RE: Clonidine and methadone for neuropathic pain

August 21, 2001

Hi Phil

Hey this sounds interesting. I would love to be able to at least decrease

the Neurontin so my thoughts would be clearer. I assume there are no mental

changes when taking Clonidine.

I am all to familiar with those weird sensations you are talking about.

Sometimes when I lie down there is this weird vibrating feeling that goes up

and down my legs.

Please keep me informed of your results.

Kaylene

In particular, I seem to have an increased

>threshold for the mechanical dysthesias that bug me so much. (Mechanical

>dysthesias are those strange, exaggerated, unpleasant sensations with

>movement or touch that are so characteristic of neuropathic pain.)

>

>The dysthesias are still pretty strong whenever I move my foot, but now

>I am able to make them drop noticeably in intensity by keeping it

>completely motionless. That comes in very handy when I'm trying to

>sleep! I will have to give it a few more days to tell if the improvement

>is really there and long-lasting, though. But it looks promising.

>

>Phil

>

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August 21, 2001

Hi Phil

Hey this sounds interesting. I would love to be able to at least decrease

the Neurontin so my thoughts would be clearer. I assume there are no mental

changes when taking Clonidine.

I am all to familiar with those weird sensations you are talking about.

Sometimes when I lie down there is this weird vibrating feeling that goes up

and down my legs.

Please keep me informed of your results.

Kaylene

In particular, I seem to have an increased

>threshold for the mechanical dysthesias that bug me so much. (Mechanical

>dysthesias are those strange, exaggerated, unpleasant sensations with

>movement or touch that are so characteristic of neuropathic pain.)

>

>The dysthesias are still pretty strong whenever I move my foot, but now

>I am able to make them drop noticeably in intensity by keeping it

>completely motionless. That comes in very handy when I'm trying to

>sleep! I will have to give it a few more days to tell if the improvement

>is really there and long-lasting, though. But it looks promising.

>

>Phil

>

_________________________________________________________________

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http://moneycentral.msn.com/tax/home.asp

March 19, 2004

Hi Phil

I have never taken either drug for my neuropathic pain but I have read a wee

bit about clonidine. What I recall off hand is that the dose has to be so

high that it can cause your blood pressure to bottom out.

I don't recall where I read this but if you have different information I

would like to read it.

Kaylene

>So does anyone on this list have any experience with both methadone and

>clonidine for neuropathic pain?

>

>Phil

>

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March 22, 2004

Kaylene Goyette wrote:

> Hi Phil

> I have never taken either drug for my neuropathic pain but I have read a wee

> bit about clonidine. What I recall off hand is that the dose has to be so

> high that it can cause your blood pressure to bottom out.

> I don't recall where I read this but if you have different information I

> would like to read it.

The doses that the neurologist mentioned were higher than those normally

used to treat hypertension, but they weren't *that* high. And she said

that hypotension was not normally a serious problem with her patients

who use it. I'm still on a diuretic, I figure I can always stop that if

hypotension becomes a problem.

Her usual dosing regimen was to start with a .1mg/day patch, then

increase the dosage .1mg/day per week. After six weeks, you're at 0.6

mg/day. That doesn't seem too terribly high.

I started a .1 mg/day patch on Friday midday, and by the following

morning I noticed a small but definite decrease in the intensity and

character of my pain. In particular, I seem to have an increased

threshold for the mechanical dysthesias that bug me so much. (Mechanical

dysthesias are those strange, exaggerated, unpleasant sensations with

movement or touch that are so characteristic of neuropathic pain.)

The dysthesias are still pretty strong whenever I move my foot, but now

I am able to make them drop noticeably in intensity by keeping it

completely motionless. That comes in very handy when I'm trying to

sleep! I will have to give it a few more days to tell if the improvement

is really there and long-lasting, though. But it looks promising.

Phil

March 22, 2004

Have eny of you tried prozac.i do not take nurontian it dose not work only

short peroiods of time prozac reduces pain and help to stablize brain.im

allergic to all the nasads product can not take much for that but prozac

really help need less pain killer,

March 22, 2004

try prozac im telling you it works on nerve pain,it has truly helped me, they

dont snow you either, matter of fact it wakes me up,they are really good for me

at least they also keep me from bustig into tears, so far they are the

best,.they help with pain,

Phil Karn wrote:

> The doses that the neurologist mentioned were higher than those

> normally used to treat hypertension, but they weren't *that* high.

