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.
