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pain, sleep, endep

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Hi folks,

 

Just thought I'd put this out there to see what others may have experienced.

 

I did a search and found a few topics from a few years ago, where a few folks said they had been prescribed Endep for pain/improving sleep - also mentioning some other side effects?

 

I'm going through a few tests at the moment, but short story is I am having quite a bit of pain (over the last few months) that is making sleep next to impossible. It's a vicious cycle of pain, lack of sleep, increased tension during the day, more pain etc. It does bother me during the day, but nights are the worst.

 

My doc this morning suggested he could put me on a low dose of Endep, (the old antidepressant) that is now sometimes used to relax muscles, help sleep and reduce pain.

 

I got the prescription filled, and was planning on trying it tonight.

 

But, out to the Tranny experiences, any words of caution? Bad experiences? Good?

 

I'm hoping the scans I had today will help identify a cause of the pain and thus help a treatment long term without the need for this. But in the short term......

 

TIA!

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My experience was not a great one.

 

It was prescribed by a neurologist to try and help me manage stress levels at work when this became the apparent cause of migraines that resulted in facial paralysis.

 

I lasted a few weeks, but my mood became so low that I had to stop. Just getting out of bed became a huge struggle.

 

Obviously it's going to affect everyone differently, this was just my experience. Not a good one.

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Hi folks,

 

Just thought I'd put this out there to see what others may have experienced.

 

I did a search and found a few topics from a few years ago, where a few folks said they had been prescribed Endep for pain/improving sleep - also mentioning some other side effects?

 

I'm going through a few tests at the moment, but short story is I am having quite a bit of pain (over the last few months) that is making sleep next to impossible. It's a vicious cycle of pain, lack of sleep, increased tension during the day, more pain etc. It does bother me during the day, but nights are the worst.

 

My doc this morning suggested he could put me on a low dose of Endep, (the old antidepressant) that is now sometimes used to relax muscles, help sleep and reduce pain.

 

I got the prescription filled, and was planning on trying it tonight.

 

But, out to the Tranny experiences, any words of caution? Bad experiences? Good?

 

I'm hoping the scans I had today will help identify a cause of the pain and thus help a treatment long term without the need for this. But in the short term......

 

TIA!

 

Seen it used in my professional role as a nurse. I would not know much about the positive outcomes, they did not come back to the hospital.

 

I saw the side of tachycardia's, non lethal atrial arhythmias, like sinus tacycardia, PAT, paroxysmal atrial tach with palpitations. Mostly intermittent palpitations.

 

We had a few cases of overdose and the major issues were tachycardia. Normally not intentional, but a few extra doses of Endep...aka Amitriptyline, Elavil, the generic and branded names, could quickly exceed the acceptable blood levels.

 

I can't say whether to take it or not, but proceed cautiously and don't exceed the recommended dose.

Edited by Kamal2

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Endep is a great drug if used wisely. I have personally used it for control of tension headache with great results. and have prescribed it numerous times for that and other things, most of which involve wound up nerves of some sort. It's good for irritable bowel syndrome, tension headaches, chronic pain, chronic fatigue, and generally highly strung people.

The important thing to consider is the dose. The maximum dose for depression is 150mg daily, in divided doses. That is a zombie dose, which I is why it's not often used for depression these days, though still is at times.

I tend to prescribe 10-25 mg to be taken at night. Take it 12 hours before you want to get up and move. I generally give a script for a 25mg tablet, for patients to take half or a whole.

It's good in that you don't have to wait a fortnight for it to kick in. Take it on the night you want sleep, don't take it other nights. Advantages are that it is non-addictive and tolerance does not develop, features which contrast sharply with benzos for example.

Yes, it's dangerous stuff in the overdose situation and historically caused a lot of ICU admissions and some deaths. So has alcohol and paracetamol. In sensible hands at sensible doses, it's fine.

Side-effects include drowsiness the next day, blurred vision, constipation etc, but not usually troublesome at the small doses I'm describing.

If you want more info, PM me. BTW, you might have eased, yes, I am a doctor.

Edited by Ken Ho

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My experience was not a great one.

 

 

 

I lasted a few weeks, but my mood became so low that I had to stop. Just getting out of bed became a huge struggle.

 

 

 

Interesting, and yeah, not good. Were you taking it during the day too? or only at night?

