Psycho-Babble Medication Thread 363567

Shown: posts 1 to 25 of 43. This is the beginning of the thread.

 

Disappearance of chronic pain with Effexor?

Posted by Colleen D. on July 6, 2004, at 19:44:18

This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?

Thanks!

Colleen
PPD, GAD and OCD

 

Re: Disappearance of chronic pain with Effexor? Colleen D.

Posted by flipsactown on July 6, 2004, at 20:16:58

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

I can't help shed light, but that is exciting news since I, too, suffer from chronic back pain (2 failed back surgeries, injections, etc.) from being struck by a truck while riding a 10 speed bike over 20 years ago. Please keep us posted if effexor continues to relieve your chronic pain. I am happy for you because I know exactly what you were going through. I am depressed, unable to work and constantly taking pain meds to get by. I am in my 4th week of Lexapro and Trazodone was recently added, but I still take 60mg of Tylenol/Codeine 4 times daily for pain. Previously I was on Oxy for the last 2 years. In fact, I tapered down from 8 Oxy tabs to 1, and in two days, I will be Oxy free. Yes!

FST

> This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?
>
> Thanks!
>
> Colleen
> PPD, GAD and OCD

 

Re: Disappearance of chronic pain with Effexor? Colleen D.

Posted by jay on July 6, 2004, at 21:18:45

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

Yes, Effexor may help with pain via it's action (besides serotonin) on norepinephrine. That's one reason I can't tolerate Effexor well, is because the norepinephrine is way too stimulating, and worsens my anxiety. But, we are all built different, so it may just be top-notch for you.

Best of luck!...
Jay

 

Re: Disappearance of chronic pain with Effexor?

Posted by nephron on July 6, 2004, at 22:41:21

In reply to Re: Disappearance of chronic pain with Effexor? Colleen D., posted by jay on July 6, 2004, at 21:18:45

I've actually found that the higher levels of norephenephrine (sp) with Efexor appear to have helped with my anxiety.

The brain is a bizarre, massively complex thing.

 

Re: Disappearance of chronic pain with Effexor?

Posted by Buckeye Fan on July 6, 2004, at 23:10:16

In reply to Re: Disappearance of chronic pain with Effexor?, posted by nephron on July 6, 2004, at 22:41:21

I do not know WHY, but I too noticed a marked decrease in overall pain while on Zoloft & Effexor.

Now off of both....the pain has returned.


Buckeye Fan

 

Re: Disappearance of chronic pain with Effexor?

Posted by SLS on July 6, 2004, at 23:27:27

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

> This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?


I can't explain exactly why they work, but some antidepressants are effective treatments for chronic pain conditions. Some of the tricyclics, Effexor, and the soon to be approved Cymbalta are particularly noted. All of these drugs inhibit the reuptake of both norepinephrine and serotonin.


- Scott

 

Re: Disappearance of chronic pain with Effexor? SLS

Posted by flipsactown on July 6, 2004, at 23:59:59

In reply to Re: Disappearance of chronic pain with Effexor?, posted by SLS on July 6, 2004, at 23:27:27

Hi Scott,

Do you think Effexor would be an effective AD, as well as a pain med, for me considering I have taken nearly all of the SSRI's including Effexor? I had to quit Effexor in less than 2 weeks because of vertigo, nausea & vomiting? I would be willing to try Effexor again if it will help get rid of or reduce my chronic back pain. I had the greatest depression relief with Prozac or Zoloft with Desipramine lasting over 5 years. I am nearly 30 days in taking Lexapro. Although my depression has slightly lifted, I am still experiencing insomnia, loss of appetite (which is actually good for me in that I have loss nearly 10 lbs) and fatigue, causing an increase of my chronic back pain. How are you doing and what is your opinion concerning the above?

FST

> > This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?
>
>
> I can't explain exactly why they work, but some antidepressants are effective treatments for chronic pain conditions. Some of the tricyclics, Effexor, and the soon to be approved Cymbalta are particularly noted. All of these drugs inhibit the reuptake of both norepinephrine and serotonin.
>
>
> - Scott

 

Re: Disappearance of chronic pain with Effexor?

Posted by Rhapsody on July 7, 2004, at 0:37:06

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

Hi Colleen,

How much Effexor are you taking and how long have you been taking it?

