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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by rovers95 on July 19, 2019, at 6:33:08
I'm taking amitriptyline at 25mg at the moment. It's definitely helping with sleep and feels relatively benign. When I tried to up the dose (to 37.5mg) I felt more anxious/worse.
Can I get an AD effect (hopefully remission) at 25mg or will I have to bite the bullet and get up to 75/100mg?
Posted by linkadge on July 19, 2019, at 8:11:17
In reply to Amitriptyline at 25mg - depression/anxiety, posted by rovers95 on July 19, 2019, at 6:33:08
I'm a believer that doses of many medications are highly individualized. You can always wait and see how you continue to do.
Linkadge
Posted by ed_uk2010 on July 27, 2019, at 9:55:46
In reply to Amitriptyline at 25mg - depression/anxiety, posted by rovers95 on July 19, 2019, at 6:33:08
Response to amitriptyline is really variable. It's not a consistent medication where you can guess the effective dose in advance. Just take whatever dose makes you feel better.
Posted by Mtom on July 28, 2020, at 12:40:54
In reply to Amitriptyline at 25mg - depression/anxiety, posted by rovers95 on July 19, 2019, at 6:33:08
I agree. A PDoc I was seeing agreed that the "standard" doses prescribed are somewhat arbitrary (based on Pharma company recommendations) and also agreed that individual response varies, sometimes lower than "standard" doses, or waiting a longer period of time before assessing effectiveness and considering dose changes, might be appropriate. When ADs are prescribed, there tends to be a sense of urgency to quickly achieve an effect which may be why some people start on or quickly titrate to doses that could be higher than they can tolerate.
I had Genetic Testing for Medications done 2 years ago and although still in its infancy, with many limitations in the information - it was also eye-opening in showing some SNPs and other mutations I have including some in P450 CYP Enzymes that metabolize many medications including ADs. It is increasingly believed that variations like these in our genes are at least in part responsible for the huge variances in how different people respond to even the same antidepressant (and other meds). I wouldn't necessarily recommend genetic testing - I think it still has a ways to go - but eventually this kind of Personalized Medicine will become available. In the meantime, we're left to experiment. My experience with "biting the bullet" and increasing dose while having side effects has only resulted in more intense side effects.
I'd be interested in hearing how things go for you as I've been thinking of trying Amitriptyline for some time.
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