tricky on the Parnate. I'll ask about clomipramine as well as nortriptyline. He has never mentioned clomipramine as a choice?
> Thanks for the info!
> GayleClomipramine (Anafranil) is definitely one drug that you cannot take with Parnate. It is too potent of a serotonin reuptake inhibitor, and could cause serotonin syndrome. Nortriptyline is okay, and is not sedating.
- Scott
Posted by ColoradoSnowflake on July 20, 2009, at 13:50:12
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e, posted by SLS on July 20, 2009, at 12:03:20
Scott, do you think I could still sleep on Nortriptyline and off Elavil?
Thanks,
Gayle
Posted by SLS on July 20, 2009, at 14:31:50
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e » SLS, posted by ColoradoSnowflake on July 20, 2009, at 13:50:12
> Scott, do you think I could still sleep on Nortriptyline and off Elavil?
> Thanks,
> Gayle
It is hard to say. Nortriptyline is usually not activating. However, it is not known for having sleep promoting properties. When I first took it, I slept for two days. Now, it neither helps nor hurts my sleep. It seems to be neutral. I am taking 150mg.
- Scott
Posted by ColoradoSnowflake on July 21, 2009, at 14:52:09
In reply to Re: TCA's - sleep architecture / anti-cholinergic s/e » ColoradoSnowflake, posted by SLS on July 20, 2009, at 14:31:50
Hey Scott, that's not the answer I wanted!!
But I'm sure it's the factual one! Darn!
Thanks for responding. I appreciate it!!
Gayle
This is the end of the thread.
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