Tricyclic antidepressants for dry eye pain?

[kanon]

Hi,
The optometrist I am seeing here in the Netherlands who seems to know a lot about Dry Eyes and dry eye pain has suggested tricyclic antidepressants to help relieve the pain of dry eyes. Has anyone heard of this working before?
Thanks! Ashley

[Guest]

Tricyclic antidepressants definitely can be helpful in treatment of neuropathic pain, so if that's part of your eye pain problem, they may help with that. However, they also might cause a decrease in tear production while you're taking them... Question is will any benefit to neuropathic pain outweigh any decrease in tear production.... won't know unless you try them, but would be interesting to hear what your doctor has to say on that...

[DCRdryeye]

I agree with SAAG, you may experience less tears whilst taking them. If you do some research about the side effects you may find "dry eye" is one of them. The specific tricyclic antidepressant they usually issue for pain is Amitriptyline (Tryptomer, Elavil, Tryptizol, Laroxyl, Saroten, Sarotex, Lentizol, Endep). Often you discover "dry mouth" is a side effect, but if it's going to cause dry mouth, it will often cause dry eyes too because the salivary and lacrimal glands both rely on the same neurotransmitter to work - and Amitriptyline blocks it.

If it's another type of tricyclic antidepressant, the side effects are all similar because they all work in a similar way. Personally I wouldn't take it. A friend had to take the medication and he is anti-medication and into natural products, but he was struck down with bowel cancer and experiencing attacks of acute PAINFUL anal pain that was so bad the only thing that gave him 'some' relief was to curl up in a foetal position. So it depends on the intensity of the pain, whether you have other choices, etc. And do you have the choices in the Netherlands compared to countries such as the USA?... Make a list of all the other things you haven't tried and those that you can obtain via mail order

[Nikki]

I advocate for amitriptyline. I use it myself, and it helps a lot with my neuropathic pain / cornea neuralgia. I think all meds may have the potential for eye dryness; the question again is the cost/benefit ratio. For me, I wish i'd discovered and used amitriptyline years ago. Another thing to take into account is the dose. For depression, it's a much higher dose (perhaps 150-300mg). For neuropathic pain, it's 10-25mg or up to 100 mg max. I say, ask your MD, try it out, and if it doesn't work, then nix it.