how long do you wait?

How long should you wait for medications to work? My husband has been on increasing doses of amitriptyline but not helping very much. For three months, the doctor keeps saying let the medicine work. My husband hasn't driven since early November, doesn't leave the house without me, many days he can't function for the pain and discomfort.

How long do we wait????

Thanks. Rhoda

Hi Rhoda,

Sorry your husband is going through this. With Amitriptyline and drugs like it it can take 3 months to feel real benefit! It is quite clear that this drug does not work for your husband and you need to go back to your Doctor.

Is this Doctor a Neurologist who has prescribed the Amitriptyline for your husband? If not, I would recommend that your husband be referred to a Neurologist who is a Headache Specialist.

To answer your original question properly, it depends on the medication involved as to how long it takes to work! Some take longer than others!

take care

Ann

I've been on amitriptyline so long (over 10 years), I don't even remember how long it took before it started helping. But many drugs take several months before they start being effective --Topamax, for example, can require 3 months at "full" dosage (whatever that is for an individual patient) before it kicks in. If that's the case for amitriptyline (and I don't know that it is), it would mean that if your husband just reached his target dosage of 100mg, it may take another 3 months. Chances are, the neurologist is hoping that there will be some effect from the lower dosages sooner -- and we all share that hope!!

The best advice I can possibly give is to reiterate what Ann has said and I heard many times but found difficult to pursue where I was living -- FIND A HEADACHE SPECIALIST. Not just any neurologist, but one who really focuses on headaches. It's best if it's a doctor who you actually like -- I haven't had the best luck with neurologists in that regard (many seem to be among the biggest jerks in the medical profession, with apologies to any exceptions who are members of this discussion board). My MD sister agrees with this assessment. Now I've found one who actually listens to me, respects my opinions, and considers me a partner in my medical treatment. This may be the biggest success in my headache treatment in 18 years -- more than any single medicine or therapy. Judging by the horror stories so many others around here have about their medical treatment, finding such a doctor is no easy task. Even if you have to drive hours to access a headache specialist, consider it a worthwhile investment of time, given how infrequent your appointments are likely to be.

Mark

Thanks for everyone's input.

It it good to know that the neurologist is maybe on track when she keeps saying wait for the medicine to work. Since my husband is a large man, the 100 mg is probably finally getting to a correct dosage. Now we will just wait to see if it helps.

Thanks for letting us know about the contraindications for Imitrex and amitriptyline - that is scary to think that we kept asking for something.

Rhoda

I wasn't sure if the amitryptiline was working, so I (with my neurologist's OK) phased it out. I quickly found out that it was helping - my headaches got worse almost immediately. I also had a great deal of trouble sleeping when I went off amitryptiline --- one of the reasons I wanted to get off of it if it wasn't working is I don't like being so sleep-dependent on a med. But since it is clearly helping (possibly BECAUSE it helps make sure I sleep solidly), I got back on it right away, and the headaches lessened in severity a bit.

Having said that, I should note that I don't have migraines -- I have what are best described as chronic daily tension headaches. Another possible name is New Daily Persistent Headaches, although I laughed at my doc when she used that term -- nothing new about them to me after 18+ years of daily headaches! But what the term means is they started on a specifically identifiable day with no clearly identifiable cause. I don't have the same symptoms as classic migraines -- no nausea, auras, sensitivity to light, etc. -- and the pain isn't generally as severe (I've had a few migraines, but generally I have a 3-4 pain level constant headache). But these kinds of headaches often respond to the same meds as migraines, and researchers seem to think all these headaches are generally related.

So, I usually don't have acute attacks, although some days are much worse than others (like yesterday and today, for example). The only painkiller that works and that I ever use is Fioricet, and I limit that to 20 or so pills per month to avoid rebound headaches (been there -- no fun at all!). No real problems with dizziness, although my body seems to be pretty resilient as far as meds go -- I've had far fewer reactions to topamax than most people on this board, for example. My biggest problem with meds is that every time I find something that works (including Topamax), its effectiveness seems to wear off after a couple of months. Very demoralizing.

So, amitryptiline, on low dosages, has helped lessen my chronic pain, but is no cure. I've come to the realization that there isn't a cure for my headaches. The best I can hope for is to keep the daily pain to levels which don't keep me from doing the things I want to do with my life. So far, I've been able to do that. I wish the same for your husband! -- incapacitation like he's suffering must be miserable for both of you.

Good luck!