Guest guest Posted August 27, 1998 Report Share Posted August 27, 1998 > If you don't give the depression the attention it deserves, I will bet in >the long run depression will sabotage almost any effective management of >your chronic pain. It has done this for me, and I'm so smart I make myself >sick. (is there a specialist to treat that problem?) Hi Ken, Thanks for your post. Lots of good food for thought. My doctor has discussed this very thing with me over the years and made me aware of many of the same things you said. Your post only helps me to understand the whole ball of wax even better. I'm curious.... I'm inferring from your post (I'm new here, remember?) that you have chronic pain are also using an anti depressant. What has worked best for you? I had such a negative experience with the SSRIs that I won't go near them. We, Dr. and I, really thought it would help with the pain management but I ended up feeling like a dishrag in pain... I watched the darn OJ Simpson trial for heaven's sake! No interest in anything really, especially no interest OR ability for intimacy, but none of that 'got me down', I just didn't care one way or the other anymore...no downs but no ups either. Pain level remained the same, I just didn't care. :-) Got off of the stuff, felt better overall, worked with a counselor on more stress management and then got into working on the acceptance issue I talked about in an earlier message. I was a bit leery of the Serzone but when, at my Dr.'s suggestion, I looked into the stuff and saw that it wasn't the same as the SSRIs, I gave it a go. The up/down cycle drove me nuts and that's why I stopped it. However, my Dr. would like me to give it a go again, especially since my pain level is overall higher than it's been since I messed up my back. I'm hovering on the brink of stopping the 5-HTP and giving the Serzone a go again. Hearing what others are trying, going through, what's worked for them, has helped me A LOT. I'm glad I found this list. CULater, Ruthie =========================== Ruthie Cunliffe K2ZQ ruthie@... http://www.cunliffegroup.com/ruthie/ experimental web cam: http://www.cunliffegroup.com/ruthie/spy/ ** A BALANCED DIET IS A COOKIE IN EACH HAND ** Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 1998 Report Share Posted August 27, 1998 Hi Ken... Thanks for the answer! A long time ago, several years before I injured my back, I was given imipramine for depression. That's a tricyclic, I believe. I had awful dry mouth and was sleepy ALL the time. Didn't seem to do a whole heck of a lot for me at the time. The situation that was causing the depression was worked through and I finally went off the stuff. Perhaps this is why my doctor doesn't want to use a tricyclic with me now?? I take 100mg of trazadone at night for sleep and have been for 2 yrs. now..since the FMS diagnosis. I was taking a small amount of imipramine for sleep, after trying elavil and giving up on it cuz of the side effects, but doc wanted to try something else to help me get better sleep. We tried nortriptalyne (sp?) and that didn't work worth beans....so next was the trazadone and that worked. I used to take 75mg but she upped it to 150mg last Winter. That made me horribly hung over so we backed it down to 100mg. The dry mouth I had, and the sleepiness, went away but I still get a good night's sleep. The one thing that messes with my sleep is the pain med so I try to NOT take it too late in the evening..usually no more after 6pm is my rule. If you see me posting later at night you know I've taken something and it's keeping me up! It's a toss up... pain med keeping me awake or the pain itself keeping me awake. :-) Do you think that the doctors today want to prescribe all the newer anti depressants because they think they are better or because it's what's " in " right now?? They sure cost an arm and a leg!! =========================== Ruthie Cunliffe K2ZQ ruthie@... http://www.cunliffegroup.com/ruthie/ experimental web cam: http://www.cunliffegroup.com/ruthie/spy/ ** A BALANCED DIET IS A COOKIE IN EACH HAND ** > I tend to favor the tricyclics, particularly Sinaquan. They (and it) are >old stand-bys that have a history of effective association with treatment >of physical illnesses. Sinaquan also helps with sleep when taken before >bedtime, may cause some drying (but in my experience nowhere near what >elavil does), does not seem sedating during the day as elavil is for me, >and leaves me feeling relatively myself. Elavil gives me a feeling of being >slightly removed from reality (fog) that is characteristic of major >tranquilizers