Elavil
What is the name of the tablet? & what is it for. it is true that for some folks after a while they do not work as well as they used to, usually it is because either your system has gotten used to them they are therefore less effective, or the condition has got worse & often it is a bit of both. All the symptoms you are describing would say the cause of your pain has deteriorated. The pain keeps you awake so you are tired during the day & catnap, tired so no energy. A lot depends on what you are telling the doc if you make light of it (& a lot of us do) then they don't realise it is as bad in a sense you need to exaggerate it just a little make them realise you are not coping. Ask to be referred to a pain clinic for advice. All the countries have them although if you live far from a town or city you may need to travel.
On the info you have given cannot think of anything else that would help

I was on this as a migraine preventative. It didn't seem to help much, gained 30 lbs while on it. Neurologist bounced my dosage around from 50mg to 150mg and everything inbetween. He did large increases and decreases without building up slowly or tapering down. Oneven time I went from 50MG to 150mg starting the next day after appt. I even asled my psychiatrist why neuro would do this when I know from yrs of being on and off psych meds that it should dangerous to do so. He laughed and said that's the difference when you see docs in different specialties. Yrs later I still am dumbfounded by this lol.

I have also been on these for a few years now anx i don't think they are working. I don'tthink my Dr gets me either, the daily pain is draining and lacknof sleep due to the pain is taking its toll on me. My daughter and husband want me to keep at the Dr to get help, they also think i should get disability payment as i had to give up work a couple years back due to pain i couldn't do the job. Now my Dr wants me to attend pain management course and has taken me off all pain meds as she said they are addictive and it has messed up my stomach. Some days i feel so depressed by it all.

Thank you for your input , i will ask Doc on how high a dosage i can take , at the moment i dont feel as if anything is helping and he doesnt seem keen to put me on a stronger pain relief tablet , but i do have oramorph for when pancreas plays up .and you are correct im maybe not explaining the extent of how much pain and upset it is causing me ,he is not keen to give me stronger tablets , co codamol which at times makes me sick so im on anti sickness as well , thank you for your comments x

Elavil is the original trade name for amitryptiline, a tricyclic antidepressant developed originally in the late '50s or early '60s, and has been used for first fibromyalgia and now for other types of chronic pain syndromes. It originally helped me a lot when all I had was fibromyalgia. Check with your doctor about the dosage you're currently taking and would an increase be possible. If no increase is allowable then ask about alternatives.

Good luck, and Blessed Be!