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Dr. Bob is Robert Hsiung, MD,
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Posted by Cairo on June 16, 2004, at 6:43:10
I've been through various meds for the atypical depression of Fibromyalgia - Prozac, Celexa, Lexapro, Effexor as well as imipramine and Remeron, amitriptyline and trazodone. With the exeception of trazodone which helps me sleep through the night, though I'm not too sure as to the quality of sleep, and Remeron (too much weight gain), anything with an SSRI component tightens my muscles even more (Prozac being the worst offender). I can never get up to antidepressant doses due to the side effects - muscle tightness, sleep disturbance, hot flushes/anxiety. Is the muscle tightness related to a muscarinic component? I tried low dose (0.25 mg) Risperdal once and it nipped a Fibromyalgia flare up in the bud, but increasing the dose or using the low dose too long worsens symptoms.
I've got this hypofunctioning HPA axis, though all my routine labs look good - adrenal function, thyroid, etc. Inflammation (mildly elevated C reactive protein), constant orthostatic dizziness, fatigue, apathy, hyperphagia, irritability, all seem to worsen in the afternoon when even mild stressors totally wipe me out. The depression seems to be atypical. My muscles are a mess with trigger points and constant tightness. Muscle relaxants just zonk me out and I can't function during the day. Relaxation techniques are transient. Neurontin is so so for pain and has a very mild muscle relaxant effect, though tolerance develops and it worsens derealization (?). My docs don't prescribe anything but aspirin for pain and I can't take NSAIDs as they elevate BP. I feel the muscle symptoms feed the depression, though it may be the other way around.
I would greatly appreciate some advice.
Cairo
Posted by King Vultan on June 16, 2004, at 21:46:59
In reply to Question: muscle side effects to meds, posted by Cairo on June 16, 2004, at 6:43:10
You didn't list nortriptyline as one you had tried. This is related to amitriptyline but is much less serotonergic (that is, much less like an SSRI). It is also less sedating and much less anticholinergic. Nortriptyline is a selective norepinephrine reuptake inhibitor with relatively mild side effects for a tricyclic. It is widely used for people with chronic pain, besides being a moderately effective sleep aid and an effective antidepressant.
Todd
This is the end of the thread.
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