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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Guy on December 23, 2004, at 21:20:15
When I fall back down in the hole, I can clearly see the results on my face. Huge bags develop under my eyes and I look (and feel) as if I've been on a two week bender. For me, everything is tied into the quality of my sleep. Lately, I've been awakening early (3am) with a running nose, and this prevents me from relaxing and falling back to sleep. The next day, my whole nervous system is in a state of chaos and I cry and cry and become suicidal from the pain. The worst is the constant headache and burning pain up and down my spine (chronic pain syndrome). I'm currently taking 2 mg clonazepam and 30 mg Remeron. This worked well for a few months, but now the benefits seem to be wearing off. I'm faced with upping my clonazepam or going back on the dreaded (fat and impotent) Zyprexa. I can't just keep increasing my benzo, can I? Please, any advice would be greatly appreciated.
Posted by blanding on December 23, 2004, at 21:48:12
In reply to Incredible Pain/Anxiety/Depression, posted by Guy on December 23, 2004, at 21:20:15
Hi Guy,
My bet would be to focus on a potent enough analgesic med as a first priority, then let your pdoc recommend you a TCA with pain-reducing potential such as amitriptyline which controls certain kinds of chronic pain and will also give you a good night's sleep because of its highly sedative quality. This might also eliminate the need for clonazepam or olanzapine (Zyprexa).
Posted by ace on December 24, 2004, at 0:15:29
In reply to Incredible Pain/Anxiety/Depression, posted by Guy on December 23, 2004, at 21:20:15
> When I fall back down in the hole, I can clearly see the results on my face. Huge bags develop under my eyes and I look (and feel) as if I've been on a two week bender. For me, everything is tied into the quality of my sleep. Lately, I've been awakening early (3am) with a running nose, and this prevents me from relaxing and falling back to sleep. The next day, my whole nervous system is in a state of chaos and I cry and cry and become suicidal from the pain. The worst is the constant headache and burning pain up and down my spine (chronic pain syndrome). I'm currently taking 2 mg clonazepam and 30 mg Remeron. This worked well for a few months, but now the benefits seem to be wearing off. I'm faced with upping my clonazepam or going back on the dreaded (fat and impotent) Zyprexa. I can't just keep increasing my benzo, can I? Please, any advice would be greatly appreciated.
Hey Friend,
Sorry to here of youre situation. But rest assured, you are in good hands here, the guys here will really support you.
OK...now you are having problems with sleep. That's identified. Furthermore your AD is not working. Here is some ideas...
1. Try Seroquel...in addition to a possible AD effect it will definately sedate....I'd start at 50mg and slowly titrate to 200-400mg...If you have psychotic symptoms you may consider going all the way to 800mg.
2. MAOI- Try Nardil or Parnate. They are extremely effect AD's and anti-anxiety agents. Contrary to popular opinion, they are very safe when used correctly.
3. I would up the Klonopin to 3mg.
4. Tramadol- this is an EXTREMELY effective agent in the right person. It is used for pain, but it is useful in a spectrum of psychiatric disorders.
When I take 100mg Tramadol, I feel so so happy....I feel total calm and motivation...try it I say. But be careful of tolerance.
There is many more options. But please, in this state, be around people who love and support you. Take a break from everything.Any qstns please ask me...
Peace to you mate, hang in there,Ace
Posted by jerrympls on December 24, 2004, at 2:40:23
In reply to Incredible Pain/Anxiety/Depression, posted by Guy on December 23, 2004, at 21:20:15
Cymbalta actually has some semi-potent clinical pain relieving properties. I was pleasantly surprised to notice a lot of pain in my arms, shoulders and back was reduced after starting Cymbalta. It also helped me sleep quite well at first.
Here's some info from a press release at http://www.cymbalta.com :
The U.S. Food and Drug Administration (FDA) has approved the antidepressant Cymbalta (r) (duloxetine HCl; pronounced SIM-BALL-TA), judging it safe and effective for the management of diabetic peripheral neuropathic pain, a symptom of nerve damage that affects up to 5 million Americans, Eli Lilly and Company (NYSE: LLY) announced today.
