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IC & antidepressants study, & a question about amitriptyline experiences

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  • IC & antidepressants study, & a question about amitriptyline experiences

    I am on Wellbutrin anyway so have been considering asking to switch from that to one like Elavil / Aimitriptalyne (sp?) if I might get IC benefits.

    But I was looking at the evidence to help me decide ... here's the summary from one study that looked at all previous studies:

    The use of antidepressant drugs for the management of chronic pelvic pain has been supported in the past. This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not adequately supported by methodologically sound RCTs. From the existing studies amitriptyline may be effective in interstitial cystitis but publication bias should be considered as an alternative explanation. All drugs were generally well tolerated with no serious events reported.
    So that makes me think possibly amitriptyline (in spite of their cautions) but in ICN there seem to be a number of reports of drowsiness.... my big ongoing struggle is for a meds. mix with less drowsiness.

    Has anyone found amitriptyline to make a huge pelvic pain difference, and not found it made them drowsy?
    Last edited by playethic; 03-12-2011, 01:50 PM. Reason: added link
    Severe IC developed fairly quickly, autumn 2010.
    So severe that I was bed-bound & on 160mg/day morphine to cope with torturous pain levels, and unable to function other than hospital/medical appointments, for seven months. Then, miracle of miracles, something started working. I am steadily lowering the methadone dose level. I have been far out of that desperate nightmare hell zone for several months now and continue to improve.

    - Ranitidine (anti-histamine, H2-inhibitor) 300mg/day
    - Methadone 9 ml/day
    - Instillations:
    - 40ml Kenalog (steroid for inflammation) 2 x per
    week, along with rescue cocktail of heparin,
    lidocaine, sodium bicarbonate
    - 20ml Uracyst, monthly @ $100/per
    - Depo lupron injections for endometriosis, monthly @ $88/per

  • #2
    Elavil made me extremely sleepy.. Also at a low dose it did not help with any depression issues I had..

    ONE Second, ONE Bite, ONE Breath, ONE Pill, ONE Minute, ONE Teardrop, ONE Hour, ONE Sip.. ONE DAY! I will Prevail from this disease! IC Hoping for a Cure!

    Link to Patient Handbook:

    Diet Reference Sheet:

    Meds For IC: Lyrica-25mg Glucosamine-500 MSM-500mg, Prosed Ds -When Flaring

    Other Meds: Levlite- Continious Birtcontrol, Micardis-40mg for High Blood Pressure

    Meds I have Tried:
    Topamax,Tofranil, Elmiron, Atarax, Cymbalta, Elavil, Enablex, Detral La, Prydium.
    Lexapro< Bad reaction to this med!
    Intstills, could not continue them due to some kind of reaction after 3rd instill. Tasted the lidocaine in my mouth, tongue and lips went numb then went into what seemed like a panic attack. Shaking, racing heart, tingling face/head, blood pressure shot up..

    Dx With IC in Nov 2006 with Hydro/Cysto
    Hydro/Cysto Caused Bladder to Rupture.

    Other Dxs-Vulvodynia,Fibro, Endo, IBS, HPV, Migraines, Spastic Colon, Mild Dysplasia.

    ICN Volunteers are not medical authorities nor do we offer medical advice. In all cases, we strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.


    • #3
      it did not help my deppression at all, nor for pain. It made me very emotional, to very mean. that is MY OWN experience.
      'The will of God will never take you where the Grace of God will not protect you.'


      • #4
        Within a month of starting Elavil, I noticed a DRAMATIC decrease in my pelvic pain. I went from sitting on a heating pad all the time, to feeling normal again. I take it at night, although it doesn't make me sleepy. Most medicines that would knock an average person out have little to no effect on me.

        I had to stop taking Elavil for about 7 weeks, and returned to my previous condition. I'm now on day 4 of it, and laying here on a heating pad, hoping it kicks in soon so I can get back to living.
        Symtoms started July 2010.
        Severe pelvic floor pain only.

        2 time PT graduate!
        In medical remission since August 2011; able to eat and drink anything I want currently.

        IC meds:
        200 mg Elmiron in the morning
        100 mg Elmiron @ night
        Macrobid after intercourse

        03/11 07/11 01/12
        If at first you don't succeed: 07/26/2013!


        • #5
          I only took it one night ha ha but it made me so tired I couldn't function the next day at all and I only had taken 5mg. I'm super sensitive to meds. Then they put me on nortriptyline which hasn't made me drowsy and makes me feel more comfortable all over my body. Wherever I had pain it made quite a bit better. My hip pain is better, my tmj is better etc.

