Posted by Scott L. Schofield on March 23, 2000, at 17:46:30
In reply to Re: Chronic Fatigue Syndrome?, posted by Ginny on March 23, 2000, at 10:25:31
> > > > Does anyone know anything about Chronic Fatigue Syndrome? I went to my eye Doctor the other day and I was telling her about how I've switched medications so much over the past year or so ( I am now on Topomax) and she said I could very possibly have chronic fatigue syndrome. Does anyone know anything? I've been taking the topomax for about 3 1/2 weeks now for migraines and it doesn't seem to be helping. I am still having to take Imitrex and BC powders. I still don't really feel like myself yet. The other day I started crying for no reason. A side effect of topomax? I've had nose bleeds. They have gone away now though. I'm having trouble thinking clearly in the mornings. I just don't think it's helping me. But I still have a week or so left on my prescription to go so I'm going to finish it so I can at least say I did try. But, I really wanted to know about this chronic fatigue syndrome and if anyone has had any experiences with it? If so, I'm curious. Thanks. Ginny
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> > Have you had a history of mental illness? What are the symptoms that are suspected to be the result of chronic fatigue syndrome (CFS)?
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> > Neurontin (gabapentin) is often used for chronic pain syndromes and migraines. I just met someone for whom it has worked well to treat her migraines. She says she has also seen an improvement in her SAD-type depressive disorder. Neurontin is one of the newer anti-convulsants that is often used to treat various psychiatric illnesses. Both Topiramate and Neurontin often fill the same roll as a mood-stabilizer or adjunct to other medications.
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> I don't have any history of mental illness. I do however think I may be a little depressed. Who wouldn't be after having freaking migraines for years. I never realized I might actually BE a little depressed until my Dr. gave me amitrtriptlyne and it made me feel so much mentally better for a while. Only problem was that when I upped the dosage when I was supposed to, I began to have heart palpitations. That's when I started the Topomax. It's not as good for the headaches as the amitr. was. And certainly not as good for me mentally. Tried keeping me at a lower dose of amitr. with verapamil but palpitations continued. That's when he put me on Topomax. But I don't think it's going to work for me. I just don't feel great. Suggestions? I'm all ears. Ginny
Hi Ginny.Didn't you submit a post earlier regarding heart palpitations with amitriptyline? I believe I wrote a reply to it.
I would like CamW to comment on heart palpitations as a side effect of amitriptyline, and to what degree it may dissipate with time. It would be good to hear from a real pharmacist. I discovered this week that I do indeed have the potential to be wrong.
If amitriptyline was so beneficial, you may want to take a closer look at the significance of the heart palpitations you experienced. The occurrence of palpitations is not an uncommon side effect of many drugs, and does not necessarily reflect a medically important change in heart function. My guess is that this is probably the case (hopefully). When I first start a tricyclic antidepressant like amitriptyline, I usually experience palpitations early on, and sometimes upon subsequent dosage increases.
As I wrote earlier, it is often the standard practice of some doctors to order EKG tests when treating with tricyclic antidepressants. I think this would be a particularly good idea for you, given your concerns. TCAs can induce cardiac abnormalities in a small percentage of people, such that discontinuation is warranted. Again, 10 and 20 milligrams of amitriptyline are extremely small dosages, but plenty enough to bring about activation and palpitations in some people. I don't think verapamil would have any effect to prevent this.
Amitriptyline is an excellent choice for migraine prevention, and is thought by many investigators to be better than calcium-channel blockers like verapamil. It is possible that the activating or antidepressant effects are only temporary, or that higher dosages are needed to maintain them. In any event, it would be a shame to discount amitriptyline based on the occurrence of a temporary side effect of little medical significance - if that is indeed the case.
You may want to take a look at the following webpage:
http://www.mentalhealth.com/fr30.html
Keep in mind that the section regarding side effects can look pretty scary without an understanding of just how frequently they occur. All significant side effects are listed, regardless of frequency - even if less than 1%.
No promises, but I just want to make sure that you don't cross-off amitriptyline from your list for the wrong reasons.
Again, Neurontin may be worth looking at, or perhaps Depakote. Topomax may do the trick, though.
Take it away, Cam...
- Scott
poster:Scott L. Schofield
thread:27717
URL: http://www.dr-bob.org/babble/20000321/msgs/27967.html