Cymbalta, a balanced and potent serotonin and norepinephrine reuptake inhibitor, is the first and only FDA-approved treatment for pain caused by diabetic peripheral neuropathy. This approval came after a six-month priority review. More than 18 million Americans have diabetes and are at risk for developing persistent pain – often described as burning, stabbing or shooting pain – as a result of nerve damage believed to be caused by high blood sugar.
(edit)
Posted by blanding on December 24, 2004, at 12:44:50
In reply to Re: Incredible Pain/Anxiety/Depression » Guy, posted by ace on December 24, 2004, at 0:15:29
Some comments regarding Ace's posting (point 3 and 4 respectively):
According to experiences found on this board and elsewhere, clonazepam seems to have the tendency to cause depressive states. Therefore I'd be cautious about continuing or even raising the dosage of clonazepam.
For immediate anxiolytic action, alprazolam is superior, because of its concurrent antidepressant effects.Quoting Ace:
"4. Tramadol- this is an EXTREMELY effective agent in the right person. It is used for pain, but it is useful in a spectrum of psychiatric disorders.
When I take 100mg Tramadol, I feel so so happy....I feel total calm and motivation...try it I say. But be careful of tolerance."Once I was deliverd into hospital because of a bone fracture and was administered tramadol.
I also experienced total calm and peace and had asked the nurse what kind of psychopharmacon I was given. She replied, I wasn't given any one. After release from the hospital I researched the effects of tramadol and found it to be a rather potent analgesic with the side effect of opioid-type bliss.After release from hospital, I continued being prescribed tramadol and felt an antidepressant effect (I was taking no other meds at that time), though I was slowly but surely developing tolerance due to daily usage.
Later on I only occasionally took tramadol 100 mg (extended release) for its antidepressant and opiod type effect, but had to stop once I was put on an SSRI, because of the risk of serotonin syndrome.
Posted by blanding on December 24, 2004, at 13:01:25
In reply to Re: Incredible Pain/Anxiety/Depression, posted by blanding on December 24, 2004, at 12:44:50
I forgot to add the warning of possibly developing neuropathy when on tramadol for even less than a year. I don't know of any statistics that might indicate the quantity of occurrence for neuropathy.
Posted by Guy on December 24, 2004, at 18:03:42
In reply to Incredible Pain/Anxiety/Depression, posted by Guy on December 23, 2004, at 21:20:15
Thanks for all the feedback. Unfortunately, I think I will have to wait until after the new year to discuss these ideas with my pdoc. Season's greetings to all you guys.
Posted by jparsell82` on December 28, 2004, at 2:17:50
In reply to Incredible Pain/Anxiety/Depression, posted by Guy on December 23, 2004, at 21:20:15
> When I fall back down in the hole, I can clearly see the results on my face. Huge bags develop under my eyes and I look (and feel) as if I've been on a two week bender. For me, everything is tied into the quality of my sleep. Lately, I've been awakening early (3am) with a running nose, and this prevents me from relaxing and falling back to sleep. The next day, my whole nervous system is in a state of chaos and I cry and cry and become suicidal from the pain. The worst is the constant headache and burning pain up and down my spine (chronic pain syndrome). I'm currently taking 2 mg clonazepam and 30 mg Remeron. This worked well for a few months, but now the benefits seem to be wearing off. I'm faced with upping my clonazepam or going back on the dreaded (fat and impotent) Zyprexa. I can't just keep increasing my benzo, can I? Please, any advice would be greatly appreciated.
Cymbalta might be helpful for you... the similar drug Ixel(milnacipran) would be even more helpful but it's not available just yet in the US. It is available in Europe if you live in Europe or you can do a search an order from some websites. I would also check out www.remedyfind.com, they have different ratings for different disorders/problems.
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