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Re: hanging in there shelliR

Posted by Elizabeth on October 10, 2001, at 13:17:48

In reply to Re: hanging in there Elizabeth, posted by shelliR on October 9, 2001, at 23:32:54

> I guess I keep asking because in posts you say quite often that you'd rather find a substitute with less side effects. Itching is pretty bad, nothing to control that?

Like I said, they can all be controlled. I use ChlorTrimeton for itching (the non-drowsy antihistamines don't seem to work very well).

> And constipation, I think, has to be managed with so many medications.

Not really; I think fiber supplementation is the most effective way to deal with it.

> > It might interest you to know that generic MS Contin (slow-release morphine) is available.
>
> I didn't know that. My pharmacy is supposed to automatically substitute generics, and it always has before. Is the generic a new thing?

It's not the same drug; it's morphine, not oxycodone. They don't substitute different drugs or different formulations -- for example, if you had a prescription for Celexa, the pharmacist wouldn't give you generic fluoxetine, but if there were generic citalopram they would give you that (unless your doctor wrote "do not substitute" or "dispense as written" on the prescription).

> I was on 30mg, then I started 45mg. I am fine, except for the sleep problems which are serious and constipation (already compounded by oxycontin).

MAOIs do cause quite a bit of sleep disruption. I thought Ambien was pretty effective.

> Also I could not adjust to changes in light on 45 mgs after several months, so I'll have to see how that goes. It was pretty dangerous--I was "whiting out"--couldn't see anything until I got into a building (from a bus to outside, or from my car to outside.)

That's odd. I wonder what could be causing that.

> So far I have no appetite. My carbo cravings on Nardil are gone, but as I've said before, I don't think it made me gain weight.

Well, you're lucky then!

> When I first started it, I was seriously underweight from the severe depression.

I was moderately underweight, but phenelzine more than compensated.

> I'm okay except when I reach a level when the oxy is not working.

I meant, does the oxycodone help you get started in the morning?

> And it feels like it's not working at all until I increase it.

Buprenorphine doesn't have much noticeable effect anymore except dry mouth (it used to make me very dizzy and wired), but it still makes me feel "normal" as it did when I first took it.

> I hope the 60mg of nardil makes a difference. I want there to be something backing up the oxy--not relying on that for the whole job, especially in light of the fact that I keep developing tolerances.

You might want to ask your doctor to justify the continued dose increases. If I were in your situation, I'd be concerned about what might happen if the doctor prescribing the oxycodone became unavailable (like if something happened to him or if he were called out of town) -- getting another doctor to prescribe it would be hard. Another issue is that if you ever get hurt and needed analgesics, you'll have a major tolerance and you'll need much more than an opioid-naive person would. Just some things to think about -- once you start taking high doses of opioids on a daily basis, stopping can be pretty hard.

> Tried tricyclics years ago and couldn't tolerate several; don't remember which ones.

Do you remember if desipramine was among them? I ask because it's been almost entirely free of side effects for me, even when my serum level was extremely high (around 500-600 ng/mL). (And I didn't tolerate other tricyclics, either.)

> Done both lithium and most anticonvulsives, as well as BuSpar with no success.

Have you tried them with Nardil?

> If I can control water weight I might try lamictal again because it was the only one I was successful one.

It has a good reputation. Did you think about trying a diuretic for the edema?

> Tried that also. My last pdoc was hopeful because of the relationship to opiates, but it felt awful. I only did a one day trial, then gave it up.

That's probably what would happen if I took naltrexone, too. Thanks for the warning. :-)

> > Which AD pooped out?
>
> Nardil. But he was talking about the success of adding stimulents to any pooped out AD in general.

Hmm. Well, I don't know what to suggest for Nardil poop-out -- obviously I wasn't very successful with it.

-elizabeth


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poster:Elizabeth thread:67742
URL: http://www.dr-bob.org/babble/20011007/msgs/80875.html