Re: Pain management and antidepressants

[Guest guest]

,

I was on Evavil 10mg for sleep-not enough to be considered for antidepressant

strength my rheumatologist said. I got off of it because of nightmares

though. I was given Paxil (which I wouldn't recommend because of the patient

uproar of this drug) for fibromyalgia pain at 10mgs (I think). I took it for 6

months and noticed nothing. Later I was prescribed 12.5 for anxiety. I took it

for 2 weeks and felt nada. I know Prozac is rxed affectly for pain...20mg is

for depression, so perhaps a lower dose for pain. It takes weeks to become

affective. Hope that helps.

Jolene -1960 fusion

[Guest guest]

No the pain effect seems only to works with low doses of Elavil or

similiar drugs. Doxepin is another one that works in low dose and is

similiar in chemistry to Elavil (In fact it's called Elavil in some

places even though it's slightly different from what I heard.)

I have been told you should try lower and lower doses until you find

a point it works. I took about 50 mgs. However the doctor said that

25 mgs might work better... go figure. The reverse isn't true though.

And I think Elavil is a terrible drug for depression because of it's

side effects at higher doses... Doxepin has lower side effects I

found but neither can compete with the modern anti-depressants for

depression. (And this is only my opinion of course.)

[Guest guest]

Hi :

You can find some info on antidepressants in controlling back pain at:

http://www.spineuniverse.com/displayarticle.php/article411.html

http://www.spine-health.com/topics/conserv/overview/med/med01.html

Regards,

On 9/5/03 6:12 AM, " qyeserasera " <queserarachel@...> wrote:

> Hi,

> I'm hoping someone here knows about the use of antidepressants in

> managing pain. I remember some dr.'s prescribe a dose of 25 or 50

> mgs. of Elavil to enhance the effects of an also-prescribed

> analgesic.

> So, does anyone know if the full strength of an antidepressant would

> have the same effect on the analgesic?

>

> Thanks for your input,

>

>

>

>

>

>

[Guest guest]

Up until about 6 months ago I was on Anti-Depressants (for depression) and my

back pain was almost nil during that time. As soon as I came off the pills

(Celexa/Cipramil) my back pain came back, big time. I think why it worked for

me was because my back pain is made a lot worse when I am stressed; the

anti-depressants helped to alleviate the stress and I guess my muscles were more

relaxed. I am now considering going back onto the meds.

My pain is caused by scoliosis and also kyphosis which I have too. Neither

condition is so bad that I have needed surgery but the pain is still very bad

some days.

Hayley

[Guest guest]

Thanks everyone for your input re: antidepressants & PM. I'm really

glad I asked my question and got feed back on Elavil esp..

I've been thinking along the idea of what Hayley has written. If I

were on an antidepressant for it's SSRI affect and not for PM, I

might get a lessening of pain. I'm very concerned about going on an

opiate for pain med. at my young-and-tender-age of 50. I'll be

meeting with a PM specialist soon - and this dr. does not limit his

practice to injections - so all this information helps me focus my

questions. I've been using ice, rest, PT, stretching, back-

stabilization exercises, pool therapy and meditation for apprx. 2

years now (3 years out of surgery) but I believe my pain is still

managing my life... I want to rearrange that process.

I'm strongly considering the Duragesic Patch and I know a couple

correspondents on this forum have had great success. Has anyone had

a negative outcome with this medication?

As always, thanks for being here,

[Guest guest]

Hi everyone.I've been a member for awhile,just haven't posted.I had

a Harrington Rod put in '76,it's been broke since '84.They also gave

me tainted blood so I have had HepC since '76 also(thanx Doc.).I've

been going to pain management for 5 months.I have been using the 75

micro-grams an hour Duragesic Patch.It works well w/me,only thing is

they are supposed to last up to 72 hrs,but I've found by the time I'm

supposed to put a new one on I'm already going into withdrawals.It

takes 8-18 hours to get in your system,so I'm usually in withdrawals

for a day b4 it starts working again.By NO MEANS would you want to

stop these patches by yourself.I also suffer from Bi-Polar and I

decided I would stop all medications as I was going thru one of my

depressed stages.BBBBBBBaaaaaddddd idea,that was the worst week of my

life.The patches are great,just do your homework as w/all opiads.

[Guest guest]

In a message dated 9/9/2003 11:14:54 AM Eastern Daylight Time,

paulettep11@... writes:

Been going to pain management for 5 months. I have been using the 75

micrograms an hour Duragesic Patch. It works well w/me,only thing is

they are supposed to last up to 72 hrs,but I've found by the time I'm

supposed to put a new one on I'm already going into withdrawals. It

takes 8-18 hours to get in your system, so I'm usually in withdrawals

for a day b4 it starts working again.

I can fully understand what you are saying about the Duragesic Patches. I

found this to be the case with a single 25 mg patch, and a 50 mg patch was WAY

too strong (unpleasant side effects). My doctor has me on a routine that I

find really works well, and those of you who mentioned this problem may want to

ask your doctors about it if you want to give the Duragesic Patches another

try. It can get a bit confusing, and; therefore, requires the use of the

stickers that come with the patches and a calendar....

Here's my routine....

Day 1: Apply first patch (pick which side of body/location, I use my rear

end, R/L (if you know what I mean))

Day 2: Skip Day

Day 3: Apply second patch (put on opposite side of body/location from Day 1

patch)

Day 4: Remove Day 1 patch, and apply a new patch on that side of body

Day 6: Skip Day

Continue Routine.

Hence, no withdrawal!! :-)

S.

