Amitriptyline and Weight Gain

aedavidson79

One of the medications I’m prescribed to help with the fibro pain is Amitriptyline. I have been taking it for about two years, ever since my official diagnosis. Right before the New Year, I realized that I forgot to call in my refill in time and ended up running out. On the second day of not taking it I noticed that I wasn’t as hungry as usual, especially at night. Now it’s been a few days and I have lost three pounds. For the first time in a LONG time I am not constantly fighting the urge (and mostly failing) to snack all night long.

The primary reason I take this med is b/c of insomnia and it has worked well for this purpose. However, if I have been sabotaging myself all along by being so hungry that I’m now obese, I am thinking I need to find an alternative.

I’m wondering if anyone else has taken Amitriptyline and has had increased hunger while taking it? Or, has anyone noticed a loss of appetite when stopping taking this med? I’m going to talk to my Dr. about it but I’d love to hear others experiences with this med.

twiztc

One of amitriptyline's well know side effects is weight gain as it definitely increases your appetite. It was originally given to me years ago as I had no appetite what so ever and was borderline anorexic. (now far from it lol) turns me into a chocoholic.
I really get a lot of help from this drug for a few of my symptoms so I have to work hard keeping my eating habits in check. For me the pros outweigh the cons. If you feel you can manage without them maybe you should discuss with you doctor alternatives.

apatheticsloth

I took it many years ago in an attempt to prevent migraines but didn't notice a weight gain issue. The biggest problem for me was that it increased my parasomnias and I was having horrific nightmares. No thanks.

Cinnabon64

This medication along with having children started me on the path to being over weight! I started taking it for headaches, long before I found out I had Fibro, and when I went off it, I lost at least 40lbs! I gained it all back later on with other meds for Fibro, mainly anti depressants that I no longer take. I was totally unaware that it caused carb craving etc. till much later, after I lost that weight.

I did have a loss of appetite when I stopped as well.

apatheticsloth

Cinna...funny how you and I both took it for headaches and ended up with Fibro, eh? I know it's just a coincidence but still.

Before I had got sick with Fibro I was running 4k every day, working full time and was a full time Mom to two very active boys. Man how things change. With the inactivity and the meds I've gained so, so much. So not only do we deal with the pain of Fibro, we have to deal with the extra weight and the effect it has on our body. Argh.

BrendaLee

I hate this drug with a passion. I'm going to go as far as to say it kinda ruined my life. I've been off of it for four years, and I have yet to recover from the side effects. It's one of those medications I believe shouldn't be on the market.

gayleanne57

Hi,I was on amytripteline also and put on 10 kg. My doctor knows that weight gain depresses me so has now taken me off of this and put me on Norytripteline. It is much friendlier for me.

somnomania

I tried amitriptyline a few years ago for my nonrestorative sleep, with minimal effect, but now I'm on it again at a much higher dose. My mom went on it before I did, for her fibro, and many other doctors she saw seemed very surprised that she was on it, as if it was a heavy-duty serious drug. Maybe it is, I don't know, but I take 200mg a night and I'm not waking up every 30-90 minutes to roll over. I've gained weight in the last several years, but it was happening regardless of whether I was on amitriptyline or not, and my appetite's had the usual fluctuations based on the season and my menstrual cycle and whatever else, so maybe it just isn't having that side effect for me. It's really unfortunate that it's causing such problems for other people, especially @apatheticslot. :frown: But I've heard of it causing nightmares and such, though I don't know how common it is to have that reaction.

melmerritt33

I've also put on a lot of weight since I was put on this drug, I gained 28lbs and have real problems trying to lose it, before I was on this drug I could lose weight without much effort if I gained but now it's taking forever as I always end up craving food and overeating. I've recently made the decision to come off it as it no longer helps me to sleep as well as it used to (maybe I've grown tolerant of the dose?) and I'm tired of the other side effects, along with the weight gain and the fibro itself it's all just making me feel really depressed. I'm going to try relaxation methods to help me sleep and feel better emotionally, painkillers for the pain as needed and gentle exercise for both and see if that all helps.

canadjineh

Magnesium is good for sleep and fibro (we have a deficiency of the mineral). You might want to try a good dose every evening -

