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I've just started taking a drug called Amitriptylene for a combination of problems -- chronic headaches and muscle aches and pains. I might have fibromyalgia but it hasn't been decided for sure. The drug seems to be helping because I feel better and can get more done at work. But when I get up in the morning, I am just dragging. I catch myself taking little cat naps at my desk. What can I do about this?

As every patient, physician, and pharmacist knows, medications come with side effects. The goal is to get maximum benefit from the positive effects of the drug with the least (if any) side effects. Daytime drowsiness is a typical side effect of the antidepressant known as Amitriptyline. Even at low doses (25 mg), patients notice this problem. There is some evidence that tolerance develops meaning your body gets used to the drug and the side effect decreases over time. It's best to check with your prescribing physician about what to do. It may just be a matter of waiting until your body accomodates to the medication. Or your physician may want to change the dose you are taking. Sometimes patients are advised to take this medication right before bed. That way the drug has it's peak or maximum uptake in the body while you are already sleeping. And sometimes, a different drug is needed. But these are all decisions that will have to be made by you with your physician's guidance.

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