Posted by Jay_Bravest_Face on November 17, 2007, at 19:14:51
In reply to Degenerative Disc Disease and Psychiatric Meds, posted by Philip Burke on November 17, 2007, at 16:39:33
> I would appreciate input regarding different drug regimes for the treatment of Degenerative Disc Disease, "Failed Back Surgery Syndrome", radiculopathy and various neuropathies associated with this illness. I have been suffering from lower back and leg pain for over 10 years. I've had discectomies X 2 @ L4-5, 1998 & 2000. I had a spinal cord stimulator implanted in 2002, but the efficacy of this device is greatly compromised by "postural problems", rendering it practically useless to me unless I am lying supine, motionless on my bed. I am trying to achieve the best balance of antidepressants, painkillers, anti-seizure medications and any other medication that is effective, for pain relief and mood improvement. I currently see a Pain Management specialist and a psychiatrist to treat chronic pain and depressed mood. I've tried several different antidepressants, and have, at this point in time, settled on a combination of two - Remeron, 30 mgs at bedtime, and Zoloft, 100 mgs in the morning. I also take 100 mgs of Lyrica three times a day and one tablet of Vicoprofen as needed up to 3 times a day. I cannot tolerate Cymbalta. Practically every doctor I have been to recommends this drug, but I have tried twice (over 6 weeks of 60 mgs) and found that although it helps with pain, I could not stand feeling like a brain dead zombie. I keep trying to find the best combination of medications, without the use of narcotics or opiates, to get the relief I need. Any input, suggestions, comments, etc. will be greatly appreciated
>
>Hi...
I am really sorry you have had to live with so much pain. (physical and mental) Myself, although I've never experienced the horrible painful situation you are in, have lived with a chronic, scarred deep sinus cavity infection that flares up out of the blue, (it puts pressure on the bone) for the past 10 years. I tried surgery without sucess. Pain management really became the focus once I realized how this pain was affecting my mental health. I have some good doctors who have helped me.
You say you do not want to turn to narcotics. I understand, greatly, your concern. I recall going to a support group for people with pain management issues, and I saw a few things that scared me a bit. But, afterwards, I immediately went to my doctor, with a list of about 40 questions. I did not want to feel 'doped up', because I always knew that with those 'good' feelings comes the 'crash'. But, interestingly enough, it wasn't until he prescribed Oxycodone to take PRN, giving me only 7 doses in 14 days, that I finally felt better with my pain threshold...but..most importantly, I snapped out of my depressions easier. I didn't use the Oxycodone FOR my depression, but it was this relief that, if the really bad, big HURT came (a flare up), I had help. And honestly, I use on average 2 Oxycodone a week, sometimes even less. The reason my doc picked Oxycodone is because it got the job done fast, and it didn't leave me feeling 'high', like say if I took Tylenol#3, 4x a day, everyday. I take a few different NSAID's more regularly, to prevent inflammation from the start, and this has worked well. Oh, I also forgot to mention, apparently in pain management, benzodiazepines are contraindicated, but again using them in extreme moderation, they seem to calm the Central Nervous System. I do not take them everyday, and every night, and that is the key, I believe. It keeps me, I think, from getting the "brain fog" that some get from chronic use of both benzos and narcotics.
For your antidepressant choice, I am not really sure what to say. I was on Effexor as it supposedly had pain-reducing properties, but the stuff drove me nuts! I've been on Prozac for 5 years, and am looking at tapering down, either switching or coming off. I briefly tried Remeron, but it didn't cut it for me. A friend of mine takes Remeron as part of his pain management for back problems. Maybe that is an option to think about. Neurontin did nothing for me.
So, I hope that maybe gives you a different perspective on your options. Please take good care...and any questions please let me know. Thanks...Jay.
poster:Jay_Bravest_Face
thread:795592
URL: http://www.dr-bob.org/babble/20071115/msgs/795620.html