> This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?
>
> Thanks!
>
> Colleen
> PPD, GAD and OCD

 

Re: Disappearance of chronic pain with Effexor?

Posted by Sad Panda on July 7, 2004, at 1:49:58

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

> This has been a surprising result of my taking Effexor. I had very painful sciatica and other joint pain as well as frequent headaches and they've gone away completely. Does anyone know why this would happen? Is it because of the extra serotonin in my system? Can anyone shed some light on this for me?
>
> Thanks!
>
> Colleen
> PPD, GAD and OCD
>

It is possible as Effexor is a close relative of the pain med Ultram. I had numb forearms when I first started taking it.

Cheers,
Panda.

 

Re: Disappearance of chronic pain with Effexor? SLS

Posted by King Vultan on July 7, 2004, at 7:32:33

In reply to Re: Disappearance of chronic pain with Effexor?, posted by SLS on July 6, 2004, at 23:27:27

>
>
> I can't explain exactly why they work, but some antidepressants are effective treatments for chronic pain conditions. Some of the tricyclics, Effexor, and the soon to be approved Cymbalta are particularly noted. All of these drugs inhibit the reuptake of both norepinephrine and serotonin.
>
>
> - Scott


That has been my observation as well, that the ADs noted as being best for chronic pain tend to be the ones that block reuptake of both serotonin and norepinephrine. In particular, the tricyclics amitriptyline and nortriptyline come to mind, as these are widely used by GPs for treatment of chronic pain. Out of the 10 or so drugs I've tried, nortriptyline did happen to be the most effective one in suppressing my chronic headaches.

Todd

 

Re: Disappearance of chronic pain with Effexor? Rhapsody

Posted by Colleen D. on July 7, 2004, at 7:41:59

In reply to Re: Disappearance of chronic pain with Effexor?, posted by Rhapsody on July 7, 2004, at 0:37:06

I am taking 150 mg XR daily. I used the startup pack beginning May 18, 2004, which was one week of 37.5 mg and one week of 75 mg and then moved up to the 150 mg dosage. Overall, I feel better than I have in years. I gave up on chiropractic care for this pain in November 2002 because it kept returning a few days after each adjustment.

Colleen

 

Re: Disappearance of chronic pain with Effexor? flipsactown

Posted by SLS on July 7, 2004, at 8:05:59

In reply to Re: Disappearance of chronic pain with Effexor? SLS, posted by flipsactown on July 6, 2004, at 23:59:59

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

 

Re: Disappearance of chronic pain with Effexor?

Posted by SLS on July 7, 2004, at 8:42:46

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

Sorry about the typos. It's too early in the morning.

Also:

"fibroneuralgia" should be "fibromyalgia"

Cymbalta = duloxetine as referred to in the last Medline citation.

- Scott

 

Re: Disappearance of chronic pain with Effexor? King Vultan

Posted by Sad Panda on July 7, 2004, at 10:42:11

In reply to Re: Disappearance of chronic pain with Effexor? SLS, posted by King Vultan on July 7, 2004, at 7:32:33

> >
> >
> > I can't explain exactly why they work, but some antidepressants are effective treatments for chronic pain conditions. Some of the tricyclics, Effexor, and the soon to be approved Cymbalta are particularly noted. All of these drugs inhibit the reuptake of both norepinephrine and serotonin.
> >
> >
> > - Scott
>
>
> That has been my observation as well, that the ADs noted as being best for chronic pain tend to be the ones that block reuptake of both serotonin and norepinephrine. In particular, the tricyclics amitriptyline and nortriptyline come to mind, as these are widely used by GPs for treatment of chronic pain. Out of the 10 or so drugs I've tried, nortriptyline did happen to be the most effective one in suppressing my chronic headaches.
>
> Todd
>

Most likely nort's 5-HT2A antagonism. A fair few of the drugs used in migraine prevention are H1 & 5-HT2A antagonists such as methysergide, cyproheptadine, pizotifen & ofcourse amitrip.

Cheers,
Panda.

