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Compare Amitriptyline vs Gabapentin head-to-head with other drugs for uses, ratings, cost, side effects and interactions. Both gabapentin and amitriptyline are good nerve pain relievers. Amitriptyline can be better for some patients because of the convenient dosing schedule. On the other hand, most patients prefer gabapentin (the relatively newer medication) over amitriptyline due to less anticholinergic effects (dry mouth, constipation) and less sedation. Amitriptyline alleviates painful diabetic neuropathy. It is recommended by a variety of guidelines as a first or second-line treatment. [14] It is as effective for this indication as gabapentin or pregabalin but less well tolerated. [29] Amitriptyline is as effective at relieving pain as duloxetine. Explore gabapentin or amitriptyline for nerve pain, sciatica, and vulvodynia. Discover the differences, pros and cons, dosage, interactions, and real patient experiences. Sciatica is a symptom rather than a specific diagnosis 4 and is used broadly to refer to pain that radiates along the path of the sciatic nerve. 5. The commonest cause of sciatica is impingement of lumbosacral nerve roots, as they emerge from the spinal canal, by a herniated intervertebral disc (fig 1). For a person with sciatica, see the CKS topic on Sciatica (lumbar radiculopathy). Offer a choice of amitriptyline, duloxetine, gabapentin, or pregabalin. Titrate the dosage according to response and tolerability. Research suggests taking between 25mg and 75mg of amitriptyline daily is effective for pain conditions like sciatica [3,4]. Lower dosages are linked to fewer side effects, but these low doses may not be enough to relieve pain for everyone. Amitriptyline may be used to treat depression or off-label to relieve chronic pain, fibromyalgia, or insomnia. Experts are unsure exactly how amitriptyline works, although historically it was believed that amitriptyline’s effects for depression were due to its ability to rebalance chemicals in the brain, such as serotonin and/or norepinephrine. Nerve pain medication: Gabapentin (Neurontin) and pregabalin (Lyrica) may help reduce neck and back nerve pain, especially sciatica. Begin with low doses to avoid daytime drowsiness and fall risk. Muscle relaxants. Tizanidine (Zanaflex) and baclofen (Lioresal) may reduce pain from muscle spasms. Children younger than 18 years of age should not normally take amitriptyline, but in some cases, a doctor may decide that amitriptyline is the best medication to treat a child's condition. You should know that your mental health may change in unexpected ways when you take amitriptyline or other antidepressants even if you are an adult over age 24. For some people, combining amitriptyline and gabapentin (Neurontin) may help relieve sciatic nerve pain further. But side effects are more likely to happen. Various forms of exercise and manual therapy can be helpful. Both gabapentin and amitriptyline provided effective pain control in peripheral neuropathic pain. Additionally gabapentin was more effective especially in paroxysmal shooting pain than other pain qualities. Amitriptyline may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these adverse effects, tell your doctor right away. We would like to show you a description here but the site won’t allow us. The first amitriptyline brand was Elavil, which was FDA-approved on April 7, 1961, and has since been discontinued. Other amitriptyline brand names include Vanatrip and Endep, which have also been discontinued. Amitriptyline is now available as a generic medication. Amitriptyline is from the drug class tricyclic antidepressants (TCA). People with sciatica typically have severe pain at onset and a slower and less complete recovery than people with back pain without sciatica. A review of pharmacological interventions for sciatica is important because people with sciatica commonly present in primary care.
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