Is It Advisable To Increase The Dosage Of Amitryn To Better Manage Anxiety?

Posted on Mon, 25 Sep 2023

Question: Good evening doctor - my medication is as under:
Quitipin 100, amitryn 150, mirtaz 37.5 all in the night
Duolextine 60, betacap tr 20 all in the morning
I am tolerating amitryn well ( fingers crossed ), increased gradually from 130 to 150, stopped trazodone completely. My anxiety is much better ( 95-97% ok), a little bit is still there. Sleep is well too. Wanted to check with you whether I can further increase amitryn to be completely ok. The internet says that for outpatients maximum dosage is 150 and for inpatients it’s 300. Is it true? If not, is it ok to increase it by another 5-10 mg to feel completely better?

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Thank you. I increased it from 145 to 150 on Sunday ( 2nd September), should I increase it to 155 today or should I wait for sometime to see its full effect? If yes, after how long should I increase it? Also, wanted to check with you if increasing duolextine from 60 to 70 ( instead of increasing amitryn) is an option for me to feel completely ok?

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Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
You can go up to 200 mg.

Detailed Answer:

Hello,

Amitriptyline is an old drug and is associated with some side effects. But that doesn't mean that high doses should be avoided. If we go by research then maximal dose is 200 mg. Doses above this dose should be preferably avoided. To remain on safe side you can try to increase the dose by 10-25 mg, but only after having talk with your doctor.

There will be not much serious side effects. You have tolerated high doses in the past too.

Thanks.

Regards

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Brief Answer:
Wait for at least a week.

Detailed Answer:

Hello,

No, you should increase the dose of Amitriptyline in my opinion. Wait till Sunday and then increase the doses further.

I don't think there is need to increase dose of Duloxetine or any therapeutic benefit in you because of this.

Thanks.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar