Fibromyalgia Support Group

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Tricyclic antidepressant question

casey1231
casey1231

Hi all, I hope everyone had a nice Thanksgiving and is feeling well. I am a 50 year old female who has had fibro (along with anxiety) for many years. I’m very sensitive to medications and take very little. I’ve been on a low dose of Paxil (10 mg) for almost 20 years, it’s the only AD that helps with anxiety for me, I’ve tried to come off it but couldn’t tolerate discontinuation symptoms which were wretched, so I’ve stayed on. Going up in dose has side effects I hate so I haven’t done that either. Over the last year or two my fibro symptoms have greatly exacerbated, which I think is related to hormonal changes of perimenopause. My doc added on a low dose of nortriptyline (10 mg) a few months ago and I felt it really helped. However I had frequent dry mouth despite it being such a low dose. A few days ago he switched me to 10 mg of desipramine (also a tricyclic) and I’ve been feeling crappy with symptoms that feel like withdrawal including hot and cold flashes, nausea, headache, and pain everywhere. He thinks the desipramine may be weaker than the nortriptyline and I should go up to 20 mg tonight. The rationale for this switch is that desipramine has the lowest incidence of side effects of all the tricyclics. Does anyone have experience with any of the tricyclics or know anything about withdrawal and/or dose equivalency? I’m so miserable right now and I’m not sure what to do :-(

Miki26
Miki26
I briefly took nortriptyline for stomach pain several years ago, but stopped after a week due to increased IBS-C symptoms on it. I stopped without tapering but I was on a very low dose so I had no withdrawal effects from stopping that (I did have horrendous withdrawals after stopping fluoxetine and Wellbutrin when I started showing signs of serotonin syndrome, but obviously those are different classes of drugs). I take 50mg of Amitriptyline daily for fibro now, I think I started on 10 mg then increased to 25, then 50. After starting and each dose increase I was groggy for a few days but my body adjusted. I do get a little dry mouth from it, and my dreams are more vivid, but those are worth it because it does help with my pain. I don't know much about the differences in doses between drugs but your doctors advice makes sense. If what you're experiencing is withdrawal symptoms, they should only last a couple days. Good luck
casey1231
casey1231
Thank you for your response, hopefully this will subside soon, its so uncomfortable
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