The need to take ever-increasing dosage of Amitryptiline

Four months ago I started to take Amitriptyline to combat anxiety attacks, mainly occurring at night and causing insomnia.
Dosage is the minimum 10mg. Initially the effects were excellent,but gradually my sleep is becoming more disturbed and it seems as if I may have to move up to 25mg to achieve the same effect as that achieved at the beginning.

My question is this: Is there a danger that I will progressively have to take ever-increasing dosages for the drug to be effective;or will things level out at some level? Presumably the higher the dosage, the more difficult it will be to reduce dependency.But should one try to reduce dependency, or, if a plateau dosage(?) can be reached, is it reasonable to simply continue at that level indefinitely?

Hope you can help.

[Roger Gould, M.D.]

Yes you can expect to reach a plateau and not constantly go up in dosage.  Also, there are many medications to choose from if the dosage  increase doesn't do the job.

In addition, you should look at the cause of anxiety. You can do that with a therapist or our online program at www. masteringstress.com.

[Skizo]

Amitryptline is not in the first line for treating anxiety attacks, although is given in low doses sometimes for insomnia and chronic pain.

The dose you are taking is very low, in the old times 300 mg daily was not uncommon. You might need 50 mg or more.

This medication is not addictive but can be very toxic, one of the reason that is now seldom used.

[lucylucy]

Hi there
I don't know what that drug it is you are taking.. but i found that initially when I started taking my drug of choice, paxil.. for anxiety... that I had to increase the dosage until i found a dosage that kept me in good mental condition long term...  My psychiatrist told me that I would level out on a dosage that was right for me, and he was correct in my instance.  Interestingly.. over the last few months, I have been able to slowly reduce my dosage again, and a smaller dosage is helping.  Therfore, I would not be too concerned that you will have to keep upping the dosage forever.  It may just mean that u have to increase your dosage until u find the right level for your system.

good luck
Peggy

[Kelp]

I took amitriptaline for a very short period of time because of side effects. This varies of cource from person to person. It is known to be the most sedative of the anti depresants. It is a very old medication getting close to about 40 since being on the market. Known side affects I expeirienced were, very dry mouth. Heart palpitations when excercising. dizzines when getting out of bed or a chair. Weight gain is also a common side affect. THis medication belongs to the group tryciclics. (first developed anti-depresentdrugs) I would ask your doctor about some of the SSRI group which are much more modern and have less side affects. I take luvox. I experiece no side affects at all now. Most disapear in about 3 months.
Kelp

[frecklesag29]

I was prescribed 100mg of amitryptiline for insomnia.  I took it one night and was numb for almost 2 days.  I said no way.  I now take Effexor and trazodone (50mg).  The two are working very well.  The trazodone be itself wasn't working so well.  I would have to take more and deal with the side effects.

[Skizo]

Anybody who prescribes an initial dose of amitryptiline of 100 mg shows ignorance of pharmacology, disregard for the patient's welfare, or both.

[kitbett]

If I am likely to reach a plateau level of dosage and will not need higher and higher dosages to achieve the same effect(MD's opinion above)what is it that would make it desirable for me to withdraw from the medication? -  apart from expense and negligible side effects.Is it necessary or desirable to withdraw from medication? If so,why?   I am 61 and have tried any number of non-medicational approaches without success.My condition is almost certainly hereditary(last three generations were sufferers). My  life is largely stress-free.My only worry is...that I have panic attacks at night which cause insomnia.

There seems to be a lot of advice on taking medication but very little on the subject of getting off it.

Any views?

[Kelp]

I would see no reason to withdraw from this medication if it is working for you. It is not addictive and it works for many people.I know someone who is on it and it works very well. It is used by this patient for the same reason as you. The problem with it is that in some cases it can have very unpleasant side affects but this does not apply to eveyone. If you do get any side affects a reduction in dose might help. 10 mg is a very small dose and your doctor may increase it. It is certainly much better to try drug sine it is non adictive than some sleeping pills which are.
Best of luck
Kelp

[Kelp]

I see no reason to withdraw from your mediction (medication) if it is working for you. for some people it works quite well. For me,I had bad side affects but this does not happen to everyone. Your doctor may gradualy increase the dose to obtain the maximum affect and then may possibly reduce it. If you get upleasant side affects lowering the dose may ease them. This drug is an excellent choice because it is very sedative and non habit forming like many other sleeping pills. The only thing is is that it takes a while to work and get the right dose so hang in there, you may find it is a real help.
all the best
Kelp