Your current medications (Topaz and Tryptomer) are preventatives that require time or dose adjustments to work effectively. Since your pain is currently unbearable, please consult your neurologist. They may temporarily add a muscle relaxant (like Tizanidine) or an anti-inflammatory medication (like Naproxen) to provide immediate relief. Because sitting triggers your neck pain and headaches, it could be related to nerve compression or muscle strain in the neck. Do not self-medicate with new drugs. Instead, ask your doctor about physical therapy, posture correction, and ergonomics, which are highly effective for this specific type of pain.

An overactive thyroid can indeed cause a fast heart rate, along with anxiety, weight loss, and feeling unusually warm. Your doctor prescribed Norton (propranolol) to help calm your heart rate, and Tryptomer (amitriptyline) to manage related symptoms. While these medications are highly effective at managing your symptoms, a simple blood test can easily check your thyroid hormone levels to see if that is the underlying cause. I highly recommend discussing this with your doctor.

What you are experiencing could be primary exertional headaches, where light exercise temporarily increases blood flow and pressure in your brain's blood vessels, triggering throbbing pain. While Tryptomer (amitriptyline) is excellent for preventing headaches, it may take time to optimize the dose, or we may need to look at your hydration and warm-up routines. Since your MRI was clear, further imaging is likely unnecessary, but I highly recommend discussing this with your doctor to review your amitriptyline dosage and safely manage these exercise triggers.

Combining fluoxetine and amitriptyline requires caution and close medical supervision. Fluoxetine can increase the levels of amitriptyline in your body, which may intensify side effects like drowsiness, dry mouth, blurred vision, and dizziness. There is also a small risk of a rare condition called serotonin syndrome, which can cause sweating, confusion, or a fast heartbeat. However, doctors sometimes prescribe these medications together at specific, carefully managed doses. If your doctor has prescribed this combination, it is safe to take it under their guidance. Please do not alter your doses on your own, and consult your doctor if you experience any bothersome side effects.

Your headaches, especially worsening during squats, sound like exertional headaches, which are often triggered by physical strain. The accompanying daytime sleepiness suggests your sleep quality might be poor, or an underlying sleep issue is contributing to both symptoms. Since amitriptyline (Tryptomer) has not helped after a few months, it is highly recommended to discuss these exertion triggers and your sleep patterns with your doctor. They can evaluate you for sleep disorders or exertional headaches and safely adjust your treatment plan to help you find relief.

To safely manage withdrawal symptoms from amitriptyline, the most crucial step is to avoid stopping the medication suddenly. You should work closely with your doctor to gradually taper your dose over several weeks or months. If you are currently experiencing discontinuation symptoms like mild nausea, headache, dizziness, or trouble sleeping, rest assured that these are temporary. To ease discomfort, prioritize staying well-hydrated, maintaining a consistent sleep routine, and engaging in light, gentle exercise. If your symptoms become highly uncomfortable, contact your doctor, as they can temporarily adjust your taper schedule to make the transition much easier for you.