Magnesium sulfate: This form is often used as an intravenous preparation but it is not used in oral formulations. Since it does have some absorbability through the skin, it is also found in Epsom bath salts.
Magnesium citrate: A commonly used form that has a good bioavailability compared to oxide. It is also very rapidly absorbed in the digestive tract but it does have a stool loosening effect.1 This form is found in many supplements and remains a solid option for delivering magnesium into the body.
Magnesium Aspartate: This form has increased bioavailability compared to oxide and citrate. There were some promising clinical trials conducted in the 1960s that found a combination of magnesium and potassium aspartates had a positive effect on fatigue and they reduced muscle hyper-excitability.2 Physiologically this makes sense since both magnesium and aspartic acid are critical players in cellular energy production. This form is not commonly found but has been used for chronic fatigue syndrome.
Magnesium Glycinate: Glycine is a well-known calming amino acid. This combination has good bioavailability and does not have a laxative effect since glycine is actively transported through the intestinal wall. Due to the calming and relaxing effect of both glycine and magnesium, this combination has been used successfully for chronic pain and muscle hyper tonicity.
Magnesium Malate: This less well-known combination has been studied for use in fibromyalgia. Since malate is a substrate in the cellular energy cycle, it can help improve ATP production; there is some preliminary evidence that it may reduce muscle pain and tender points in fibromyalgia patients.4

Relaxation methods and painkillers as needed do help too. I've never had to take amitriptyline but I do find that the above suggestions work pretty well for me.

melmerritt33

canadjineh wrote: »

Magnesium is good for sleep and fibro (we have a deficiency of the mineral). You might want to try a good dose every evening -

Magnesium sulfate: This form is often used as an intravenous preparation but it is not used in oral formulations. Since it does have some absorbability through the skin, it is also found in Epsom bath salts.
Magnesium citrate: A commonly used form that has a good bioavailability compared to oxide. It is also very rapidly absorbed in the digestive tract but it does have a stool loosening effect.1 This form is found in many supplements and remains a solid option for delivering magnesium into the body.
Magnesium Aspartate: This form has increased bioavailability compared to oxide and citrate. There were some promising clinical trials conducted in the 1960s that found a combination of magnesium and potassium aspartates had a positive effect on fatigue and they reduced muscle hyper-excitability.2 Physiologically this makes sense since both magnesium and aspartic acid are critical players in cellular energy production. This form is not commonly found but has been used for chronic fatigue syndrome.
Magnesium Glycinate: Glycine is a well-known calming amino acid. This combination has good bioavailability and does not have a laxative effect since glycine is actively transported through the intestinal wall. Due to the calming and relaxing effect of both glycine and magnesium, this combination has been used successfully for chronic pain and muscle hyper tonicity.
Magnesium Malate: This less well-known combination has been studied for use in fibromyalgia. Since malate is a substrate in the cellular energy cycle, it can help improve ATP production; there is some preliminary evidence that it may reduce muscle pain and tender points in fibromyalgia patients.4

Relaxation methods and painkillers as needed do help too. I've never had to take amitriptyline but I do find that the above suggestions work pretty well for me.

Thanks for this, really helpful. I've started taking Magnesium tablets, I'll have to check what type they are and what else I can get. I've also been doing warm salt baths in the evening which are helping me relax for sleep and so far haven't found my sleeping any worse than before.

canadjineh

@melmerritt33 How's it going? Has the Magnesium helped out yet?

melmerritt33

I think the changes I made are really working out for me so far, although I'm in a lot of pain from a flare-up caused by overdoing things last week I'm sleeping better than I have for ages, feel like I'm coping better with the flare pain and I'm actually waking up properly. That may sound weird but until now I've had real problems, struggling to wake up at all then falling asleep as soon as I wake, then finding it impossible to get fully awake for hours after I get up. For the last few days I've actually woken naturally and been able to stay awake after waking up, I feel more alert and haven't felt like I needed to sleep in the afternoon. I'm taking Magnesium Citrate every day and noticed a definite improvement with my constipation as well, bonus effect! I think the combination of the Magnesium, salt baths and no more Ami is the right move for me.

canadjineh

I hope things continue on the uptrend @melmerritt33 . Now you may have to watch out that you do not overdo things more often, lol, since you are sleeping better and generally feeling better.

melmerritt33

canadjineh wrote: »

I hope things continue on the uptrend @melmerritt33 . Now you may have to watch out that you do not overdo things more often, lol, since you are sleeping better and generally feeling better.