March 22, 2004

Dee:

I have heard both good and bad things about Prozac. I hear that it can be

good with neuropathic pain but a friend of mine's son is being screened and

tested for bipolar and/or manic-depression, etc... His pediatrician put him

on Prozac and he literally lost it mentally. He is only 14 though. The

thing that worried me when he was on the Prozac is that he is a big boy and

his mother is like a bean pole. She is really skinny and small. He is like

a mac truck. Her husband is a big man but even so, her son is about as big

as her husband is. He lost it so badly one night that they had to call the

police who were supposed to take him to a mental facility for children but

instead, the dumb officer took him to lock-down. It took them two months to

get to court and get that off his record. They were already working with a

psychiatrist who was in the process of changing his medication. They were

just waiting for an appointment date. He is now on a different medication

and it is working great for him thus far. I just think that Prozac didn't

work for him because of his condition which is still somewhat up the in the

air as for a diagnosis. His biological father and biological paternal

grandmother act just as he does though I suspect his paternal grandmother is

medicated. His biological father is not. It finally took him breaking her

nose in a fight in front of their son for her to leave him. I thank God

that she did. I kept telling her that if she didn't leave him one or the

both of them would end up killing each other.

Her husband now is pretty good but she is also having similar problems with

him that I am having with my husband. They are about the same age too so we

are both thinking mid-life crisis.

Anyhow, different drugs react differently with each person. For example,

Adderall is a very good ADD (attention deficit disorder) drug but there have

been known proven cases of this drug causes psychotic episodes in some

children who take it. My daughter is on Concerta. Her pediatrician and I

have been considering the stimulant-free drug but since she is having such

good results with the Concerta, we have decided to leave it alone. Plus, it

is working very well with her heart medicine and we don't want to do

anything that would throw that out of balance.

Another friend of mine takes the Neurontin and says it does help her. I

haven't taken it personally. I haven't taken the Prozac either. I have

tried numerous other anti-depressant drugs for the nerve damage pain

control. None have worked.

Sam

Have eny of you tried prozac.i do not take nurontian it dose not work only

short peroiods of time prozac reduces pain and help to stablize brain.im

allergic to all the nasads product can not take much for that but prozac

really help need less pain killer,

March 22, 2004

dee fry wrote:

> try prozac im telling you it works on nerve pain,it has truly helped me, they

> dont snow you either, matter of fact it wakes me up,they are really good for >

me at least they also keep me from bustig into tears, so far they are the

> best,.they help with pain,

Prozac is an SSRI - selective serotonin reuptake inhibitor, one of the

newest and most popular class of antidepressants. The conventional

wisdom is that while the tricyclics, an older class of antidepressants

that isn't much used for depression anymore because of side effects, is

highly effective on neuropathic pain, SSRIs generally don't work as

well. But some of them do seem to work for some people, and you're

probably one of them.

A few weeks ago I did try small doses of Lexapro, another SSRI, but I

stopped after some minor side effects that may have been the fault of

another medication change we made at the same time. (That's a lesson I

keep re-learning. Change only one medication at a time. That way, if it

works -- or causes problems -- you'll know which one is responsible.) So

I might try it again in a while.

Prozac is rather notorious for its interactions with certain other

drugs. Normal doses can completely shut down one of the liver's

important enzymes for metabolizing certain other drugs, especially the

tricyclic antidepressants. Without this enzyme they can build up in the

body and become toxic. So you should make sure that your doctor knows

*everything* you're taking.

Phil

March 22, 2004

thankyou phil im well aware the doc told me not to take enything unless he

tells me is okay the only other thing i used is vicdone at night, thanks for

caring enofe to tell me i will be carful. im afraid of meds so im kind of

freaky about taking them.

>

>Reply-To: chronic_pain

>To: chronic_pain

>Subject: Re: Clonidine and methadone for neuropathic pain

>Date: Mon, 22 Mar 2004 06:32:15 -0800

March 22, 2004

you know sam i heard that prozac is not for persons under aged, i cant

remember reason but im sure it has to do with brain cimastry, i hope you

all can understand my spelling,

so far so good, its one of the only things that work, i have such

allergies to ibuprofin products, i am very limited what i use for pain.

i will be careful, My ten year old granson just left for grandpas house,

he came clear back in the house to tell me he loved me, what a blessing.

>

>Reply-To: chronic_pain

>To: <chronic_pain >

>Subject: RE: Clonidine and methadone for neuropathic pain

>Date: Mon, 22 Mar 2004 09:30:42 -0500

>

March 22, 2004

Dee:

That is what I kept telling my friend with the son who was on Prozac. I

didn't think it was made for children of his age. Since coming off of the

Prozac and going on what he is taking now, I can't remember off the top of

my head what they put him on, but he is doing much better. His manic highs

are much more controllable and less frequent.

