Amitriptyline and/or codiene?

Hi guys,

Last November I was diagnosed with fibro. Three months ago I was given two months worth of co-codamol (Codipar 15mg/500mg). One month ago I went back to the doctor and asked if I can have a slightly stronger pain killer as these ones weren't giving me much relief. She suggested amitriptyline but I was against that idea as I had heard and read about a lot of people who had such a bad time on it. She accepted my refusal but was hesitant and apprehensive about giving me a stronger pain killer. So she suggested I take more at a time. Before, I was instructed to take four a day. This time she suggested I take 8 a day. I said I'd try that. Still, it wasn't helping much and now I keep getting headaches. And she perscribed me 60 tablets which only lasted me a week!

So, today I went back to the doctor (not my usual doctor) and explained the situation. He suggested I try amitriptyline. I told him about what I had heard about it, and the concerning fact about having thoughts of suicide, and his response was "I don't know who you've been talking to but that's all rubbish. And people who DO have thoughts of suicide are people who are already clinically depressed anyway". I told him, regardless, I don't wanna risk it (mainly because of the other side effects, especially weight-gain as I already have an issue with that) and I asked very politely can I have a stronger pain killer. The co-codomol doesn't really do much for me. Again he was apprehensive too, and basically pushed for the amitriptyline. I relented and said ok. He did say though that if I have a bad time with it then I should come back and see what 'other options there are'.

This guy is new to me. I have never met him before. He also seemed unwilling to give me what I requested. And he seemed rather dismissive too. When I ask for the pain killers he asked me what were they for. Then when I told him about fibro he asked what pains was I experiencing and how often. Now, he could be asking these questions to ascertain which pain killers would suit me, but combined with his attitude and demeanour previously I got the impression he was sceptical of the fact I even had fibro! I found it all very insulting.

Why are these two doctors hesitant about giving me stronger pain killers when clearly the other ones arent working? Why are they not really accepting my right to refuse a medication that I'm too worried about taking?

But getting to my original question I was going to ask lol -

I'm willing to give amitriptyline a try. I've been prescribed 10mg and to take one tablet each night before bed time. But I'm apprehensive about leaving such a huge gap between pain relief right now, as I'm used to taking a co-codomol in the morning, afternoon, and before bed. Currently though in the last couple of weeks I've been taking over-the-counter Solpadeine Max (12mg codeine). So my question is can I take a pain killer, whether that be a Co or Solp, in the afternoon or something whilst having an Ami at night?

I know I seemed to have gone around the houses to get to my question but I figured for anyone who is awesome enough to reply it would be easier to give all the facts before hand lol.

Many thanks 😊

I'm sorry your in so much pain and the meds you've been given aren't working. I am not familiar with that drug so I'm unable to guide you.

The scripts that were given to me caused side effects and scared of issues with others I went off the meds and went to alternative meds and therapies which has helped more than the scripts.

Hi, kiki,

Thank you for your reply.

What alternative and therapies have you tried that have helped?

By all means do not quit cold turkey like I did. Withdrawal sucks! Talk to your physician first.

Changing your diet is huge. Avoiding night shade vegetables, sugar, caffeine, gluten and dairy. Especially if you have ibs. I use a nutri ninja so I can make my green smoothie every day.also take probiotics and digestive enzymes and Bone broth.

Also switched out meds for supplements. Tumeric ( natural anti inflammatory), Sam e (relieves joint pain and helps with mood), b12 and d (energy), magnesium calcium and zinc ( sleep aid and helps with restless leg and pain). Epson salt and baking soda detox baths 29 min 3 times a week helps relax muscles and help with pain.

Found a chiropractor that won't charge a fortune that also does accupuncture and physical therapy. I was in so much pain but they also used biofreeze to help with the pain before working on me and use the table to raise and lower to stretch out my back if they can't touch because of the pain while in a flare.

Right now I'm in a flare cause there was a 20 degree change in weather and I had a virus that stirred everything up. But my flares are reducing and pins and needles, muscle spasms, ibs, and restless leg were under control for months.

The meds just made me loopy and even more foggy than fibro did on it's own. I couldn't get out of bed some days. I want my life back so trying whatever I can. Try doing some of this while on the medication but talk to your pcp to make sure there aren't any interactions. Hope you find some relief and keep me posted.

Hi Hun

I'm not sure why you have been prescribed the co codramal that wouldn't do much to me.

My meds are

Pregabalin x2 a day

Amatriptolin up to 50mg a night

Zapain up to 8 a day if needed

Ibuprofen 200mg up to 6 a day

Ibu gel for sore muscles

And I also attend a pain clinic

I think you need one of the nerve blocker meds

Hi Yasmine,

you say you were diagnosed with Fibro last November, can I ask who diagnosed it?  Also have you seen a Rheumatologist.

My GP referred me to a Rheumatologist many years ago and it's her that diagnosed my arthritis and Fibro etc and she decides after discussing it with me, what medication I take.  I actually have a very supportive GP, but I know some people really struggle to get theirs to prescribe things.  

If you don't already see a Rheumatologist, that may be a good starting point. x

I took Amti. and got severe constipation .im on co codamol and Ibrufen and paracetamol and for the spasms i get Disapam 2mg. also citilapram 40mg. im still constantly in pain none of them work. but i also have cervical spondiloses .

yes Sukes , my gp is always giving me the most cheapest of tablets he can swop them with. we a practice of a number of gp.s. and there,s one especially whome actually told me i was (wasting his time ) that was the month before i got the fibro.diagnosis from the rhumo. I now try to see any of the other doctors ,I won,t see him again but he is my ( named doctor ) and ive tryed to get him changed to any other doctor in the practice ( as by law i can now ) But they won,t let me they keep saying you can see any other doctor here you dont HAVE to see this particular doctor ) But he has the last word on all my meds. and he keeps changeing them to really cheap versions of what i have had prescribed by other doctors in the practice !! and half of them he swops them for are too big for me to swollow !! im at my whits end !

HI I take amitriptyline and doc has now upped my dose as I have had 3 bad flare ups.  I am struggling work wise because they do not understand.  I also take co codamol if its a bad time.

Hi, Sukes,

Yeah I saw a rheumatologist last November. She suggested amitriptyline for about 4-6 months time if none of her suggested exercises weren't working. Which they didn't.

We went through the history of the pain, the fatigue, etc, and she aslo did that pressure point test thing. I didn't even know those areas were sensitive until she started poking me! Lol. My huge aversion to sudden loud noises is part of it too apparently. It literally makes me cringe and I feel a physical pain shoot through my body when it happens.

Thanks, Kiki.

That's a lot of good information right there. If only it didn't sound like such a hassle. Why can't life just be simple and easy! Lol

It's gotten to the point of just learning to live with it as much as I can.

There are still people around me who just don't seem to get it though either, which doesn't exactly help.

Thanks for your info 😊

Hi Denise,

Yeah it seems they'll give us the cheapest meds possibly, regardless of what are actual needs are.

You can change doctor whenever you like because, like you say, it's the law. So demand they allow you to change. If they say they can't ask them for a written explanation as to why. Also, you should explain that you are not confident or comfortable seeing him so if they refuse you then basically they are ignoring the patient care act/policy, and most of all, it's against your human rights to deny you a health professional you feel you can trust! By not allowing you to be assigned to a doctor you trust they are compromising your health, because you are less likely to seek him out if he makes you feel so worthless. Give them hell. I would.

I'm so sick of professionals telling me what something ISNT. Yeah, they may be experts (arguably) but it's YOUR body, you know what's what, what feels right or unusual, etc. They should really start listening to us because if they get something wrong then it's US who suffer.

Oh my goodness, I am the same as you Yasmine where loud noises are concerned, but I didn't have a clue that it was part and parcel of Fibro.  You learn something new every day. 

I didn't know that either, Sukes, I just accepted it as 'normal' lol.

My 8 year old nephew likes to hide round corners and startle me as much as he can. I have told him to stop and why, but I don't think he understands. But I think I've become a ninja when I know he's around lol. I'm instinctively on the look out for him now!

Also, I was sitting in the garden with my boyfriend the other day and he put a blade of long grass between his hands and blew, making that horrible shrill loud squeak.......my god I could have killed him! He did apologise as apparently he was a bit absent minded about my fibro for that second, but I have never wanted to punch someone so much in my life! Lol

It's not funny I know, but your post just made me really laugh. 

Ah well good! I like you spread the joy 😊 If nothing else we must keep a sense of humour, no?

Laugh or cry? Always opt for laugh!

I haven't been able to work for a long time because of it either. It's so soul-destroying.

A few years ago someone made a joke about me wanting work to be handed to me 'on a silver platter'.......what?!?! I couldn't be bothered with explaining to them the reasons behind why I wasn't working because 1. they are one of my friends and so therefore already KNOWS how I suffer, and 2. why should I justify myself to someone who is clearly narrow-minded. I didn't speak to them for a while after that. It was cold how they said that comment.

I've spent years explaining to people how this affects me, what I can and cannot do, and mainly the fact that just because you can't see it doesn't mean it's not there. All that is exhausting in itself!

Hi  I was diagnosed in jan 16.  I continue to work although I had to reduce my hours. I am a carer for the elderly.  My work have not been at all supportive of me.  I have been threatened with the sack!!!  even though they know why I have been off.  Like you say because you cannot see it people think you are okay which is not fair.  I ache most days but some are much worse than others especially when i get a flare up like now and it makes me exhausted. I just wish my employer would see that some days I am not 100 percent but still go in and offer me lighter duties which dont put strain on me.  When I had a discussion with her  a month ago, all I got was ' my mother has this and I know all about it'  clearly not because if she did she would understand.  I want to work and am actively seeking a change of direction but nothing is coming up.  Exhausted is an understatement at the moment.  

I'm sorry you have to endure all that. It's sickening. Could you perhaps ask your doctor to write a letter for your employer about how you struggle? Your employer has to by law make your job and duties suitable for you. Granted, if a person is unable to carry out the main duty they are employed to do, and amended options don't work, then the employer can have grounds for dismissal, although they still have to be very careful about it!

But well done to you though, for striving on helping others even though you're in pain and could use some help yourself. Nice to know there's still some good Samaritans out there!

Hi my daughter has had fibro for 10 yrs nw an we have walked this road.... its hard an you need to find what works for you.....wht I can tell you is pain pills taken everyday cause rebound pain which is a vicious circle.... she has been on Trepiline 25mg amitriptyline 1 at night if you take it early about 7pm you'll have no problem just don't drink alcohol with it.....Lyrica 75mg changed her life.... she now only takes pain pills if having a flare-up an stays away fm codeine as far as possible it the worst when giving rebound pain..... also myprocam a new antinflamitory pill work very well..... talk to your docter and don't read up too much about pills everyone is affected differently.... Goodluck