Help with depression-amitriptyline

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I've suffered from depression for a very long time. I still trying to figure out an answer. I've tried cyproheptadine (periactin) after reading that it can lower serotonin and can be effective in treating depression. However, I haven't really noticed any improvement. My doctor has recommended that I try amitriptyline, a drug that has been around since the 1950's. Everything I read says that it works similiarly to serotonin inhibitors, increasing serotonin in the brain to "promote positive feelings." But I am confused because I read that it is in the same family as cyproheptadine, a drug that is supposed to reduce serotonin. They are both chemical compounds with the tryclic structure.

"In recent times, the TCAs have been largely replaced in clinical use in most parts of the world by newer antidepressants which typically have more favorable side-effects profiles such as the selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and the norepinephrine reuptake inhibitors (NRIs) like reboxetine, though they are still sometimes prescribed for certain indications."

In addition, I asked Ray if he thought this drug is safe and he said the following:


Me:
Hi Dr. Peat,

I wanted to know if amitriptyline would be a safe option for treating depression/anxiety in your opinion. My doctor is recommending that I take it.

Thanks.
Ray:
I think it's safe. Compare the structure with cyproheptadine. Have you tried niacinamide, pregnenolone, and thyroid?

Me:
I currently take cyproheptadine. From my understanding, amitriptyline and cyproheptadine have opposing effects on serotonin. Is this true, and could this be problematic, if so?

Thanks.

Ray:
Both of those are appetite stimulants that tend to cause weight gain. Serotonin tends to cause anorexia. The drug industry generates noise in the process of selling drugs, and "serotonin" is one of their favorite noises.




What is the deal with this drug? Is all the crap I read on the internet B.S. Why would ray say it's "safe" it is increases serotonin? I'm losing my mind here, and I don't know what to make of all this. Any advice or insight would be greatly appreciated. Thank you in advance.
 

4peatssake

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I think he's saying that he doubts it increases serotonin and feels it is similar to cyproheptadine.
Moreover, he's suggesting you try niacinamide, pregnenolone and thyroid to treat the depression. Those are the supplements I would try first.

B6 and zinc deficiencies can also cause depression and may be worth supplementing as well.

How is your diet? What other supplements are you currently taking?

Welcome to the forum!
 

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My diet is pretty good. I find that a lot of liquids make me colder, so I'm a bit torn on all the milk and OJ. However, I do try and focus on dairy, include the carrot, etc. Are there any blood tests I can have done so I know how to target any deficiencies I may have...if so where can I have these done?
 

charlie

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lookingforanswers, :welcome

The body becomes depressed due to lake of energy. Fix the energy and the body will come alive again. Thyroid hormone, proper fuel and nutrients, limiting PUFA, getting the correct amount of light, bag breathing, etc., will get the energy flowing again.
 

4peatssake

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lookingforanswers said:
My diet is pretty good. I find that a lot of liquids make me colder, so I'm a bit torn on all the milk and OJ. However, I do try and focus on dairy, include the carrot, etc. Are there any blood tests I can have done so I know how to target any deficiencies I may have...if so where can I have these done?
If you can list the foods you are eating on a daily basis, that will help us see where you may be deficient.

I'm not the best resource on bloods tests but here's what Mittir posted last month.

Mittir said:
If you can afford try to follow certain labs RP recommends.

Blood tests for cholesterol, albumin, glucose, sodium, lactate, total thyroxine and total T3 are useful to know, because they help to evaluate the present thyroid status, and sometimes they can suggest ways to correct the problem.

Less common blood or urine tests (adrenaline, cortisol, ammonium, free fatty acids), if they are available, can help to understand compensatory reactions to hypothyroidism.

You can use cronometer to track your nutritional intake. It takes a good amount of work and patience to heal a body that was malnourished for a long time.

Another forum member - Dan Wich - has created a terrific resource for those in the US who are looking for test providers and lists the blood tests commonly taken by people with thyroid disease.

