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Drug for Pain Triggered Fainting

Q. My father has atrial fibrillation and is treated with a pacemaker and digoxin.

His heart doctor ordered amitriptyline because of a burning sensation in his feet. He had fainting spells within two weeks of starting on the amitriptyline. With his heart condition, what is a good alternative for treating his neuropathy?

A. Amitriptyline is an old-fashioned antidepressant that is sometimes prescribed for nerve pain (peripheral neuropathy). This drug is rarely appropriate for senior citizens. For one thing, it can trigger irregular heart rhythms, which might have contributed to the fainting spells. This drug can also cause dry mouth, dizziness, drowsiness, constipation and confusion, among other side effects.

We are sending you our Guide to Drugs and Older People with a list of medications that people over 65 should usually avoid, along with drugs that can cause forgetfulness and fuzzy thinking.

Your father might ask his doctor about benfotiamine, a synthetic form of vitamin B1. Studies suggest it helps ease neuropathy for some people (Pharmacological Research, Jun. 2010). You can learn more about this little-known remedy here.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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