Posted by Elizabeth on November 28, 2001, at 15:58:17
In reply to Re: barbs, opioids, etc. » Elizabeth, posted by nightlight on November 25, 2001, at 16:52:00
> Propoxyphene napsylate is the main ingredient in Darvocet. (Thanks for the spelling lesson)
And thank *you* for the propoxyphene salts lesson! :-)
> My description of Soma as potent is strictly empirically based.
"Potent" just means that it works in low doses (it's a relevant thing, of course). I usually find that 700 mg of carisoprodol is optimal for my back pain. Compared with, say, 0.3 mg of buprenorphine, that seems like a lot. < g >
> I tried I had tried Skelaxin, Robaxin, Flexeril & others I cannot remember w/no relief.
Those are what I call "fake muscle relaxants" -- the only reason they seem to work at all is because they're sedating (I think they're all antihistamines and/or anticholinergics). Flexeril, for example, is similar to amitriptyline, which works for neuropathic pain but not for musculoskeletal pain.
> One doc prescribed finally prescribed clonazepam. Bingo! It worked well for about 2 yrs. I still take it for anxiety and mood regulation, but my myofascial pain got outta hand again.
Yeah, I've tried using various benzos as muscle relaxants too. Valium worked pretty well the first few times I took it but now it doesn't work at all. (I tried up to 40 mg -- nothing.) I wasn't taking it regularly -- not every day or even every week, just every once in a while. I think that with benzos, as with most of the drugs marketed as muscle relaxants, a lot of the apparent effect is due to sedation.
> I had asked about soma in the past, but was denied it due to its *supposed* recreational properties.
It's related to meprobamate (Miltown, the benzos' predecessor) and I think a small amount is metabolized to meprobamate. Meprobamate was supposed to be a bit of a party drug (compared with the benzos, anyway) and I guess some people get a kick out of Soma too. (It's definitely not something you should take if you're planning on drinking or operating heavy machinery, anyway.) Glad you were able to get it. I always feel like doctors are playing games trying to see if I'm a "drug seeker," so when they recommend something that I know won't work initially, I just go ahead and give it a try. (In this case, I had to take baclofen for a month before I was able to get Soma. Then the doctor in question wrote a script for me to take Soma 3 times a day, which is much more than I use it in real life.)
> I had been taking the Fiorinal #3 but it really had begun to affect me adversely, made me feel worse, like I had more toxins building up in my muscle tissues and more pain.
I know the feeling.
> By the way, what would you consider to be a *potent* muscle relaxer?
Hmm. Well, barbiturates are usually effective at around 100 mg, but I wouldn't count that as much more potent than the typical 350 mg dose of Soma (same order of magnitude). Valium, with doses starting at 5 mg, would be considered more potent. Even Valium is considered "low potency" for a benzo, though. Potency isn't generally the most relevant characteristic to consider when you're picking out a med, IMO.
> Why is twice daily dosing unusual?
I was wrong about that, sorry. I was thinking of something else. Propranolol is usually given 2-3 times daily.
I seem to recall that it's not all that unusual for women to develop hypertension when they're pregnant. I don't know why, though -- you might ask your doctor about it if you're planning on having any more kids.
> It is quite good for the squeezing chest pressure I feel when particularly anxious, and if I feel headachey, have visual auras, etc. I use it to help w/potential migraine.
It's effective for preventing migraines and also, often, for the peripheral manifestations of anxiety, like chest pain, shakes, tachycardia, etc. (I use it for essential tremor. Good stuff.)
> I have not delved much into the DSM-IV, I've had way too little free time in the past few yrs., so my grasp of psychiatric argot is weak.
"Endogenous depression" isn't used in DSM-IV anyway.
> And, I have read some articles that say otherwise, that they both respond almost equally well to medication (and time). Weird.
Yes, that's true. You can try to label someone "situationally" or "nonsituationally" depressed, but it isn't much of a predictor of how they will respond to treatment.