Test Providers
 

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Anyone have any experience with amitriptyline? Or any thoughts on this medication? I'm still curious as to why Ray would consider it to be safe. I will say that after taking it, my mood is definitely improved...something I could not say about Cyproheptadine which is similar in structure. Any insights would be appreciated.
 

Blossom

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I took amitriptyline on and off over the years. I took 25mg at night due to the sedating side effects. Out of every antidepressant I tried it was the only one that actually didn't make me feel worse and maybe that was because it helped me sleep. I decided to try it because none of the SSRI meds ever helped at all. This was way before I discovered Peat. I also noticed after about 4.5 months of following a approach as outlined above with thyroid, chronometer, bag breathing, progest-e, prgnenalone etc. my mood improved to a level I've never experienced. I think you will be surprised what the approach as a whole will do,I sure was!
 

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I just wanted to add that my amitriptyline was 25mg and I would often cut them with a pill cutter and take 1/2 to 1/4 tablet so I actually took the minimal effective dose for me. The reason I tried it when the other meds didn't work was because my great grandmother was able to stay out of the mental institution when it first became available. I felt at the time it had a more proven track record compared to the newer drugs. I believe 75mg is considered the antidepressant dose. If Peat thinks it safe for you it probably is. I'm not a scientist but I wanted to share my personal experience with the medicine. I'm glad to not need it anymore but I never had a negative experience with it when I was taking it. It's cheap too. Hope that helps some. If you feel you need it while doing your healing work I don't think it will set you back any. The real healing factors will be the nutrients, hormones etc. though.
 

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Blossom said:
I just wanted to add that my amitriptyline was 25mg and I would often cut them with a pill cutter and take 1/2 to 1/4 tablet so I actually took the minimal effective dose for me. The reason I tried it when the other meds didn't work was because my great grandmother was able to stay out of the mental institution when it first became available. I felt at the time it had a more proven track record compared to the newer drugs. I believe 75mg is considered the antidepressant dose. If Peat thinks it safe for you it probably is. I'm not a scientist but I wanted to share my personal experience with the medicine. I'm glad to not need it anymore but I never had a negative experience with it when I was taking it. It's cheap too. Hope that helps some. If you feel you need it while doing your healing work I don't think it will set you back any. The real healing factors will be the nutrients, hormones etc. though.

thank you for this, it is certainly helpful...i really do appreciate it. My father has been on it for 30 years now, so I'm not too nervous about it. I'm 23. Sometimes I feel like, I inherited the anxiety or depression, so amitriptyline will hopefully be the missing piece I've been looking for.
 

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it's this quote from ray's article that really confuses me, i feel like he's contradicting what he said in his email to me:

"Biochemical studies have revealed that in contrast to classical tricyclic antidepressant, tianeptine stimulates 5-HT uptake in vivo in the rat brain. This somewhat surprising property was observed in the cortex and the hippocampus following both acute and chronic administrations. This increase in 5-HT uptake has also been confirmed in rat platelets after acute and chronic administrations."
 

aguilaroja

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This same discussion is taking place on the peatarian.com. I will aim to briefly answer here:

Disclaimer: I do not speak for Dr. Peat, and am only an appreciater of his work.

(1) If you have a good working relationship with your doctor, and this is the recommendation, consider a low dose short term trial as a starting point. Alternatively, consider keep looking for a provider with whom there is a good rapport.

(2) Amitriptyline and the tricyclic antidepressants are noted in research to raise serotonin, and from this point of view might be less than ideal, less "peatarian". Dr. Peat mentions "niacinamide, pregnenolone, and thyroid". Many restorative measures may help mood. My observation is that sometimes Dr. Peat is polite by deflecting things and raising other possibilities.

(3) From a "theoretical" viewpoint, Amitriptyline and the tricyclic antidepressants may be relatively preferable to the SSRI's (Prozac, etc.). There is some similarity to the cyproheptadine structure. The tricyclics have other major actions besides lowering serotonin re-uptake. The anticholinergic effect of the tricyclic category may itself be helpful for some issues. SSRI's generally lack the anticholinergic action.

