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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by floatingbridge on February 15, 2011, at 21:13:18
Hi. Lyrica isn't helping much for pain. It does decrease anxiety, lifts my mood somewhat, considering I am tapered to about 10mg or less of Cymbalta.
I am not happy that Lyrica is a neuroleptic. Duh. I didn't get that when I started.
Look. I have too much going on.
Here it is:
Cymbalta less than 10mg
Lyrica 75x3 per day
Dexedrine 60mg
Xanax xr 1.0
Xanax .5 as needed (like almost daily)
Norco 20-30mg (more likely 30 :( )I hate this sh*t. Sometimes I want to just get on an maoi (as if that's a guarantee) and be done with it
How does this sound:Introduce nortriptyline while more aggressively taper/dump Cymbalta.
Slowly taper Lyrica. Go back to two times per day, or 3x50.
Any thoughts?
Posted by sigismund on February 15, 2011, at 22:54:53
In reply to meds again. taper lyrica? add nortriptyline?, posted by floatingbridge on February 15, 2011, at 21:13:18
When you say that Lyrica is a neuroleptic......?
Do you want to say more about that?
I'm not sure I understand.
Posted by floatingbridge on February 16, 2011, at 0:34:59
In reply to Re: meds again. taper lyrica? add nortriptyline?, posted by sigismund on February 15, 2011, at 22:54:53
Hi Sigi,
Well, it's just that neuroleptics are considered among medications as having more harmful side effect potential.
If I don't absolutely need to take a medication from that category, I'd rather not.
Does that help?
Posted by sigismund on February 16, 2011, at 1:01:39
In reply to Re: meds again. taper lyrica? add nortriptyline? » sigismund, posted by floatingbridge on February 16, 2011, at 0:34:59
>Does that help?
well, no, not really :)
By which I mean, Lyrica is not a phenothiazine or an antipsychotic. (Is it?)
I know it has a side effect profile which I would not want.
Posted by morgan miller on February 16, 2011, at 1:05:13
In reply to Re: meds again. taper lyrica? add nortriptyline? » sigismund, posted by floatingbridge on February 16, 2011, at 0:34:59
Hey FB, Here's some links on info about neuroleptics. I don't think Lyrica falls into that category. As you will see, a neuroleptic blocks D2 receptors. This is not one of Lyrica's mechanisms.
http://www.wisegeek.com/what-are-neuroleptics.htm
http://en.wikipedia.org/wiki/Antipsychotic
http://counsellingresource.com/medications/medication-types/neuroleptic.html
http://www.wemove.org/pediatric_treatment/medication_neuroleptics.html
Morgan
Posted by floatingbridge on February 16, 2011, at 1:09:55
In reply to Re: meds again. taper lyrica? add nortriptyline? » floatingbridge, posted by sigismund on February 16, 2011, at 1:01:39
>
> By which I mean, Lyrica is not a phenothiazine or an antipsychotic. (Is it?)According to Wiki it is heaped in with the antipsychotics (I actually think they are considered neuroleptics.)
That other word you used; got me. I gotta Google it.
Thanks.
>
> I know it has a side effect profile which I would not want.
Posted by floatingbridge on February 16, 2011, at 1:13:20
In reply to Re: meds again. taper lyrica? add nortriptyline?, posted by morgan miller on February 16, 2011, at 1:05:13
Wait, Morgan, I got my info from Wiki. Let me check out your links. I searched neuroleptic. Hmmm.
Thanks for posting these. Off to read.
Posted by morgan miller on February 16, 2011, at 1:16:47
In reply to meds again. taper lyrica? add nortriptyline?, posted by floatingbridge on February 15, 2011, at 21:13:18
FB, would you be open to another trial of Lexapro or Zoloft. I know you said Zoloft made you feel like you were tripping, but sometimes feelings like that(I can't imagine it was really like tripping) are typical in the beginning of a trial that might just work out for someone. I was thinking you could try out one of these SSRIs again for a few months and then add Nortriptyline if you feel it is necessary. Or, just do both Nortriptyline combined with Zoloft or Lexapro from the get go. I don't know.