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Endep is a great drug if used wisely. I have personally used it for control of tension headache with great results. and have prescribed it numerous times for that and other things, most of which involve wound up nerves of some sort. It's good for irritable bowel syndrome, tension headaches, chronic pain, chronic fatigue, and generally highly strung people.

The important thing to consider is the dose. The maximum dose for depression is 150mg daily, in divided doses. That is a zombie dose, which I is why it's not often used for depression these days, though still is at times.

I tend to prescribe 10-25 mg to be taken at night. Take it 12 hours before you want to get up and move. I generally give a script for a 25mg tablet, for patients to take half or a whole.

It's good in that you don't have to wait a fortnight for it to kick in. Take it on the night you want sleep, don't take it other nights. Advantages are that it is non-addictive and tolerance does not develop, features which contrast sharply with benzos for example.

Yes, it's dangerous stuff in the overdose situation and historically caused a lot of ICU admissions and some deaths. So has alcohol and paracetamol. In sensible hands at sensible doses, it's fine.

Side-effects include drowsiness the next day, blurred vision, constipation etc, but not usually troublesome at the small doses I'm describing.

If you want more info, PM me. BTW, you might have eased, yes, I am a doctor.

 

cheers, that's pretty much exactly what my GP has said.

 

He gave me the 10mg tabs, said to start at 1/2 a tab, and early-ish in the evening, or at least 10 hrs before I need to get up and be clear headed. He said I could work up to 2 1/2 or so if needed, but shouldn't need to.

 

At this point, my sleep is so bad that I'm stuggling in the mornings anyway.

 

Good to know, thanks Ken! I'll be in touch if I need to pester you further.

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I only took it at night, right before bed. It will certainly help you sleep, for the first few days it knocked me out within about half an hour of taking it. Aside from the mood issues, mornings used to feel like I was waking from a sedative. On the few occasions I managed to force myself to train, I didn't ride on the road. I just felt too groggy. That seemed to wear off after about a week or so though.

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cheers, that's pretty much exactly what my GP has said.

 

He gave me the 10mg tabs, said to start at 1/2 a tab, and early-ish in the evening, or at least 10 hrs before I need to get up and be clear headed. He said I could work up to 2 1/2 or so if needed, but shouldn't need to.

 

At this point, my sleep is so bad that I'm stuggling in the mornings anyway.

 

Good to know, thanks Ken! I'll be in touch if I need to pester you further.

 

5mg is a bit homeopathic. He's gone that low as an intro dose so you don't reject it. Not a bad strategy. Dot be scared to use a bit more. 10mg won't knock you around too much, and as you have noted, you are rooted in the morning anyway.

Sleep is a wonderful thing, and I've believed in it all my life. It's finally become trendy after years of people boasting how little they need. I'm a ten hour a night man myself.

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I was on for 18 months for nerve pain. First time took it, had some weird sensations initially lasting 10mins. Yes it did help me sleep and settled nerve pain.

Side Effects were damaged liver, slowing of metabolism, take away appetite, and weight gain. Problem with my doctors they would let me go off it when I wanted too so I took myself of it.

Since been off it (April this year) my last blood test showed my liver function had improved, still metabolism slow though.

 

I also got offered Lyrica initially as well. Stay away from this.

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Stillnox

Sleep like a baby and wake with zero drowsiness. Ive used before every 70.3 and IM. Will get shouted down but for me its the gold class. Benzo's = drowsy next day plus i need high doses to knock me out. Pain - depends on degree. Lack of sleep plus pain, i'd try mersyndol. Its both pain relief and helps sleep. No script reqd

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From my experience, medicated sleep is unhealthy.

I know you are struggling to sleep without meds so ok, but try and find the source of pain and treat them.

Medicated sleep isn't proper sleep.

PM me if you want details of my experience.

Cheers mate

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From my experience, medicated sleep is unhealthy.

I know you are struggling to sleep without meds so ok, but try and find the source of pain and treat them.

Medicated sleep isn't proper sleep.

PM me if you want details of my experience.

Cheers mate

 

yeah, I totally agree.

 

I took the endep (small dose) last night, and had the best sleep I've had in months. I still woke up with some discomfort a few times, but it wasn't excruciating like it has been for so long.

