Re: Appropriate Antidepressant

May 2, 1998

Dear new friends,

Amitryptyline (Elavil) has long been known for its pain management ability.

It is an older antidepressant and relatively cheap to purchase. It can help

manage many problems.

I use it with my Reiters Syndrome to:

l. Helps to manage pain from my disease (arthritic). It is not a pain

reliever but seems to enhance the ability of the body to produce its own

pain reducing chemicals. For me, this means less pain relievers like

aspirin, NSAIDS, and tylenol.

2. Reduces the frequency and urgency feelings related to the inflamation of

my urinary tract, another part of my syndrome. Honestly, I don't know what

I'd do without it when I'm having urinary tract inflamation. I haven't

found anything else that works as well for this problem. Negative side

effect: reduced sex drive and ability to function sexually.

3. Normalizes sleep pattern. One of the biggest problems for those of us

with chronic pain is getting a good night's sleep. Though it seems to work

fairly well by itself, Amitryptyline combined with a sleeping pill like

Ambien (the astronaunts' sleeping pill) has really assisted me during

flare-up periods when I could not get sleep any other way. Neither of these

seems to be addicting for me. I can take them when I need them or stop

taking them without any problem. Check with your doc, for further

information.

Ray in Virginia

May 3, 1998

I have been taking Zoloft (a first cousin to Prozac, I think?) for almost

two years now. It was prescribed to help reduce pain, which it never has

done. However, it does make everything seem " brighter " somehow. It's

difficult to explain: It's as though there had been a thin gray veil over

my eyes and Zoloft lifts the veil away. I hadn't realized I WAS depressed

until I started to take Zoloft. For this reason, I have kept up the

prescription.

I have never tried Elavil. How does it differ from the Zoloft I'm now

taking?

For sleeping, the best aid I've found has been Melatonin. It has worked

wonders for me. I am now able to get five hours straight of decent sleep -

the only problem, however, is when I do wake up the pain is excruciating,

having slept through the length of time for the meds to wear off! Still,

it's great to get some sleep!

Peggy M.

At 04:43 PM 5/3/98 -0000, you wrote:

>

>Dear new friends,

>

>Amitryptyline (Elavil) has long been known for its pain management ability.

>It is an older antidepressant and relatively cheap to purchase. It can help

>manage many problems.

May 3, 1998

I have been taking Zoloft (a first cousin to Prozac, I think?) for almost

two years now. It was prescribed to help reduce pain, which it never has

done. However, it does make everything seem " brighter " somehow. It's

difficult to explain: It's as though there had been a thin gray veil over

my eyes and Zoloft lifts the veil away. I hadn't realized I WAS depressed

until I started to take Zoloft. For this reason, I have kept up the

prescription.

I have never tried Elavil. How does it differ from the Zoloft I'm now

taking?

For sleeping, the best aid I've found has been Melatonin. It has worked

wonders for me. I am now able to get five hours straight of decent sleep -

the only problem, however, is when I do wake up the pain is excruciating,

having slept through the length of time for the meds to wear off! Still,

it's great to get some sleep!

Peggy M.

At 04:43 PM 5/3/98 -0000, you wrote:

>

>Dear new friends,

>

>Amitryptyline (Elavil) has long been known for its pain management ability.

>It is an older antidepressant and relatively cheap to purchase. It can help

>manage many problems.

May 4, 1998

At 11:00 PM 5/3/98 -0000, you wrote:

>

>I have never tried Elavil. How does it differ from the Zoloft I'm now

>taking?

Zoloft (along with Paxil, Prozac and a couple others, I think) are

Selective Sertotonin Reuptake Inhibiters (SSRI's) which prevent the brain

from reabsorbing as much sertotonin as it naturally does, which increases

the amount of sertotonin available for neruotransmitter functions. Elavil

is a tricyclic. I have no idea how tricyclics work, but I DO know you DO

NOT want to take an SSRI and a tricyclic together, as it can be lethal.

What I " m wondering is if there's a difference between the SSRI's and

Wellbutrin, or is it one of the SSRI's -- it seems very different in a lot

of ways, so I'm curious...

Griselda

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May 4, 1998

At 11:49 PM 5/3/98 -0000, you wrote:

> Interestingly, natural remedies seem to be out-stripping developments in

>medicine in this area. First we rediscovered St's wart, which provides

>the body with a natural material that gets turned into useful Seratonin if

>you are lucky. This is a more simple approach than trying to improve the

>body's efficiency in using what it has learned to discard. Beyond this, a

>more direct substance called5-hydroxytryptophan occurring naturally in an

>African seed & also easily cheaply made in the lab, appears *identical* to

>the body's own Seratonin production chemistry. It is cheap and possibly

>more direct & better than the Prozac/Stjohn's wort route. Curiously, my

>body responds very well to this. Doesn't stop pain, but sure makes it a

>happier experience.

