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PPI + amitryptiline

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Posted 9/13/2012 2:05 AM (GMT 0)
As some of you may know, PPIs give me side effects. aciphex is the best one I can tolerate ... but it too had given me side effects (although much lesser than the other PPIs) - after being on it for >2 weeks.

However, for the last month or so - I've been on aciphex 20mg/day (1 hr. before morning breakfast). Plus, based on my new GI's advise, I am also trying 20mg of amitryptiline at night.

My side effects that I usually get on aciphex are now much lower (mild ache and pain in the back and fingers and legs and bloating once in a while). My reflux symptoms are now well controlled (however, they do rear their ugly head once in a while). My theory on the side effects is that the amitryptiline is possibly controlling those side effects - but I am not 100% sure.

I am happy that the reflux symtoms are under control but I will experiment aciphex without the amitryptiline (and also amitryptiline without the aciphex) - to see how my GERD and the side effects behave in such experiments.

Even though I don't like amitryptiline (makes me somewhat sluggish in the AM) - my current plan is to ride on this "cocktail" for as long as I can.

I am curious to know what you all think about this regimen of aciphex + amitryptiline and whether anyone has successfully managed their symptoms with such a combination.

Thanks
Posted 9/13/2012 9:09 PM (GMT 0)
My experience of Amitryptiline is that you have no effects at night as you are completely out of it. I struggled to function on it as I was just so tired, however it is a drug that changes serotonin to make you happier and so things seem less stressful. If it works for you then good luck but just be aware that after prolonged use it is hard to get off as you feel down. I took it for about 3 months as I had a migraine for over 4 months.
Posted 9/14/2012 1:37 AM (GMT 0)
hi PPI,

i started elvil 10 mg last week.  It does seem to provide some relif to throat pain and throat clearing..

i think it still too early to tell for me..

did you feel ur symptomps kept improving the longer you take it?

The only problem with taking it is feeling really tired till about 11am in the morning..

are you still groggy in the am, i was hoping the groggyness might wear off soon.

i still have throat sensitivity...

please keep us up to date with your progress on elavil.

 

Posted 9/14/2012 1:06 PM (GMT 0)
Yes, the symptoms kept improving for me. However, I believe my GERD symptoms were improving because I could stay on the PPI (aciphex) - which I am able to do 'cause of amitryptiline (I think).

Elavil (amitryptiline) definitely causes drowsiness and tiredness during the first few days. It did get better for me after the first week (I started with 10mg and then increased it to 20mg per my GI's instructions).

I wish I could just take the PPI (without having to take the Elavil) though.
Posted 9/15/2012 12:32 AM (GMT 0)
PPI-LESS,

I am not sure  why the Dr. ordered the Amitryptilline as I understood Amitriptyline is a tricyclic antidepressant and like other tricyclics they can have severe anticholinergic effects
such as weakening the LES and causing GERD. 

I would suspect that the Amitryptilline used at low dose may  help decrease anxiety.  Stress/anxiety plays havoc with the digestive system/stomach.

Please remember I am not a Dr. but just sharing my own personal knowledge which may be right or not. 

Do let us know how you are doing and know we are here to support you.

Kindly,

Kitt 

Posted 9/18/2012 2:36 AM (GMT 0)
Hi Kitt -

I have symptoms of LPR"ish" GERD (I had severe throat symptoms when all this started in Feb 2011 - and my pH tests showed more reflux in the top than at the bottom of the esophagus).

I seem to complain about my symptoms excessively (not in proportion to) what the pH tests show. Plus, I have these sensitivities to drugs (PPIs, H2s etc.). This has led this GI to believe that my body (including my esophagus) is sensitive. Elavil seems to calm the nerves down - and does address over sensitive esophagus.

In my case, the side effects of neuro-muscular pain from the PPIs/Aciphex are probably being controlled by Elavil ...

I've been doing much better with respect to my symptoms .. likely because I was able to stay on Aciphex as a result of Elavil holding down the side effects (I think).

I plan to stay on this cocktail for a few more weeks and then will start experimenting with some reduction of Elavil and then Aciphex and see where I land!
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