I take the lowest dosage available of nortriptyline (10mg) at bedtime with my other meds, and it helps contain my PN numbness in my toes/feet so I can sleep with minimal sedation upon rising from bed in the morning. I also apply lidocaine to my toes/feet and wear warm thick socks (not tight) for sleeping, which helps. But before I took nortriptyline, I tried amitriptyline (25 mg) and I could not handle the increased sedation it caused, so I switched to nortriptyline, with a much better outcome. It made a difference.

Please use caution when combining amitriptyline with tramadol, due to the potential increase with sedation, etc., but I'm no doctor, so you may want to discuss with your doctor. I've also found it helps to chat with my pharmacist about medications and potential conflicts. Good luck!