I don't think taking Lyrica is that big of a deal. I do think it might help if you eventually cleaned up your medication regimen. I feel like you fell into the same hole of polypharmaceutical treatment that many do. I worry that this approach eventually makes one's condition worse in some ways and less responsive to future treatments and introductions of new additions.
I know Scott believes in polypharmacy. Maybe it works for some people and it works for a long time. I still question whether some or many people are rushed into this adopting this approach by their doctors before they are given more time to heal and find a medication or two that help enough to allow them to do other things that further improve their condition.
Morgan
Posted by morgan miller on February 16, 2011, at 1:20:01
In reply to Re: meds again. taper lyrica? add nortriptyline? » morgan miller, posted by floatingbridge on February 16, 2011, at 1:13:20
> Wait, Morgan, I got my info from Wiki. Let me check out your links. I searched neuroleptic. Hmmm.
>
> Thanks for posting these. Off to read.If it does not block D2 receptors in any way, I don't think it can technically be considered a neuroleptic/antipsychotic.
Off to bed! Goodnite!
Morgan
Posted by floatingbridge on February 16, 2011, at 1:46:00
In reply to Re: meds again. taper lyrica? add nortriptyline?, posted by morgan miller on February 16, 2011, at 1:20:01
Morgan, you're a gem.
(Still reading.)
Pleasant dreams :)
Posted by sigismund on February 16, 2011, at 3:58:54
In reply to Re: meds again. taper lyrica? add nortriptyline?, posted by morgan miller on February 16, 2011, at 1:16:47
>I worry that this approach eventually makes one's condition worse in some ways
Slowly and in a way that is hard to recognise.
Posted by Phillipa on February 16, 2011, at 11:30:23
In reply to Re: meds again. taper lyrica? add nortriptyline? » morgan miller, posted by floatingbridge on February 16, 2011, at 1:46:00
FB lyrica isn't an antipsychotic that I know of my doc also says two classes of meds at a time. So I have two of each. Let me know what you find out. Phillipa
Posted by Roslynn on February 16, 2011, at 16:34:44
In reply to meds again. taper lyrica? add nortriptyline?, posted by floatingbridge on February 15, 2011, at 21:13:18
Hi fb,
Have you responded well to nortrip in the past? With another AD or by itself?
Roslynn
> Hi. Lyrica isn't helping much for pain. It does decrease anxiety, lifts my mood somewhat, considering I am tapered to about 10mg or less of Cymbalta.
>
> I am not happy that Lyrica is a neuroleptic. Duh. I didn't get that when I started.
>
> Look. I have too much going on.
>
> Here it is:
>
> Cymbalta less than 10mg
> Lyrica 75x3 per day
> Dexedrine 60mg
> Xanax xr 1.0
> Xanax .5 as needed (like almost daily)
> Norco 20-30mg (more likely 30 :( )
>
> I hate this sh*t. Sometimes I want to just get on an maoi (as if that's a guarantee) and be done with it
>
>
> How does this sound:
>
> Introduce nortriptyline while more aggressively taper/dump Cymbalta.
>
> Slowly taper Lyrica. Go back to two times per day, or 3x50.
>
> Any thoughts?
Posted by floatingbridge on February 17, 2011, at 11:18:54
In reply to Re: meds again. taper lyrica? add nortriptyline? » floatingbridge, posted by Phillipa on February 16, 2011, at 11:30:23
Hi. It isn't a neuroleptic. It's an anti-convulsant. I was reading waaay to much stuff too fast and feeling scared. Sorry for the alarm.
I haven't tried nortriptyline. No tca before, except flexeril, a very close relation, and that was a very strange, unpleasant experience.
I'm looking at it as a pain option, first and an AD second.
I don't know. I'm having a difficult time. Decisions seem insurmountable. Thanks.
This is the end of the thread.
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