Just a couple notes of caution: I am not a medical professional, but I do

a lot of reading, so understand that I'm presenting my understanding of

what I've read elsewhere...

Anyway -- St. 's Wort can be very effective, but it's important to be

aware that since it functions similarly to the SSRI's, it should NOT be

taken in combination with ANY anit-depressants. The potential exists for

some fairly serious problems. Also, some of the newer diet drugs,

including the two that were taken off the market (Redux and fenflueramine),

also work to try and increase the amount of sertotonin by various methods,

and should also not be combined with St. 's Wort or other

anti-depressants.

Also, the 5-hydroxytryptophan is very similar to L-tryptophan that was

pulled from the market a few years back after some people died from taking

it. I heard reports indicating that this new formulation is safer, and

I've heard some saying it isn't, so just be real careful with it, and,

since it also is closly related to sertotonin and the levels of sertotonin

in the brain, it is unwise to mix it with St. 's Wort, SSRI's and other

antidepressents.

I use a lot of natural remedies myself, but it's important to remember that

even natural remedies can have side-effects. They don't get publicized as

much, and GENERALLY they're not as serious or detrimental, but they do

exist...

Apparenly, our brain gets weird if we have too little sertotonin, but it

can get REALLY bad if it gets too much.... ::sigh:: It never gets to be

easy, eh?

OK. I'll stop being the voice of doom now.

Griselda

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" We are become grey. We stand between the darkness and the light

....between the candle and the star " -- B5

**************************************

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May 4, 1998

,

Thanks for your response (see below) to the issue of antidepressants for

pain management. How true that our response to medication is a matter of

how our body and our minds react to it. Guess that is one reason why we

have so many new meds coming on line all the time. My wife, a doctor, gave

me a new med for migraines recently. I took one pill and the side effects

were far worse than the migraine I wanted to get rid of. Four hours later

when the medication wore off, I still had the migraine...but luckily the

side-effects were gone. Took my old standby migraine medication and the

headache was gone in half-an-hour. It was a lesson for me! New isn't

necessarily better! At least I know to stay away from one particular

medication and its clones.

Personally, having had to deal with chronic pain for more than 23 years now,

I hesitate to take any medication, especially pain medications, most

especially anything falling into the " controlled medication " list. I don't

like the feeling of being " drunk " and refuse to give up control of my body

and mind to escape from the pain. I'd rather be in pain and in control than

the other way. I've got a life to live and I have to have a clear mind to

do all that I do. But, if others find they can function better with such

medications, then I'm all for them having it. It is definitely a matter of

individual reactions and preferences.

Ray in Virginia

Re: Appropriate Antidepressant

>

>Moderator's note--

>

> While message traffic on our list is a little laid back today, subscribers

>are still coming on at a rapid pace. I would especially like to recognize

>the considerable response we are getting from international subscribers,

>welcome you & mention that if there is anything we can do to facilitate

>international subscriptions, let me know at chronic_pain@....

>Although this list originates in the USA, there are no geographical

>restrictions intended. In fact, I expect to learn more from participants

>abroad, since you get access to many drugs & treatments that seem to get

>buried in our federal drug agency bureaucracy.

>

> We have two posts on meds today-- one on amitrytriptaline (elavil) & one

>on zoloft. As you will eventually all be reminded many times, I am what is

>termed a classic non-responder: Enough medication to kill an elephant may

>do nothing for me except side-effects. It took a lot of weeding out even to

>find a pain-killer that works for me. I spent years on elavil with

>horrendous side-effects, & as I later realized, no gain at all. Likewise

>for zoloft. Now the chemistry lesson: These drugs, as do many others,

>attempt to increase the blood level in your body of Seratonin, a drug that

>makes us feel good & happy if its there in the right amount. The way they

>do this however, is not to create the Seratonin, but cut down the body

>re-absorbing it out of the bloodstream unnecessarily (thus the name anti

>Seratonin re-uptake inhibitor). This is not exactly the case for

>amitryptaline, but it is for most of the recent, sexy antidepressants.

>

> I've been involved in research myself, & learned never to take anything at

>face value. I am not aware of studies that confirm all of us actually make

>an effective form of Seratonin for our own bodies. This is a little

>speculative, but if our own Seratonin is not too effective in our own

>bodies, capturing more of it may not be the answer for non-responders like

me.