I can't take aspirin and am allergic to certain metals so I can understand

some of what you are going through. I imagine it is hard to find something

that works. I don't know what I would do if I didn't have the regimen of

meds I am on now. When I take them on time and every day as I am supposed

to, there really is a difference in the way I feel. But then again there is

always the wild cards such as the weather, bad days, and lupus flares.

Stress seems to be a huge trigger for me as well.

That is what I am looking forward to and pray that I live long enough to see

it, grandchildren. I don't want them right now mind you. I want my girls

to go through college, get an education, get a career where they are

self-supporting before they settle down. My teenager has said that she

never wants to get married nor have children. I think she will change her

mind in time. She knows that her biological father walked out on us when

she was 10 months old for another girl. She sees how hubby and I are at

each other's throats lately and that doesn't help matters. She is 16 and a

half years old and doesn't have a boyfriend. She had one but he broke her

heart really bad and she hasn't been interested in guys as boyfriends since.

Many like her but she isn't interested right now. Plus, she knows that with

her ADD she will have to work very hard to get into the college she wants to

go to. A girl at school is mad at her now because the girl's boyfriend

likes my daughter and broke up with the other girl. He and my daughter are

friends but she has made it plain up front that her studies come first. I

never lied to her about how hard it was for me to go back to school after

dropping out in the 10th grade to marry her father then after he left, how

hard it was to get back to get my GED then go on to spend 6 years in college

for a dual degree. Then lose it all when I started going blind. I did go

back through a very good vocational program for medical transcription but I

lost even that when the pain got so bad that I had to stop working and

finally found out what was causing the pain. She has a first cousin on my

husband's side and a second cousin on my side of the family that she really

looks up to. One is in college now and is boyfriend-free while she works

her behind off to keep a high GPA. Her second cousin, who is my first

cousin, went through college and after she had her career established, she

married a guy she went to college with. These two girls are wonderful role

models for her. I hope my youngest daughter will go the same route, putting

studies before everything else. I want them to be self-supporting so they

never have to rely on a man to help them do anything. I want them to be on

complete equal footing with whomever they choose to spend the rest of their

lives with. I don't want either of them to have to go through what I did.

I also don't want them to have to settle. Not that I think I settled in my

second marriage. It was wonderful in the beginning, as I have mentioned.

But these last few years have been rough. I don't want either of them

tainted by our, hubby and mine's, problems.

Enjoy that grandbaby.

Sam

you know sam i heard that prozac is not for persons under aged, i cant

remember reason but im sure it has to do with brain cimastry, i hope you

all can understand my spelling,

so far so good, its one of the only things that work, i have such

allergies to ibuprofin products, i am very limited what i use for pain.

i will be careful, My ten year old granson just left for grandpas house,

he came clear back in the house to tell me he loved me, what a blessing.

March 22, 2004

wrote:

> Dee:

>

> That is what I kept telling my friend with the son who was on Prozac. I

> didn't think it was made for children of his age. Since coming off of the

> Prozac and going on what he is taking now, I can't remember off the top of

> my head what they put him on, but he is doing much better. His manic highs

> are much more controllable and less frequent.

" His manic highs " ?? That implies he has bipolar disorder (formerly

" manic depression " ). *Every* antidepressant I've read about carries a

stern warning that it might trigger a manic episode in such people. If

the prescribing doctor knew this diagnosis, I'm very surprised he wasn't

monitoring him more closely. While many people find hypomania (mild

mania) to be exhilarating, full-blown mania is a serious medical

emergency; even if the patient doesn't attack anyone, he can die from

sheer physical exhaustion.

I've also read that when treating bipolar disorder, you take care of the

manic component first, usually with lithium. If the mania can be

controlled, the depression will often take care of itself.

Phil

March 22, 2004

wrote:

> Dee:

>

> That is what I kept telling my friend with the son who was on Prozac. I

> didn't think it was made for children of his age. Since coming off of the

> Prozac and going on what he is taking now, I can't remember off the top of

> my head what they put him on, but he is doing much better. His manic highs

> are much more controllable and less frequent.

" His manic highs " ?? That implies he has bipolar disorder (formerly

" manic depression " ). *Every* antidepressant I've read about carries a

stern warning that it might trigger a manic episode in such people. If

the prescribing doctor knew this diagnosis, I'm very surprised he wasn't

monitoring him more closely. While many people find hypomania (mild

mania) to be exhilarating, full-blown mania is a serious medical

emergency; even if the patient doesn't attack anyone, he can die from

sheer physical exhaustion.

I've also read that when treating bipolar disorder, you take care of the

manic component first, usually with lithium. If the mania can be

controlled, the depression will often take care of itself.