 

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
>

 

Re: extreme constipation flipsactown

Posted by Colleen D. on July 7, 2004, at 12:24:57

In reply to Re: Disappearance of chronic pain with Effexor? SLS, posted by flipsactown on July 7, 2004, at 12:10:11

I am a bit constipated on Effexor, but I was before I started this med. Instead of adding fiber, try taking docusate sodium stool softener, if you have the constipation again.

Colleen

 

Re: Disappearance of chronic pain with Effexor? flipsactown

Posted by Sad Panda on July 7, 2004, at 23:01:03

In reply to Re: Disappearance of chronic pain with Effexor? SLS, posted by flipsactown on July 7, 2004, at 12:10:11

Hi FST,

Have you tried or considered Amitriptyline or Nortriptyline? I don't want to deter you from trying Effexor but these two have a pretty good track record for treating neuropathic(nerve damage?) pain.

Cheers,
Panda.

 

Re: Disappearance of chronic pain with Effexor? Sad Panda

Posted by flipsactown on July 8, 2004, at 0:24:56

In reply to Re: Disappearance of chronic pain with Effexor? flipsactown, posted by Sad Panda on July 7, 2004, at 23:01:03

Hi Panda,

I did try Amitriptyline for nearly 2 months, but gave it up in favor of Prozac because of weight gain and the fact that I was still depressed. In retrospect, I probably should have added Amitriptyline to augment Prozac.

I have not tried Nortriptyline. I will keep it in mind should Lexapro fail. Another idea would be to ask my pdoc to Rx Nortriptyline or Amitriptyline to augment Lexapro. I probably will try this first before I try Effexor again because of my previous terrible experience with Effexor's SEs.

Thanks for the advice.

FST

> Hi FST,
>
> Have you tried or considered Amitriptyline or Nortriptyline? I don't want to deter you from trying Effexor but these two have a pretty good track record for treating neuropathic(nerve damage?) pain.
>
> Cheers,
> Panda.
>

 

Re: Disappearance of chronic pain with Effexor? flipsactown

Posted by Sad Panda on July 8, 2004, at 4:27:09

In reply to Re: Disappearance of chronic pain with Effexor? Sad Panda, posted by flipsactown on July 8, 2004, at 0:24:56

> Hi Panda,
>
> I did try Amitriptyline for nearly 2 months, but gave it up in favor of Prozac because of weight gain and the fact that I was still depressed. In retrospect, I probably should have added Amitriptyline to augment Prozac.
>
> I have not tried Nortriptyline. I will keep it in mind should Lexapro fail. Another idea would be to ask my pdoc to Rx Nortriptyline or Amitriptyline to augment Lexapro. I probably will try this first before I try Effexor again because of my previous terrible experience with Effexor's SEs.
>
> Thanks for the advice.
>
> FST
>
> > Hi FST,
> >
> > Have you tried or considered Amitriptyline or Nortriptyline? I don't want to deter you from trying Effexor but these two have a pretty good track record for treating neuropathic(nerve damage?) pain.
> >
> > Cheers,
> > Panda.
> >
>
>

Hi FST,

I am in the process of switching from Effexor + Remeron to Effexor + Nortriptyline. I'm trying to understand the P450 system since I don't think my pdoc spent too much time thinking about it when she gave me the script for Nortriptyline. Looks like Nort & Effexor raise each others levels somewhat, so I have to be carefull with the dosages. Prozac & Paxil look to be bad choice for combination with TCA's because they are inhibitors of CYP2D6 which is the enzyme that is responsible for the metabolism of a lot of drugs.

Cheers,
Panda.

 

Re: Disappearance of chronic pain with Effexor?

Posted by SLS on July 8, 2004, at 7:52:21

In reply to Re: Disappearance of chronic pain with Effexor? flipsactown, posted by Sad Panda on July 8, 2004, at 4:27:09

FST:

> Another idea would be to ask my pdoc to Rx Nortriptyline or Amitriptyline to augment Lexapro. I probably will try this first before I try Effexor again because of my previous terrible experience with Effexor's SEs.

I agree with you. I think augmenting the Lexapro makes sense, especially since you are expereriencing a partial response to it. If you opt for nortriptyline instead of desipramine, be sure to use blood levels to help determine proper dosing.


Panda:

> Looks like Nort & Effexor raise each others levels somewhat, so I have to be carefull with the dosages.

