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Re: Chronic pain -best med and weird reactions Cairo

Posted by Sad Panda on July 10, 2004, at 9:40:23

In reply to Re: Chronic pain -best med and weird reactions, posted by Cairo on July 9, 2004, at 21:42:59

> I have Fibromyalgia with atypical depression/HPA axis hypofunction and SSRIs make me worse. At very low doses they disrupt my already unrestful sleep and my muscles start to feel like I have a severe case of the flu! Effexor is supposed to work for some people with FMS, but I've never been able to up the dose to get past the SSRI action to the norepi reuptake inhibition component.
>
> Would Strattera or another NRI make sense? I use Desyrel for sleep, but I don't think the quality of my sleep is good and it probably worsens the sleep apnea that you get with HPA dysfunction. I use a CPAP machine.
>
> I need something for depression and pain, but as I've said, I can't up the SSRI doses. Neurontin works a bit for pain and muscle relaxation, but poops out after awhile. I used Elavil years ago when I was first diagnosed and it did help with pain and sleep, but that was before my symptoms worsened. Weight gain has been a problem on Elavil, Neurontin and Remeron, so that's why I was switched to Desyrel.
>
> A trial of low dose Risperdal (0.125mg)for a couple of weeks successfully aborted a Fibromyalgia flare awhile ago, but a repeated course for the next flare did not seem to work as well. Upping the dose to 0.5mg or higher made symptoms worse (muscle aches, flushes, nervousness).
>
> At this point, I don't care about weight gain. I need to help the pain and depression. My doctor won't touch narcotics, so I use only aspirin. NSAIDs cause elevation in BP.
>
> How would you rate Elavil compared to other TCAs for pain? Would it help the atypical type depressive symptoms? How about med combos? I think that if some of the pain and muscle tightness could be controlled, some of my depressive symptoms would improve.
>
> Thanks!
>
> Cairo
>
>

I would suggest you try Nortriptyline, it is a NRI type TCA. It is an active metabolite of Elavil(Amitriptyline) & has a lot less of the side effects while retaining most of the good things.

Amitriptyline & Nortriptyline, besides being effective antidepressants, are good at treating neurological pain, preventing migraines & treating IBS.

Cheers,
Panda.



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poster:Sad Panda thread:363567
URL: http://www.dr-bob.org/babble/20040710/msgs/364682.html