like Stellazine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 1999 Report Share Posted August 27, 1999 Ruthie, Arica, All, Felt I had to put in this view on meds. Psychiatrists must be very frustrated people. The have an incredible amount of pharmaceutical tools & need to translate them into carefully balanced solutions, in our cases, most often for depression. Other doctors can be good for medicating depression too. Often, their outlooks are not as complicated by the constant changes brought on by 'new drugs on the block " as are the psychiatrists, who get overwhelming data on each and every psychiatric med. Also, in some specialized kinds of treatment (like chronic pain) there tend to emerge pretty standard treatment plans, combinations of treatment & medications used most often. This can be helpful for many patients, but there are always those who don't get the standard responses. Since matching people & anti-depression drugs can get very, very intricate, we have to work closely with docs to get any decent results at all unless we're very, very lucky. Also, if you need fine tuning with anti-depressants, you or you & your doc, need to consider getting a psychiatrist into your treatment team. I don't think other doctors would be offended by this at all. Chronic depression is a recognized, major biochemical disease all by itself. So why should a chronic pain patient get *less* attention for it than for other problems. People with chronic pain are sitting ducks for major depression. When your world is being torn up all around you, in your body & your life due to the havoc of chronic pain, its not surprising to become depressed. And when the depression is prolonged (2 years is the guideline) because chronic conditions don't go away, can get worse, & generally tear up your life, the body can go through a biochemical change where the chemistry of depression become relatively permanent. This is called an endogenous depression. It is very treatable, but please try & recognize that this is a whole additional disability on its own, and would scramble you even if you didn't have chronic pain. That's why it is a wise practice to see a psychiatrist as well as someone who is treating you for the chronic pain. There are so many anti-depressants that I doubt most psychiatrists, let alone other doctors, are clear on all of them at the same time. Another issue about depression I want to mention is that it touches on one of our social taboos. It may well be easier for a drug addict to admit he/she is addicted than admit you have a real depressive illness & seek treatment. Why? well we could look at that some other time. But my point here is that serious depression is a " piggy-back " illness likely to affect people with chronic pain, and tough enough in its own right to treat. I would bet that this explains why many doctors treating chronic pain so readily put people on elavil-- in hopes that it may prevent them from getting the endogenous (permanent) depression. A very worthwhile precaution. But in treatment of psychiatric problems (yes, admit to yourself you have one if you suffer from depression) one-size treatment definitely doesn't fit all, and maybe you need a specialist in that department on your side. Exploring the many meds that could help you is very pain-staking & tedious for the patient as well as the doctor. so unless your depression is managed as well as it can be, get a psychiatrist you can work with too. If you don't give the depression the attention it deserves, I will bet in the long run depression will sabotage almost any effective management of your chronic pain. It has done this for me, and I'm so smart I make myself sick. (is there a specialist to treat that problem?) Ken At 11:03 AM 8/27/98 -0400, you wrote: > > >Hi Ray, > >I tried Serzone last Winter/early Spring and although it didn't help me with >pain it DID help with an overall feeling of not being so down. My Mom >passed away on Jan. 2 and then in January I had my SSDI review come up, more >problems with my neck, MRI, EMG, and visits with a new neurologist, plus >anemia coming back with a vengence. Needless to say I was really getting >overwhelmed and my bag of tools for dealing with stress and depression was >being taxed sorely....so my Dr. suggested the Serzone. Started with a tiny >dose and worked our way up SLOWLY. I stopped taking it because it was >driving me nuts with a cycle like this: I'd take a dose, about an hour and >a half later I'd get the jitters....then that would subside in about two >hours and then two hours later I'd come CRASHING down.... then time