 

We are trying to find the problem so that we can work out a solution that treats the problem (or ways to not make it worse) rather than covering up the symptoms. I had another x-ray yesterday, and should have the results on Monday - in time for my next physio appointment.

 

What I plan on doing in the meantime is, if I'm having a bad day and the muscle spasms/pain is really bad, then I will take a dose in the evening. If not, then I won't.

 

I realise I wasn't specific in my description before, of what the pain actually is. It's in my neck. It's limiting how much I can turn my head, and pretty much any neck movement. It radiates up into terrible chronic headaches all day, and when I sleep, there just isn't a comfortable head position. If I keep my head still for a while it's painful, and then when I move it's excruciating.

I've been seeing my physio for a while as we know a lot of the pain is coming from muscle tension - but whats the cause of that? Still trying to nut it out.

Some days the exercises and heat packs are effective. Others not.

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I won't bash you for using Stilnox. It got a bad rap with the swimming teams using it, but that was mostly media beat up and I don't look to them for balanced info. Look at how well the team did when they banned it, and the poor buggers could not get any sleep.

It's better for short term or occasional use.

I don't get emotionally invested in medications. They are just tools. I have posted some unpopular opinions here in the past not condemning the use of PEDs for that matter.

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yeah, I totally agree.

 

I took the endep (small dose) last night, and had the best sleep I've had in months. I still woke up with some discomfort a few times, but it wasn't excruciating like it has been for so long.

 

We are trying to find the problem so that we can work out a solution that treats the problem (or ways to not make it worse) rather than covering up the symptoms. I had another x-ray yesterday, and should have the results on Monday - in time for my next physio appointment.

 

What I plan on doing in the meantime is, if I'm having a bad day and the muscle spasms/pain is really bad, then I will take a dose in the evening. If not, then I won't.

 

I realise I wasn't specific in my description before, of what the pain actually is. It's in my neck. It's limiting how much I can turn my head, and pretty much any neck movement. It radiates up into terrible chronic headaches all day, and when I sleep, there just isn't a comfortable head position. If I keep my head still for a while it's painful, and then when I move it's excruciating.

I've been seeing my physio for a while as we know a lot of the pain is coming from muscle tension - but whats the cause of that? Still trying to nut it out.

Some days the exercises and heat packs are effective. Others not.

 

In my considerable experience, both personal and professional, your muscle tension is caused by a combination of postural issues and emotional stress.

Endep is a good strategy, Ice packs, no heat.

If I examined you I could pinpoint all the grotty pain points and show you some facilitated stretches (a combination of an active contraction phase, berthing techniques and a relaxation phase) which make a huge difference to the muscle spasm.

Edited by Ken Ho

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In my considerable experience, both personal and professional, your muscle tension is caused by a combination of postural issues and emotional stress.

Endep is a good strategy, Ice packs, no heat.

If I examined you I could pinpoint all the grotty pain points and show you some facilitated stretches (a combination of an active contraction phase, berthing techniques and a relaxation phase) which make a huge difference to the muscle spasm.

 

And I wouldn't hesitate to agree with you. I've been seeing my physio for a while now, and we have been working on the muscular side. Posture, stretching, etc.

 

However, over that time, things haven't improved - and have in fact become more painful and limiting.

 

If we can rule anything structural out, we can go harder with the muscle work - but the pain has been worst when we were doing all the right things as if it was muscular. The pain is reminiscent of the issues I had with my lower back. We were treating it as muscular and such, and found that things actually worsened. An MRI showed a few other things going on which explain why what we were doing wasn't working.

 

I have had some neck injuries in the past, so it's be good to rule out any structural stuff before we get too excited over knotty bits.

 

cheers though - if it all comes back clear I may follow up with you on some ideas.

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I like to use imaging to exclude significant structural issues so that Physio can be pursued with confidence, especially with lower back issues.

Most of the neck stuff is functional,rather than structural, and while a bit of bone oedema might light up the worst spots on an MR, by and large imaging is only good for showing what's not wrong, as opposed to what is wrong.

Plain x-rays don't tend to show much, although there can be a surprising amount of unsuspected OA. After my sandbar crash, I had a terrible time despite normal x-rays.

 

I tend to advise people to go gently with neck, rather than "go hard".

In short, muscles in spasm are hot and angry. Don't heat them up, or piss them off. Deep tissue massage is about the worst hing you can do, for example.

Edited by Ken Ho

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