Taking alcohol with amitriptyline for PD - is it good for everybody?

[LenkaX]

PPH suggest to drink alcohol after taking all the pills. But my experiences with alcohol were always a bit different than for usual people. Usually it gives people a deeper sleep but for me it doesn't work that way. If I took alcohol late in the evening, I would certainly have problems with falling asleep and maintain a good sleep. I even don't drink alcohol because I have bad mood from it and the sleep issues.
Do you think that I should take the alcohol or not with the amitriptyline method, taking the above in consideration?
I would surely like to use Cimetidine instead of alcohol, but this medication is not possible to get in my country.
I need for this method to be 100% effective within 12 hours.

 

[LenkaX]

Can somebody help me? Should I take alcohol as a part of the Amitriptyline cocktail?

 

[SleepyTime]

The addition of alcohol or cimetidine with amitriptyline have different effects.
Both of which increase the damage from an amitriptyline OD.

The use of cimetidine delays the body from metabolizing the amitriptyline.
This allows the amitriptyline to work longer, since as you mentioned it takes hours to CTB.

The use of alcohol increases the effects of the amitriptyline.
This is due to the Central Nervous System Depression of both the amitriptyline and the alcohol.
When alcohol is mixed with another CNS depressant (or actually any combination of CNS depressants, like benzos, opiods, etc.) this magnifies the CNS depression above the individual substances. This is why all drugs that are CNS depressants warn not to mix with alcohol. Doing so is dangerous and can lead to coma and death.

So the suggestion to include alcohol shouldn't concern you. You are not drinking enough to get drunk. Just a single drink to increase the CNS depression from the amitriptyline. If you are still concerned about alcohol you can substitute any other CNS depressant (a benzo, an opiod, etc.) The use of cimetidine is highly suggested and since you are not able to obtain this specific drug there are other drugs that also inhibit the metabolism. Some of these are anti-psychotics and calcium channel blockers (hypertension). Alcohol and cimetidine are suggested because for many they are easily obtained. The other choices probably need a prescription. Your best bet is to do a search on CNS depressants and try to find something that you can easily obtain.

 

[Aap]

Alcohol impairs proper sleep; you are not alone or unique in that regard. The biggest issue is the timing, as amitriptyline may take longer than 12 hours. I don't recall alcohol mentioned in PPH for amitriptyline, but if it is, it is there as a method to get the taste out of your mouth after drinking the amitriptyline and as a potentiator for the benzos. You didn't mention benzos. Cimetidine is the least of your worries.

 

[LenkaX]

Some of these are anti-psychotics and calcium channel blockers (hypertension).

I have plenty of Ziprasidone, Quetiapine and Haloperidol which are antipsychotics. So do you think I can include like 10 tablets of each of these drugs to potentiate the coctail?

You didn't mention benzos.

So far I have only 20 tablets of Zolpidem (which is said to be not even a benzo). I will do my best to obtain Diazepam, but it's probable that I will not be able to get it.

 

[SleepyTime]

Here is a link regarding the suggested use of cimetidine as an inhibitor of CYP2D6 with amitriptyline. Scroll down to the section Ligands. The chart shows 3 columns - substrates, inhibitors, and inducers. In the first column (substrates) you will find amitriptyline. In the second column (inhibitors) you will find cimetidine listed as a weak inhibitor - meaning it will reduce the clearance of the amitriptyline by 20-50%. While there are stronger inhibitors, I am guessing that cimetidine is suggested because it is easily obtainable in the US without a prescription. While many of the other drugs are harder to obtain.

Regarding haloperidol. While it is listed as an inhibitor (unspecified potency) it is also listed as an inducer (unspecified potency). So I not sure what the specific action would be, decreasing or increasing the elimination of the amitriptyline.

Good luck with your search.

https://en.wikipedia.org/wiki/CYP2D6