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    Dr. G opinion pls..
    snowyowl33 posted:
    Hi Doc, long time no see, hope all is well with you.

    Ok, I would like your opinion on the use of Elavil (amitriptyline) low dose 10mg. one to start at bedtime for a month and then two per night for nerve pain from my damaged spine. I have recently had a back specialist prescribe this to me for nerve pain issues and I have concerns about using it. thoughts please?

    Secondly, I am already on Lamotrigne, Adderal a water pill -hydrochlorothyazide and an anti inflammatory (diclophen) spelling? daily and am wondering about interactions with all these other meds.....

    Thanks Doc

    People take different roads seeking fulfillment and happiness. Just because they're not on your road doesn't mean they've gotten lost. Dalai Lama
    Joseph F Goldberg, MD responded:
    Hi Snowy,

    Welcome back. Elavail is probably the best-studied drug for neuropathic pain, so the 10-50 mg at night range is pretty customary and well-studied, and often very effective. Very sedating, and can cause constipation and dry mouth, but usually livable. Theoretically a tricyclic antidepressant can cause or worsen mania -- something to watch for, though less likely probably at a low dose. You aren't taking any anti-manic drugs so the risk may be a little higher than if you were taking lithium, Depakote or an atypical antipsychotic.

    There are no interactions with the medicines you mentioned.

    Dr. G.

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