amitriptyline

[retiredfg5]

A little history first. Last year I augmented on mirapex /pramipexole and had to wean myself off of it and then start up again at a lower dose. Things were going good, my dosage was .25 mg in afternoon and .125 mg at bedtime. Then I saw my neurologist NP and told her I was having some new serious pain with neuropathic pain in my feet. She started me on amytriptyline (sorry, don't remember the dose). I had some bad side effects, namely I kept passing out and falling. This has been a problem for me off and on through the years, and always medication related. So when I saw my primary doctor, as an ER follow up, he told me to immediately stop the amitryptyline. I did and the falls were greatly reduced. My psychiatrist explained it to me that the amytriptyline and one of my other antidepressants were both affecting the serotonin and it was too much. So, I just thought I would warn everyone that if you have the same problems, check the amytriptyline.

[Polar Bear]

I'm glad your falls are now reduced following the cessation of the amitriptyline and thank you for flagging this up for others to note. I'm wondering about the neuropathic pain in your feet, has this returned without the amitriptyline.

[retiredfg5]

Actually the neuropathic pain has been minimal lately. When it first started to bother me, about 6 months ago it was so bad I could not even touch the foot to the floor. Then it was less painful when it did occur. Now it is very, very seldom. For the falls my primary doctor had me drop one of my 300 mg gabapentin.
Another problem I am having that is causing the rls to be more difficult. I need a hip replacement, on hold because a wound on my foot is slow in healing. Because of the hip pain and arthritis I am experiencing muscle spasms in the thigh. This combines with the usual rls "twitches" and they just magnify the pain/discomfort of both. A case of rls and another medical condition not playing well together.

[debbluebird]

Oh yes. I've been there. Every time I needed a replacement and right afterwards until I healed. my RLS would get worse.

[retiredfg5]

Sorry it's been so long to get back to this. For an update, my neuropathic foot pain is not happening much at all. My left foot is still not healed, a sore under a callus, treated for 14 months, 5 allografts applied. The right foot is worse, the tip of the second toe has osteomyelitis. I'm scheduled for surgery TOMORROW to remove the tip of the toe thus removing the infection, also straightening the next joint. From the RLS point of view, I have to sometimes warn the staff and doctors that my legs might twitch (MRI, steroid joint injection) I will definitely tell them tomorrow along with the card from RLS Foundation listing which meds to use or avoid. Debbluebird, thanks for the warning about the RLS getting worse because of the replacement. Because the ortho docs won't do surgery because of the sore on my left foot, and when I told them about the osteomyelitis I think I saw one of them doing the sign of the cross, so this surgery is on hold til ??? Hopefully it will get done this year, By the way I'm having the surgery tomorrow done under just local anesthetic, wish me luck!

[Polar Bear]

Best wishes for your surgery. I hope it all goes perfectly.

[retiredfg5]

I wrote up an update but it didn't go through. Here it goes again. The toe surgery went well, I got to watch it since it was done under local. Very interesting. That should take care of the osteomyelitis.
Now I have a problem that I would like your opinion on. It has to do with my med., pramipexole. After going through withdrawal last year because I was augmenting, I started up again with a much lower dose. I take .25 mg at mid afternoon and .125 at bedtime. This has been going quite well for several months now. But lately I've occasionally had to take an extra .25 mg tablet in the morning because the restless legs is really bad. I do this about 1-2 times a week. The restless legs is exacerbated by the muscle spasms I'm having in my right upper leg, a result of the bad hip. I know I shouldn't be taking the extra dose, but now is not a really good time to wean off the pramipexole. I'm hoping to finally have the hip replacement surgery in the next couple of months. Any suggestions will be welcome. Now I'm going to try to send this.

[ViewsAskew]

That really sounds like augmentation to me. The longer you wait, the worse it gets. Tough call...