Thanks, @canadjineh I actually think I did exactly that because things took a turn for the worse and I ended up in so much pain that I was back where I started, lol! After a talk with my doctor I'm back on the ami but at a low dose (just 10mg a day) and along with a modified exercise programme this seems to be working well. I'm struggling to lose weight still, it's a very slow process, but still sleeping better and more able to wake up in the morning than I was at the higher dose. My doctor thinks I may be very sensitive to the ami so that a higher dose was causing more problems than it was treating. Fingers crossed that this new regime will work and I've told myself not to stress about the weight but to keep trying to be healthy and let nature take its time.

canadjineh

@melmerritt33 you could try concentrating your diet on above ground veggies, and proteins, with extra fats like avocado and full fat dairy (if dairy is OK for your system). Ditch the grains and the root veggies (the whole point of that fat root aka beets, carrots, etc is to store 'energy/sugars/starches' for plant growth) if you can and minimal fruit (berries & tart apples are the lowest carb). Since the ami causes carb cravings it's best to fight it with lower carb eating to help cut the cravings - but it may take a week of eating lower carb to feel less craving. Gluten intolerance/celiac disease is often found in concert with fibromyalgia and other autoimmune issues. You may have to get serious about gluten too.
Keep updating, I'd like to hear how things are going...

melmerritt33

@canadjineh Great, thanks for the tips. I'm already low fruit as it just doesn't appeal to me but you're right about the carbs, I keep trying to go low carb and keep falling off the wagon, bread in particular gets me every time. Time to get serious with it I guess, I've just done my online shop order and left out the bread and cereal this time, luckily I live alone so can remove the temptation to eat them every day by not having them in the house.

canadjineh

Here's another thing to look out for with amitrypteline: Just came in my inbox from MedScape Rheumatology section today....

11 Rheumatologic Findings Not to Miss
Kevin D. Deane, MD, PhD; Jason R. Kolfenbach, MD | August 29, 2016

Rheumatic diseases can have a wide range of clinical presentations involving multiple anatomical regions, including the joints, skin, lungs, eyes, and nervous system. Because many of these diseases are complex and other conditions, such as infection, can mimic rheumatologic illness, providers need to consider certain key items when developing a differential diagnosis and performing a diagnostic workup, in order to arrive at the correct diagnosis. The following cases highlight several don't-miss findings or diagnostic tests for rheumatologists or other healthcare providers across a variety of disease presentations.


Serotonin Syndrome in a Patient With Fibromyalgia

A 38-year-old female presents with worsening anxiety and restlessness for 2 months. She has noticed excessive sweating even at rest, as well as increased frequency of loose stools. She has had no sick contacts and denies travel. Her medical history includes irritable bowel syndrome, fibromyalgia, and anxiety.

Medications include amitriptyline 20 mg at night, venlafaxine 150 mg twice daily, and tramadol 100 mg three times daily as needed. On physical examination, the patient is slightly tachypneic with a borderline elevated temperature at 100.6° F. On neurologic examination, she has a slight resting tremor, and brisk (abnormal) deep tendon reflexes.

On the basis of these findings, there was high suspicion for serotonin syndrome due to medication interaction. Amitriptyline and tramadol were immediately stopped and the venlafaxine dosage was decreased by 50%, with close monitoring of symptoms.

Take-home points:

Serotonin syndrome classically presents with changes in mental status as well as autonomic and neuromuscular hyperactivity. The syndrome represents a clinical spectrum spanning from milder to more severe presentations.
Treatment consists of stopping the offending medications. In more severe presentations, immediate stoppage of all medications should be considered, and additional intervention, such as use of benzodiazepines, may be necessary.
Selective serotonin reuptake inhibitors increase serotonin levels, but other medications can increase risk as well; these include amitriptyline, trazodone, and tramadol.
Providers who manage patients with fibromyalgia should be aware of this syndrome, because offending agents are commonly used in combination for these patients.

joey72talk

I ditched this medication and instead use NYTOL 50MG strength.... You have to ask the pharmacy for them as they are not on the shelves

melmerritt33

Update on my case, I’ve been eating low carb and am also now trying very low to zero carb. Since going very low to zero carb I’ve been able to stop the ami and also cut down on painkillers.

I’ve not been perfect on the diet and think I would have better results if I had been. I definitely have problems with any kind of bread and cutting that out makes a huge difference, I’ve decided that bread has to be a rare treat for me and to expect the consequences after eating it!

I’ve lost 20lbs just down to diet as I wasn’t able to continue exercising. I’m now going to try incorporating gentle exercise again and try to lose another 20lbs to get down to what used to be my normal weight.

I feel so much better since finally ditching the ami, I no longer have trouble waking or staying awake and after a while I was able to sleep again naturally although that did take a while to sort itself out. I do have to manage my pain in other ways but find that things like hot baths, relaxation exercises and most of all not pushing myself is helping me to cope.

canadjineh

Wow, @melmerrit33! Sounds like you are figuring out a health plan that works for you. Congrats on ditching the ami and feeling better. Weight loss is in the kitchen and not in the gym, so don't stress too much about the exercise, mainly in our case it is good for mental health as well as keeping muscle tone and strength as we age. When I am following my best food plan I eat =<50g net carbs. Lately I've been stress eating due to very difficult elderly parents' health issues (sole caregiver) and have gained a little but at least I know to stay strictly celiac gluten free.

joey72talk wrote: »

I ditched this medication and instead use NYTOL 50MG strength.... You have to ask the pharmacy for them as they are not on the shelves

@joey72talk: Are you in the UK, or US? The drug in NYTOL is an old-style antihistamine Diphenhydramine (an ingredient in the old 'makes you drowsy, so don't drive etc' nighttime cold medications). It's also in Benadryl and Gravol and they work similarly.