Phil

March 22, 2004

Kaylene Goyette wrote:

> Hi Phil

> Hey this sounds interesting. I would love to be able to at least decrease

> the Neurontin so my thoughts would be clearer. I assume there are no mental

> changes when taking Clonidine.

Clonidine's main side effect (and the only one I've noticed so far) is

dry mouth. I can live with that. Other common side effects include

drowsiness and postural hypotension (feeling dizzy when you stand up

suddenly due to a momentary drop in blood pressure). I haven't noticed

these yet, but I'm still on a small dose.

Clonidine only works on " sympathetically mediated pain " . I'm still

trying to learn the exact mechanisms here; I'm not sure they're

completely understood.

When I first saw my pain doc in July 2002, he ran a phentolamine test

intended to determine if my pain was sympathetically mediated. Like

clonidine, phentolamine lowers blood pressure but in a different way.

Clonidine reduces adrenalin levels while phentolamine blocks the effect

of adrenalin on the periphery. Either way, your blood vessels relax and

expand, and your BP drops.

He administered it IV in his clinic to see if it affected my pain level

and/or the temperature of my injured foot (which has always been

considerably colder than my uninjured one). I had just gone on Oxycontin

so my pain level was already fairly low, but my foot did seem to warm up

a bit. I stopped the test when my BP dropped to 74/41 and I nearly

passed out. The test was either negative or inconclusive, but I've read

that it often gives such results even when sympathetically mediated pain

is present. So I wish I had tried clonidine earlier...

Phil

March 22, 2004

Kaylene Goyette wrote:

> Hi Phil

> Hey this sounds interesting. I would love to be able to at least decrease

> the Neurontin so my thoughts would be clearer. I assume there are no mental

> changes when taking Clonidine.

Clonidine's main side effect (and the only one I've noticed so far) is

dry mouth. I can live with that. Other common side effects include

drowsiness and postural hypotension (feeling dizzy when you stand up

suddenly due to a momentary drop in blood pressure). I haven't noticed

these yet, but I'm still on a small dose.

Clonidine only works on " sympathetically mediated pain " . I'm still

trying to learn the exact mechanisms here; I'm not sure they're

completely understood.

When I first saw my pain doc in July 2002, he ran a phentolamine test

intended to determine if my pain was sympathetically mediated. Like

clonidine, phentolamine lowers blood pressure but in a different way.

Clonidine reduces adrenalin levels while phentolamine blocks the effect

of adrenalin on the periphery. Either way, your blood vessels relax and

expand, and your BP drops.

He administered it IV in his clinic to see if it affected my pain level

and/or the temperature of my injured foot (which has always been

considerably colder than my uninjured one). I had just gone on Oxycontin

so my pain level was already fairly low, but my foot did seem to warm up

a bit. I stopped the test when my BP dropped to 74/41 and I nearly

passed out. The test was either negative or inconclusive, but I've read

that it often gives such results even when sympathetically mediated pain

is present. So I wish I had tried clonidine earlier...

Phil

March 22, 2004

hi phil im not manic I have post tramatic stress sydrom a bad case of it,the

doc said that it takes two on this list of things to make somone pts i have

all but one.i well be careful thankyou for caring,you really help with the

information you send.

>

>Reply-To: chronic_pain

>To: chronic_pain

>Subject: Re: Clonidine and methadone for neuropathic pain

March 22, 2004

Phil:

That is what I thought but I found out this evening it turned out it was his

pediatrician that started the prozac, not his psychiatrist.

I am really worried about this little boy even though he isn't a little boy

anymore. He is very near and dear to my heart. I know that when his father

seemed to hit these highs, that is when he would usually beat the crap out

of my friend. Thankfully he never laid a hand on Josh but he certainly hurt

his mom a lot throughout their time together. I was so greatful when I

heard she had left him for good.

Right now, in addition to problems with his disease, which as I say is still

in the diagnosing stage and treatment stage, is he is having problems with

his father who promises to see him or talk to him then disappears again. I

told her that he doesn't need this in his life and to see what Josh's doctor

can do to stop any and all visitation or even phone calls between the two

until they get him stabilized. My biggest fear for him is that he will get

manic and will end up killing himself. He has already made off-comment

remarks about " if he wasn't around anymore " .... He hasn't come right out

and said it but his mom has made sure his doctor is aware of the

possibility.

Thank you for all the info on Prozac. I know it must be a great drug for

some but for others, like Josh, it is nothing but trouble.

I wish all of you a wonderful pain-free night. Hugs and warm wishes.

Blessed Be.

Sam

[snip] " His manic highs " ?? That implies he has bipolar disorder (formerly

" manic depression " ). *Every* antidepressant I've read about carries a

stern warning that it might trigger a manic episode in such people.[snip]

March 22, 2004