Posted by jasmineneroli on October 4, 2009, at 14:15:00
In reply to Antidepressants for chronic pain, posted by Cecilia on October 4, 2009, at 4:48:30
Cecilia:
You have 2 diff. types of pain, with Arthritis & peripheral neuropathy - they have different mechanisms/pathways. You may have to try polypharmacy for those kinds of pain :(I take Celebrex for arthritis pain. It does help to some degree. Have you tried that???
Also, dosages of AD's for pain can be different for depression relief. It takes longer to achieve depression relief from AD's than pain relief.
Another complicating factor is drug metabolism. Many drugs are metabolized by varying CYP 450 liver enzymes. Some people are slow or fast metabolizers of different drugs, depending on the iso-enzyme required to metabolize a given drug. AAAAAAGGGHHH!!!
I've found an excerpt from a book "Bonica's management of pain" at Google Books: http://books.google.com/books?id=TyNEicOiJqQC&pg=PA1714&lpg=PA1714&dq=norepinephrine+mechanism+pain+relief&source=bl&ots=wY4tCLaJ7Z&sig=zruHITyUgEJb6LODRH6GBg3ovMY&hl=en&ei=gOvISpKmK4entgf-8sUl&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=norepinephrine%20mechanism%20pain%20relief&f=false
It is a little complicated, but it talks about ratio of NE to 5HT, NE blockade & 5HT re-uptake, NMDA & Sodium Channel blockers all as affecting pain. Diff types of pain etc.
Hope it helps.
J
poster:jasmineneroli
thread:919638
URL: http://www.dr-bob.org/babble/20091001/msgs/919680.html