Just beware of side effects: Wikipedia

Dimenhydrinate is recreationally used as a deliriant.[3][4][5]
Many users report a side effect profile consistent with tropane alkaloid (e.g. atropine) poisoning as both show antagonism of muscarinic acetylcholine receptors in both the central and autonomic nervous system, which inhibits various signal transduction pathways.[4] In the CNS, diphenhydramine readily crosses the blood-brain barrier, exerting effects within the visual and auditory cortex.

Other CNS effects occur within the limbic system and hippocampus, causing confusion and temporary amnesia due to decreased acetylcholine signaling. Toxicology also manifests in the autonomic nervous system, primarily at the neuromuscular junction, resulting in ataxia and extrapyramidal side-effects and the feeling of heaviness in the legs, and at sympathetic post-ganglionic junctions, causing urinary retention, pupil dilation, tachycardia, irregular urination, and dry red skin caused by decreased exocrine gland secretions, and mucous membranes. Considerable overdosage can lead to myocardial infarction (heart attack), serious ventricular dysrhythmias, coma and death.

melmerritt33

Thanks @canadjineh it’s taken a lot of time and experimenting and I’m still learning. What’s been really interesting to me is how much diet makes a difference, I had a week of higher carb including lots of bread a couple of weeks ago and I’ve been in a flare up which has left me completely exhausted.

I really think what we eat affects us more than we realise with this condition. My problem is that I love bread too much and I seem to have problems with really low energy on zero carb so there’s still room for further experiment to find what’s the best balance for me. I’m just so glad to be able to give up the side effects of daily medication, I know lots of people aren’t that lucky.

canadjineh

You don't have to be zero carb....just choose more of the kinds of carbs that support your health. You can make breads from nut flours if you are not allergic and they are a bit lower in carbs. hang in there.... keep up with the learning Here's an easy low carb mug muffin (you don't have to put cinnamon in it) you could put other herbs like oregano/basil/garlic powder to make it savoury. Gluten free too as long as you confirm your baking powder is GF.

canadjineh

geniuskitchen.com/recipe/one-minute-flax-muffin-low-carb-295649?mode=us&st=true&scaleto=1 sorry I forgot the link @melmerritt33

melmerritt33

@canadjineh Thanks, I thought zero carb would help more as lots of people find it resolved their health problems. Unfortunately every time I get serious about it I seem to crash and get worse, I think I just can’t eat enough meat to be healthy on it, I struggle to even get up to 1000 calories on meat only and even then only by adding dairy to up the calories and that’s not a healthy diet for anyone unless very short term. All the zero carb people eat tons of meat to keep healthy but I can’t seem to do it for more than a day or two then fall back and start not eating enough. At least I’ve made some progress in my health so I’m getting there, it’s always worth trying something in case it works!

I think you’re right and I need to find carbs that don’t upset my stomach then keep it to just a low carb diet rather than no carb. Maybe going gluten free will help more. I’m going to try that mug muffin for a start!

canadjineh

As everyone is fond of saying in the Low Carber Forum, we are all an n=1, meaning we are all our own scientific experiment in a sample of one. What's healthiest for one person may not be the best choice for another. I see you are a friend of Karlottap too. She's a great encouragement. You are welcome to friend me too if you wish, @melmerritt33.

What we eat in autoimmune conditions makes a huge difference... leaky gut syndrome is often implicated in all kinds of AI diseases. It's possible that you do not have an abundance of the normal enzymes and bacteria that process meat protein, the same idea as some of my friends who have a real problem digesting fruit & vegetable carbs - 2 of them are fully carnivore zero carb (with good health results for them, but it doesn't work for me either). Many people with Fibro have difficulty with gluten (grain protein) like Celiacs - in fact, often those with FM or Chronic Fatigue Syndrome are found to have undiagnosed Celiac disease.

You may be better off trying for <50g net carbs (mainly from non starchy veggies and a bit of fruit) while concentrating on getting strict about gluten which is hidden in all kinds of things. You might find the articles in this link useful - similar to the FM ones I post but focused on Celiac and Non Celiac Gluten Sensitivity: community.myfitnesspal.com/en/discussion/10104290/medscape-medical-professionals-continuing-ed-site-celiac-disease-gluten-sensitivity-articles/p1