(4) I don't know details but Dr. Peat seems to field many thousands of questions these days. I would guess that some answers need to be brief. His way also seems to include giving information and leaving people to follow up. These forums seem an outgrowth of the teaching approach of providing a basis for improvement without dominating authoritarian commands.

(5) There are certainly reports of side effects for Amitriptyline. Some of these case reports have been amplified after the SSRI patents become more profitable. There was a generation of people that got some relief from Amitriptyline and its cousins, though tricyclics are used less now.

(5) It's understood that depression can be quite impairing, all the more when it persists a long time. I have seen a Peatarian approach help a lot of friends. In other cases, other measures besides generally boosting metabolism are very helpful. I have no quick summary nor across the board suggestions for surefire absolute depression cures.
 

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I'm looking for a straight answer, and it doesn't look like there is one.

but thank you for your help...here is the response I got from Ray, pretty similar to the points you mentioned:

"The inhibition of serotonin uptake is definitely harmful, but some of the so-called SSRIs (such as fluoxetine) actually lower serotonin, and have other effects. Amitryptiline is considered to be an MAO inhibitor, and I think it's less harmful in small amounts than the SSRI drugs."

"Amitryptiline is so similar in structure to cyproheptadine that I don't think it would be good to take them together. Do you drink coffee? Vitamins B1, B6, and niacinamide, and thyroid, help to protect and regulate the nerves."
 

Blossom

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I was excited to learn that this medication is anticholinergic since Peat has pointed out this is important in in cancer. I'm assuming if the cancer is a serotonin secreting tumor the fact that elavil is a serotonin uptake inhibitor would negate any value in that context. I just happened to run across that info in a drug manual today and initially became interested until I read the serotonin part. I suppose if he really felt it was a valuable drug we would know about it. Oh well
 

jyb

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lookingforanswers said:
"Amitryptiline is so similar in structure to cyproheptadine that I don't think it would be good to take them together. Do you drink coffee? Vitamins B1, B6, and niacinamide, and thyroid, help to protect and regulate the nerves."

I'm curious, why would it be bad to take them together? I only know about cypro. But if two drugs do good stuff like lowering serotonin, why is it bad to take them together?
 

Blossom

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jyb said:
lookingforanswers said:
"Amitryptiline is so similar in structure to cyproheptadine that I don't think it would be good to take them together. Do you drink coffee? Vitamins B1, B6, and niacinamide, and thyroid, help to protect and regulate the nerves."

I'm curious, why would it be bad to take them together? I only know about cypro. But if two drugs do good stuff like lowering serotonin, why is it bad to take them together?
The cyproheptadine lowers serotonin but the Elavil doesn't. The Elavil apparently is anticholinergic but I guess if you need an anticholinergic and you don't want higher serotonin then stay away from Elavil. That was the only antidepressant I took back in the day that didn't make me feel worse so maybe it was the anticholinergic effects. I guess like most things there are pros and cons. Just though I'd share what I found.
 

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I think Elavil lowers serotonin, just like cyproheptadine. I have taken both and the side effects are extremely similar. If I took them blind, I don't think I could tell the difference. They both increase my appetite and seem to have the anticholinergic effect. I think a lot of information on the internet suggests that Elavil is just the first generation of the modern-day SSRI, but that is just a reason to convince people to take the new stuff. Drug companies want people to believe that something like Amitriptyline raised serotonin, but the newer ones are less risky. I think this point sums things up excellently:

(5) There are certainly reports of side effects for Amitriptyline. Some of these case reports have been amplified after the SSRI patents become more profitable. There was a generation of people that got some relief from Amitriptyline and its cousins, though tricyclics are used less now.
 

tara

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Many years ago I was prescribed 10mg amitriptyline for possible migraine prophylaxis. I was told it would not have an antidepressant effect because the dose was so low (as B said, I was told 75mg was AD dose). It wasn't very effective against migraine, but it did make me sleep long and feel not quite myself - neither happy nor sad about anything much. After a few months I mostly stopped, but for a while I was using 1/3 tablet (c.3 mg) occasionally as a sleep aid - it would send me to sleep in 15 mins for a good 8 hours. I wouldn't have been keen to use 75mg.
 
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