How long after stopping 5-htp may I start taking Amitriptyline?

[Julie8514]

How many days after stopping 5htp 100mg, may I start amitriptyline 10mg for sleep?

[Paxiled]

Try asking your pharmacist, though they might turn out to know nothing about 5-HTP.  You can also google them and see if there any contraindications listed  between these two.  You can also try asking your psychiatrist, who "should" know about tryptophan since it was used for many years as an antidepressant and sleep aid by the pharmaceutical industry and medical community.  I did notice in a quick google search that if you've taken an ssri within 5 weeks of starting this drug it says to tell your doctor.  While HTP doesn't work like an ssri, it is the substance the body uses to make serotonin, and while amitriptyline is a tricyclic, not an ssri, it indicates it may affect serotonin more than a little.  The bigger question, of course, is why you're taking an antidepressant to help you sleep.

[Julie8514]

Thank you Paxiled for your advice! My friend who has the same kind of sleeping issues has had great success with Amitriptyline 10mg. That's why I am asking about the Ami :) Thanks again!

[Paxiled]

But keep in mind, the drug is there to stay for your friend and will be for you, too.  That means the side effects and the not learning why you're not sleeping and how to get over the problem stay as well until the drug stops working.  Also, people get very different reactions to taking antidepressants -- for some it's sedating and the same drug for another can make it impossible to sleep.  I don't know what you've tried, but once sleep becomes dependent on medication, it can make insomnia worse in the long run, so I hope you've exhausted all options before taking this step.  Whatever happens, I hope it works.

[gandelf]

Paxiled, your information is almost quite good up until a point. Amitriptyline is indeed a tricyclic 'anti depressant', but it also has many other effects and uses too. The anti-depressant properties comes from its abilities to inhibit the reuptake of serotonin, (making it a serotonin reuptake inhibitor), but it also inhibits the reuptake of norepinephrine, which - whilst not fully understood - helps to regulate nerve pain from misfiring, or damaged nerves. The reason it is sometimes prescribed for sleep, is because it is also an extremely strong anti-histamine and has a powerful sedating effect. Indeed, its strongest affinity is for the histamine transporter, so calling it an 'anti-depressant', whilst 100% accurate, is also somewhat of a misnomer, or at the least slightly misleading.

In terms of mechanism of action on the reuptake of serotonin, Amitriptyline is no different to an SSRI, the difference between Amitriptyline and an SSRI is that Amitriptyline also inhibits the reuptake of norepinephrine and works on the H1 (histamine) transporter too; (indeed, as detailed earlier, this is its strongest affinity). There are many other transporters that Amitriptyline works on too, which can be found on the Wikipedia entry for tricyclic antidepressants, but I've detailed the most important ones.

An SSRI on the other hand targets just the serotonin transporter in the brain, which makes them much preferable for most people, as there are fewer side effects and much less opportunity for such, due to their limited nature.

[Paxiled]

Actually, not entirely true.  And Wikipedia isn't an authoritative source, just saying, you can learn all this by looking at more authoritative websites.  Not trying to be mean, just trying to say, quoting that source can get any of us into trouble.  But ssris don't just affect serotonin.  Any drug that affects serotonin, that disrupts the way the brain uses it normally, also disrupts melatonin.  That means it could help sleep or hurt sleep depending on the person.  Melatonin is made by serotonin.  ssris also affect choline receptors, some more than others -- Paxil is really strong on that.  That can cause cognitive problems or not, but can also be hard when you try to stop taking the drug.  Anti-histamines don't in and of themselves promote sedation -- it depends on which one you're using.  They come in two categories, those that are very stimulating and those that are very sedating.  Norepinephrine-affecting drugs are very well studied -- this includes wellbutrin and the entire snri class.  This causes stimulation, not sedation, and can lead to an anxiety problem in sensitive people or those who already have an anxiety problem depending on how strong the affect is.  With this drug, the affect on all three things are less than the ssri effect on serotonin or the snri effect on norepenephrine or a pure anti-histamine's effect on histamines.  But the main point still remains, you are talking about using a drug for its side effects, that being sedation, and not for it's intended use, which is as an antidepressant.  The manufacturer would have been a lot happier if it didn't turn out to be sedating, but these companies turn lemons into lemonade and tell doctors about their sedating qualities.  This still makes one dependent for sleep on a powerful drug that affects mood, the nerves, magnesium absorption, and can be very hard to stop taking.  If this is what is necessary, it is what it is.  If other things haven't yet been tried that don't do this, it's a better way to go.  I don't think anyone fully understands how any of these drugs work -- I think wellbutrin, for one, was on the market for a decade before they figured out what neurotransmitters it was affecting and how.  So it goes.  Peace.