          Gelnique for frequency/urgency - works great
          Macrobid after sex
          Prilosec, continuous birth control pills
          synthroid .088mg, mucinex-d, restasis

          Supplements: Desert Harvest Aloe vera, Cysta-q, prelief, magnesium and calcium, Vit D, flaxseed oil

          Diag Mild IC Jan 11 but have had symptoms for 25 years. Also have GERD, TMJ, IBS-C, chronic dry eye syndrome, hashimotos thyroiditis, non-allergic rhinitis.

          IC Diet Link:
          AUA 2011 Guidelines to diagnosing and treating IC overview-
          AUA 2011 Guidelines to diagnosing and treating IC PDF:
          Great treatment flowchart on page 19 of the pdf


          • #6
            If wellbutrin is working you could stay on that and add Elavil for some pain relief?
            What helps
            Elmiron 200 mg bid
            Wellbutrin XL anxiety and depression
            Oxybutynin ER 10 mg

            tried and failed
            Cardura, Hytrin, Flomax, Prosed DS, Vesicare, Pyridium, Cystoprotek (caused GI problems), Lyrica, Pamelor

            "We can't wait until the storm is over. We need to learn to dance in the rain."


            • #7
              I'm on Wellbutrin too and I take the Elavil at night...but since Wellbutrin is a mild stimulant I take it in the morning and it helps counteract the sleepyness I get from the Elavil.
              Diagnosis: IC, VV, anxiety


              • #8
                I tried amitryptyline in the past and had not luck. I tried it again recently, but this time for sleep and although it did not seem to help me sleep I noticed that my bladder frequency was better after a couple of days.

                I am trying it again, just a dose of 11.5 mg added to 4 mg of Mirtazapine to see if I can alleviate bladder discomfort and get some sleep.


                • #9
                  I took my first 10mg dose of amitryptyline last night and it completely knocked me out! I actually had to leave work early because I was so light headed. But this afternoon I feel great and haven't gone to the bathroom in FOUR hours!

                  So I'm not sure what to do. Maybe take half a pill and see what that does? Or maybe I'll wait until the weekend to try it again.


                  • #10
                    In December, I started on a combination of hydroxyzine and amitriptyline for IC - no depression. I started on 25 mg Hydroxyzine and one 10 mg amitriptyline at night. I gradually increased to three amitriptyline but only at night. I tried to take one in the morning and almost didn't make it through the work day. Generally, I am fairly sensitive to medications.

                    I'm getting ready to taper off both meds because alot of my pain that was thought to be IC was actually kidney stone blockages in both ureters. I'm hoping that I can manage with just the diet, but will go back on the meds if I need them.

                    If I had to make a recommendation, I would say to give it a try. If it doesn't work or agree with you, you can taper off it easily. I would recommend starting with a small dose at night and see how you react.

                    Good luck with your decision !

                    * ITP - autoimmune blood disorder - spleen removed 1978 and in remission since
                    * MS- diagnosed Jan-2010
                    * IC - confirmed by cysto and hydro Nov-2010 - currently taking no medication
                    * possible adenomyosis - suspected by urogyno May-2010
                    * low Vitamin D levels - taking 2000 IU daily
                    * sleep issues - 1/2 alprazolam


                    • #11
                      I started taking it several weeks ago and it has made a HUGE difference in managing the pain, frequency and urgency. For the first 6 or 7 days I was a walking zombie, but then I started to adjust to it pretty quickly and the fatigue rapidly disappeared. I began at 25mg and worked up to 50mg taking one at night and one in the morning. It has done wonders for my quality of life...


                      • #12
                        Originally posted by Sasapippi View Post
                        I took my first 10mg dose of amitryptyline last night and it completely knocked me out! I actually had to leave work early because I was so light headed. But this afternoon I feel great and haven't gone to the bathroom in FOUR hours!

                        So I'm not sure what to do. Maybe take half a pill and see what that does? Or maybe I'll wait until the weekend to try it again.
                        Knocked me out like that for a few days but I quickly got used to the effects. I still sleep like a log and it's harder to get up in the morning but I'm not a zombie all day like I was at first -- I was afraid to drive my kids to school! Same with the hydroxyzine. But the adjustment was faster than I expected...

                        And I do feel a positive change in pain levels...
                        Mom to two littles (remissions while pregnant/breastfeeding)
                        Sufferer since mid-90s
                        Finally dx'd properly much later