Posted by Cairo on October 8, 2005, at 23:53:40
In reply to Painful stiff neck from Celexa, any advice?, posted by 4wd on October 5, 2005, at 23:13:16
I cannot tolerate SSRIs either, due to stiff neck as well as distubed sleep and muscle tremor, especially the jaw muscles. I think raising serotonin is not necessarily the answer for me. I have been diagnosed with Fibromyalgia and Myofascial pain syndrome and have not had any success loosening up the knots with any muscle relaxant (I tried them all), SSRIs, imipramine, amitriptyline, Klonopin, Effexor, Wellbutrin or Topamax. Neurontin caused some relaxation of the muscles, but "pooped out" and higher doses caused too much weight gain and cognitive side effects. I could only tolerate 5mg of Cymbalta which gave me LOTS of energy, but worsened the mucle tightness. I am currently on nortriptyline 20mg which does help with pain somewhat. I, too, have a bit of bulging disc, but I personally think this is due to constant tight muscles, adding to the problem, but not initially causing the problem. Tried a course of steroid injections and trigger point injections which I think made matters worse. Botox injections did not help and, in fact, also made things worse by reciprocal tightening of muscles on the opposite side of the injections.
I'm about to try Inderal in addition to the nortriptyline to see if that might help, but it is being prescribed for residual, physical symptoms of anxiety/panic caused by a trial of Topamax. It will be interesting to see if that helps. Buspar was mentioned, but I really don't want anything with an SSRI component because I've gone through such hell trying them (Celexa, Lexapro, Prozac). Only Topamax side effects were worse.
I will also want to give Lyrica (pregabalin) a try since Neurontin helped with anxiety and gave some muscle relaxation, but I wonder if "poop out" might occur with that it also. My pdoc doesn't want to prescribe it yet as he doesn't know much about it and Pfizer seems a little gun shy about promoting it for anything except neuropathic pain since some big lawsuits with Neurontin for off label use. Mestinon interests me also.
I've done neurofeedback, acupuncture, regularly stretch and exercise, practice progressive relaxation, CBT, use a CPAP for sleep apnea, regularly use a home neck traction device, use moist heat and rest, take thyroid medication, and go to a wonderful physical therapist who uses a combination of manual therapy, Paris techniques, myofascial release that work, but only for a little while. A couple of hours and I'm as tight as a violin string again.
A careful regimen of walking and strength building exercises help the stiffness and pain, but often I pay the price by more muscle knots, so I know what you're going through.
Muscle relaxants may work for you, but I've never been able to raise doses to levels where they might work because I get way too zombified to function during the day.
You've got to be patient and try everything to see what works for you. You also need to rule out Lyme's disease, Lupus, Rheumatoid arthritis, thyroid disease, CP, and other things that may be responsible for your symptoms.
Good luck.
Cairo
> I've had this with every SSRI I've ever been on. The muscles in my neck and shoulders just stay clenched. There are also knots of muscle spasms in my upper back along the shoulder blades. Except for this problem, Celexa would be an okay drug for me but the pain is just not acceptable.
>
> I didn't have this problem on Effexor (but Effexor quit working). So I know it's the SSRIs- I've switched back and forth many times and the pain comes and goes as I switch from SSRI to non-SSRI.
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> Is there any solution?
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> Marsha
poster:Cairo
thread:563558
URL: http://www.dr-bob.org/babble/20051003/msgs/564772.html