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Re: Disappearance of chronic pain with Effexor? SLS

Posted by flipsactown on July 7, 2004, at 12:10:11

In reply to Re: Disappearance of chronic pain with Effexor? flipsactown, posted by SLS on July 7, 2004, at 8:05:59

Hello Scott,

Thanks for the useful information. I will save this message and refer to it later on. Since I have only been on Lexapro for a month, it is probably best that I give it another month or so before I make a change. Also, when I was taking Effexor, another bad side effect was extreme constipation despite taking lots of fiber drinks. Not only that I remember the withdrawals were very similiar to the WD's I had experienced tapering off of Oxy after being on it for 2 years. I will be totally off Oxy in two days. It took several months to taper off the Oxy and at times I did experience dts withdrawals. It was extremely unpleasant and that is another reason why I am hesitant in going back to Effexor. However, if it will decrease my chronic pain or even totally get rid of it, I will surely give it another chance. I don't remember the exact dose of Effexor I started out with, but if I were to go back to Effexor I will titrate very, very slowly as per your recommendation.

I did feel a reduction of my chronic back pain when Desipramine was added to Prozac, especially in the beginning, but it did not last as my chronic back pain had worsen after a year or so.

Thanks again for your insight.

FST
> Hi FST.
>
> > Do you think Effexor would be an effective AD,
>
> I can understand anyone being apprehensive about trying Effexor (venlafaxine) given all of the negative posts to be read here on Psycho-Babble. The fact still remains that it has demonstrated itself to superior to the SSRIs in the percentage of people who respond to it and in the quality the of response obtained (more people achieve remission).
>
> > I had to quit Effexor in less than 2 weeks because of vertigo, nausea & vomiting?
>
> I guess I don't have to expouse the virtues of the "low and slow" paradigm of dosage titration. What dosages did you use to begin trestment? Usually, these side effects are only temporary. That, of course, is the ideal explanation for your experience. I hope a slower titration will help mitigate these effects for you.
>
> > as well as a pain med,
>
> There are no guarantees, but there is some precedent for using Effexor to treat pain associated with depression and chronic pain disorders in the absence of depression (fibroneuralgia, diabetic neuropathy).
>
> > I had the greatest depression relief with Prozac or Zoloft with Desipramine lasting over 5 years.
>
> This might indicate that combining the reuptake inhibition of both serotonin (5-HT) and norepinephrine (NE) is important to treat your depression and perhaps the pain as well. Effexor, a dual-action drug, does both of these things at the same time at higher dosages. Did your pain remit during those 5 years? It might make sense to add desipramine now if you wish to remain on an SSRI and avoid Effexor. That's pretty much common sense, as desipramine is a NE reuptake inhibitor. Then, if that doesn't work, you could investigate the antidepressantes Effexor, imipramine, amitriptyline, and Cymbalta, all of these being combination 5-HT / NE reuptake inhibitors. Cymbalta might become available by the time you have competed your current drug trial (wishful thinking).
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11230034
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12625792
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15162896
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14709757
>
>
> From a totally different class of drugs, Neurontin has been used to treat pain disorders.
>
> What are your feelings at this point?
>
>
> - Scott
>


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poster:flipsactown thread:363567
URL: http://www.dr-bob.org/babble/20040704/msgs/363735.html