[Guest guest]

Dear -

I have just started on the Duragesic patch, having asked my doctor about

it after hearing others in this group mention it. I was on Lortab, which

simply were not working for me any longer unless I over-medicated. I am

only 41, and my doctor (and me, of course) was concerned about liver damage

from over-use of a Tylenol-based med. (which Lortab is). Duragesic is a

strong opiate (fentanyl), and the literature talks about how it should not

be prescribed unless other types of opiate drugs have been tried first. Of

course, you would have to talk to your doctor.

I have started on the lowest dose, which is 25 units (not sure what

they're called) per hour. Pain relief is decent, but not complete - I still

struggle in the evening when making dinner, etc. (I work and am a single

parent of a 6-year-old who is going through some behavioral problems, so

life keeps me hopping). At first I was not crazy about how it made me

feel - I was telling people that my back still hurt, I was just too spaced

out to care. I've been on it for a full week now and feel better - not as

spacy. I am very happy not to have to take pills and to have a steady dose

of the med being released - when I took oral meds, I'd feel pretty good for

about 2-3 hours & then would grit my teeth until it was time for my next

pill. I have another appt. with my dr. on Thurs & will inquire about a

slight increase in dosage - as long as I am going to be on this type of med,

it might as well work.

I work as a paralegal/law office manager and am able to do my job when

on the opiate meds. At this point the pain would distract me more than the

narcotic effect of the drugs. (I am 30 years post Harrington rod surgery,

with flatback syndrome.) Of course, I do not advertise the fact that I take

such strong med.

Good luck to you,

mary b

Re: pain management and antidepressants

Thanks everyone for your input re: antidepressants & PM. I'm really

glad I asked my question and got feed back on Elavil esp..

I've been thinking along the idea of what Hayley has written. If I

were on an antidepressant for it's SSRI affect and not for PM, I

might get a lessening of pain. I'm very concerned about going on an

opiate for pain med. at my young-and-tender-age of 50. I'll be

meeting with a PM specialist soon - and this dr. does not limit his

practice to injections - so all this information helps me focus my

questions. I've been using ice, rest, PT, stretching, back-

stabilization exercises, pool therapy and meditation for apprx. 2

years now (3 years out of surgery) but I believe my pain is still

managing my life... I want to rearrange that process.

I'm strongly considering the Duragesic Patch and I know a couple

correspondents on this forum have had great success. Has anyone had

a negative outcome with this medication?

As always, thanks for being here,

[Guest guest]

I had to stop taking the Duragesic patch for the same reason. I

suffered withdrawals on the third day as it wore off. It happened

every time and I was sick and tired of it. I switch back to MS

Contin. I still get withdrawal problems if I forget to take the

medicine on time but at least it goes away when I finally get around

to taking it. With the Duragesic patch I had to wait until it was

time to change them. Some people don't have this trouble but for

those that do it's really isn't pleasant. And there was no convincing

my doctor that this was happening and that I needed to change them

more often.

[Guest guest]

B.

I've been on the patch for some time now. I started with 25 for 72 hours,

and gradually went up to 100, where I stopped. I've never had ANY side effects

at all. I do believe that this regimen is what put me back on my feet. I am

not completely pain-free, but before the patch I was pretty much bedridden.

My doctor says it just puts me where other people start!

Carole

Hope it provides the relief wished for!

[Guest guest]

,

I'm so sorry you had such awful luck with the patches. My doctor nearly

always asks me how long they are lasting! Was your doctor from a pain clinic?

Carole

P.S. Hope you are feeling well.

[Guest guest]

Barb,

Perhaps Neurontin (Gabapentin) for the nerve pain - start with the smallest

dose, then increase as needed. It may also help with the depression, perhaps

giving the Elavil a boost as well or without the Elavil. And it may help with

tremors. Neurontin first came out as an antileptic, but is used off label for

many things. (CIDP, CFS, et al)

The only med I ever took (for a very short time) was Prozac, which I do not

recommend. There are so many anti-depressants out there now. Have you consulted

a psychiatrist on this?

As for the trembling, which I call 'tremors', Symmetryl has worked the best for

me. (Also used off label for other things)

I can only imagine what your daughter is going through. Being 14 in itself with

CMT was bad enough. Her stress is insurmountable.I hope she has a very

compassionate psychiatrist. One that " listens " and " understands " the nature of

CMT and it's effects.

As for young people's support groups - email pat@... she may know of

one, or at least connect you to some other young people in the area.

Gretchen

[Guest guest]

Barb,

There is a Bucks county CMT support group but not sure if that is near you?

Lori

[Guest guest]

Barb,

There is a Support and Action Group in Bucks County. Please go to

www.cmtausa.org and there will be info there. Our prayers go out to you.

Mark, CMT SAG Facilitator in Central NJ

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[Guest guest]

Barb,

I have suffered from depression since a teenager. I am currently on

Cymbalta, which is also somewhat helpful for nerve pain. I also have a

prescription for Lyrica specifically for nerve pain, but it makes me very

sleepy.

I have had wonderful success with Primidone (it's an anti-seizure med) for my

hand tremors, at a very small dose.

I do not know if these medications are suitable for a teenager, however, so

please check with a doctor about that. Some things that work well in adults work

differently for them. Also, my variant of CMT1A is very slowly progressive (I am

51), so YMMV.

Sending you my best wishes and prayers,

Bonnie

[Guest guest]

I had a really nasty side effect of spasmic contractions taking Cymbalta. It was

also making me depressed, ironic for an anti-depression medicine.

Weaning myself off the Cymbalta, the spasms lessened, but have not entirely gone

away. The depression got better and I felt I had more energy.

O 55 CMT2