According to my reference, they do, but not to a large degree. However, since dosage is so critical with nortriptyline when treating depression, you should test for blood levels. It will make things easier.

> Prozac & Paxil look to be bad choice for combination with TCA's because they are inhibitors of CYP2D6 which is the enzyme that is responsible for the metabolism of a lot of drugs.

I don't think they are necessarily bad choices so much as they are choices that require knowledge of pharmocokinetic interactions and appropriate adjustment of dosages. You can pretty much cut the dosage of the TCA in half. Prozac or Paxil + desipramine makes for a reasonable combination. I combined Paxil with desipramine with no trouble at all. Again, blood tests are available to make this a viable option.

I'm surprised that I found the following abstract so easily. It is important to consider that the blood concentrations of desipramine were controlled. Many previous reviews of such combinations offered as discussion the possibility that the increased rate of antidepressant response observed was due to increased blood levels of TCA produced by the CYP2D6 inhibition produced by the SSRI.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14744472

Good luck with your new combo!


- Scott

 

Re: Disappearance of chronic pain with Effexor? SLS

Posted by Sad Panda on July 8, 2004, at 10:28:04

In reply to Re: Disappearance of chronic pain with Effexor?, posted by SLS on July 8, 2004, at 7:52:21

> FST:
>
> > Another idea would be to ask my pdoc to Rx Nortriptyline or Amitriptyline to augment Lexapro. I probably will try this first before I try Effexor again because of my previous terrible experience with Effexor's SEs.
>
> I agree with you. I think augmenting the Lexapro makes sense, especially since you are expereriencing a partial response to it. If you opt for nortriptyline instead of desipramine, be sure to use blood levels to help determine proper dosing.
>
>
> Panda:
>
> > Looks like Nort & Effexor raise each others levels somewhat, so I have to be carefull with the dosages.
>
> According to my reference, they do, but not to a large degree. However, since dosage is so critical with nortriptyline when treating depression, you should test for blood levels. It will make things easier.
>
> > Prozac & Paxil look to be bad choice for combination with TCA's because they are inhibitors of CYP2D6 which is the enzyme that is responsible for the metabolism of a lot of drugs.
>
> I don't think they are necessarily bad choices so much as they are choices that require knowledge of pharmocokinetic interactions and appropriate adjustment of dosages. You can pretty much cut the dosage of the TCA in half. Prozac or Paxil + desipramine makes for a reasonable combination. I combined Paxil with desipramine with no trouble at all. Again, blood tests are available to make this a viable option.
>
> I'm surprised that I found the following abstract so easily. It is important to consider that the blood concentrations of desipramine were controlled. Many previous reviews of such combinations offered as discussion the possibility that the increased rate of antidepressant response observed was due to increased blood levels of TCA produced by the CYP2D6 inhibition produced by the SSRI.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14744472
>
> Good luck with your new combo!
>
>
> - Scott
>

Thanks Scott! :)

I get a lot of my info from http://www.psychotropical.com/
The pdoc that has that site, Dr. PK Gillman, like to prescibe Zoloft + Nortriptyline or Desipramine. His site has recently been updated & it looks prettier, but half the info on it has gone.

Cheers,
Panda.


 

Re: Disappearance of chronic pain with Effexor?

Posted by starlight on July 8, 2004, at 17:40:24

In reply to Re: Disappearance of chronic pain with Effexor?, posted by Buckeye Fan on July 6, 2004, at 23:10:16

It's very common for pain management specialists to prescribe antidepressents for neuropathic pain, so it's not surprising that you would have positive results for your pain with effexor. Congrats!
starlight

 

Re: Chronic pain -best med and weird reactions

Posted by Cairo on July 9, 2004, at 21:42:59

In reply to Disappearance of chronic pain with Effexor?, posted by Colleen D. on July 6, 2004, at 19:44:18

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

 

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.


 

Re: Chronic pain -best med and weird reactions Cairo

Posted by King Vultan on July 10, 2004, at 11:12:28

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

I quite agree with Panda. I've tried this med myself and found it the most effective of the ten or so I've tried for my chronic headaches, and I think it is an effective antidepressant. It is not as sedating as amitriptyline, but it has much more mild side effects.

Todd


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