"systemic lupus for 3 years, severe spinal issues and now a trapped nerve in my buttocks. after no sleep for 5 days i became suicidal. doc prescribed 10 mg&#039;s of elavil...but it didn&#039;t work until i increased the dose to 30 mg&#039;s.  now i am finally getting sleep and pain relief.  this medicine is more effective than oxycontin, hydromorphone and many other medicines i have taken for pain (ibuprofen, and other otc medicines.) for me, the key was to increase the dose.  yes, there are side effects - constipation, dry mouth, drowsiness - but this is mild compared to suffering in so much pain that i did not want to live anymore."