Amitriptyline at 25mg - depression/anxiety

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?

I have taken amitriptyline too at a small dose. It can help with sleep. For me it makes me sleepy all day and I cannot tolerate at larger doses. Like you say it makes my anxiety much worse.

Valium is the only med that helps but my supply is limited as it is addictive.

Medication is not the answer for everyone although there is much pressure from doctors to take it.

Have you tried management steps at all?

I've been on amitriptyline for a very long time. I've titrated up, down and sideways. I've gone off it a few times. I know exactly how different dosages affect me.

25 mg daily would be too little to help me much. 45 mg is way, way more effective. At 45 mg, I get the most bang per mg. If I increase it above 45 mg, the increases don't give me all that much added benefit. At 75 mg, I start getting a very dry, sore throat. The added benefit - if any -isn't enough to be worth the sore throat. Doctors tend to want to prescribe me 50 mg because to take 45 mg, I need 3 pills. So I go along with taking 50 mg (1 pill) a day - in the evening.

Amitriptyline changed my life. I wish I had been on it right after high school. Then I might have completed college in way less time. I always tried to drop it to the lowest dose that helped. 40 mg helped. 35 mg was just too little to do much good. So I'm a good example of how different dosages can have very different effects and tolerability.

I've met people taking 200 mg per day. I couldn't possibly tolerate that. I couldn't tolerate 100 mg/day.

45 mg/day was the magic dosage for me. That dosage is constipating, but Miralax fixes that. That dose didn't make me gain a lot of weight. That dose did hugely improve my sleep pattern, which made staying in school or holding a job possible. It gave me more physical strength and energy, so I could ride my bicycle up hills more easily.

Doctors don't like to prescribe it. I've been on everything else you could name (except MAOIs.) Nothing other than amitriptyline helped me the least little bit - nothing. (Remeron kind of worked the same, but made me dream too much.)

Conclusion: amitriptyline 45 mg taken once every eve about 7 p.m. dramatically improved my life. I still struggled with depression, but I coped way, way better. Dosages higher than that didn't do much better and had too much side effects.

If you increase amitriptyline, do it gradually . . . or you might get akathisia, which could make a person almost suicidal. It's a miserable sensation of restlessness. I literally couldn't stay still. Awful.

For years it made me light-headed, if I got up rapidly from a squatting position . . . but that side effect went away after about 5 years.

Now I have tinnitus. It's possible that the amitriptyline caused it. But it still was worth it.

Re: sleep. Once I got used to it, amitriptyline did not cause me any sleepiness the following day. That side effect went away after 3 days.