for >another dose and the cycle would start again. My Dr. seemed to think this >was a rather odd experience but I chose to stop the medicine, with her >guidance, because of it. It sure sounds like this medicine is working well >for you and I'm wondering if you have any sort of side effect like this??? >I know that Serzone is supposed to be just about side-effect free...not like >the SSRI drugs (Serzone isn't exactly a SSRI)..and that's why the Dr. wanted >me to try it instead of anything else. I did get some dry mouth but that's >not a big deal for me, it wasn't TOO bad. Your report of how it's helping >you makes me wonder if perhaps my up and down cycle was more from the anemia >I was dealing with than the Serzone! > >CULater, >Ruthie >=========================== >Ruthie Cunliffe K2ZQ >ruthie@... >http://www.cunliffegroup.com/ruthie/ >experimental web cam: http://www.cunliffegroup.com/ruthie/spy/ > ** A BALANCED DIET IS A COOKIE IN EACH HAND ** > > >> >> >>Brain Fog this morning. I can't remember if I responded to this >>question or if I thought I should. I used to be on Elavil with too >>many side effects including the weight gain. I've switched to Serzone >>and no longer have the craving for food, nor most of the other side >>effects. I'm actually losing weight again. Ask your doctor about >>switching to Serzone or another antidepressant with pain management >>effects but without the craving for food side effect. >>Ray > > > > >------------------------------------------------------------------------ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 1999 Report Share Posted August 27, 1999 Hi Ruthie, I tend to favor the tricyclics, particularly Sinaquan. They (and it) are old stand-bys that have a history of effective association with treatment of physical illnesses. Sinaquan also helps with sleep when taken before bedtime, may cause some drying (but in my experience nowhere near what elavil does), does not seem sedating during the day as elavil is for me, and leaves me feeling relatively myself. Elavil gives me a feeling of being slightly removed from reality (fog) that is characteristic of major tranquilizers like Stellazine. Ken At 05:00 PM 8/27/98 -0400, you wrote: > > > >> If you don't give the depression the attention it deserves, I will bet in >>the long run depression will sabotage almost any effective management of >>your chronic pain. It has done this for me, and I'm so smart I make myself >>sick. (is there a specialist to treat that problem?) > > >Hi Ken, > >Thanks for your post. Lots of good food for thought. My doctor has >discussed this very thing with me over the years and made me aware of many >of the same things you said. Your post only helps me to understand the >whole ball of wax even better. > >I'm curious.... I'm inferring from your post (I'm new here, remember?) that >you have chronic pain are also using an anti depressant. What has worked >best for you? I had such a negative experience with the SSRIs that I won't >go near them. We, Dr. and I, really thought it would help with the pain >management but I ended up feeling like a dishrag in pain... I watched the >darn OJ Simpson trial for heaven's sake! No interest in anything really, >especially no interest OR ability for intimacy, but none of that 'got me >down', I just didn't care one way or the other anymore...no downs but no ups >either. Pain level remained the same, I just didn't care. :-) Got off of >the stuff, felt better overall, worked with a counselor on more stress >management and then got into working on the acceptance issue I talked about >in an earlier message. I was a bit leery of the Serzone but when, at my >Dr.'s suggestion, I looked into the stuff and saw that it wasn't the same as >the SSRIs, I gave it a go. The up/down cycle drove me nuts and that's why I >stopped it. However, my Dr. would like me to give it a go again, especially >since my pain level is overall higher than it's been since I messed up my >back. I'm hovering on the brink of stopping the 5-HTP and giving the >Serzone a go again. Hearing what others are trying, going through, what's >worked for them, has helped me A LOT. I'm glad I found this list. > >CULater, >Ruthie >=========================== >Ruthie Cunliffe K2ZQ >ruthie@... >http://www.cunliffegroup.com/ruthie/ >experimental web cam: http://www.cunliffegroup.com/ruthie/spy/ > ** A BALANCED DIET IS A COOKIE IN EACH HAND ** > > > >------------------------------------------------------------------------ > Quote Link to comment Share on other sites More sharing options...
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