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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by JohnX2 on January 4, 2002, at 19:48:41
For those familiar with my case, I recently
resolved my chronic myofacial pain syndrome which
greatly opens the door to many medicine choices.
For those not, I am bpii with comorbid chronic
myofacial pain.I've tested many things that would trigger this bizarre
obscence pain in my jaw/head, and the recent Topamax has
them all licked hands down:- Wellbutrin
- Flaxseed oil
- Fish oil
- 5-htp
- DMAE
- Zoloft? (havent tested)Prior to this even without taking something that
triggered severe myofacial pain, I would have at least
a mild chronic pain. Klonopin was the only thing that
helped and the neurologist were clueless until we
hit the Topamax majic bullet.So now I take:
- Lamictal 150 mg
- Topamax 400 mg
- Zyprexa 5 mg
- Klonopin ~5 mgI still feel anxious and have compulsive type behaviour
and am wondering if giving Zoloft a 2nd try would not
be a bad idea before tapering the Klonopin. My mood is
not horrible. But I do feel persistant anxiety and
I am extremely restless and wouldn't claim to feel
anywhere near euthymic.I have tried Zoloft twice. The 1st trial was standalone.
That was a disaster. The drug me me instantly numb and
caused myofacial pain. It then triggered hypomania and
pooped out. The 2nd time was only for 1 week, but I
was on Klonopin, and the Zoloft did not make me emotionally
numb and after one week I actually felt pretty good.
(Clearly the klonopin was acting as a bipolar mood
stabilizer and fixer for the myofacial pain).So now that I have the topamax in the fray, I need to
dump klonopin. I've done this before with the help
of Neurontin. But I'm wondering if it might be a little
easier and if I might feel a bit less anxious if I
got onto Zoloft 1st. Any thoughts? I think I would
respond to Zoloft in 1.5 weeks based on my experience.The 2nd choice is focus on dumping the klonopin and
then seeing how I feel and seeing if I want to add
in an AD. I'm predicting the Klonopin tapering will
take upto 2 months based on my last try.thnx,
John
Posted by JohnX2 on January 4, 2002, at 19:58:00
In reply to To Zoloft or Not To Zoloft, That is the Question?, posted by JohnX2 on January 4, 2002, at 19:48:41
I wanted to add that I get an appreciably strong
response from taking 5-htp,flax oil, and fish oil.
Very anxyiolytic and weird dreams.
If the pdoc won't give me aids like Neurontin
to help with the Klonopin withdrawal then I
go for the OTC shit 'cuz I don't like the pain.
Curiously when I have tried 5-htp it generally
releaves my anxiety substantially but makes me
depressed, but this go around I actually feel
a bit better....which is why I am wondering about
the SSRI addition....Anyways I don't recommend mixing these OTC
stuff with meds, although flax oil and fish oil
are ok.-john
>
> For those familiar with my case, I recently
> resolved my chronic myofacial pain syndrome which
> greatly opens the door to many medicine choices.
> For those not, I am bpii with comorbid chronic
> myofacial pain.
>
> I've tested many things that would trigger this bizarre
> obscence pain in my jaw/head, and the recent Topamax has
> them all licked hands down:
>
> - Wellbutrin
> - Flaxseed oil
> - Fish oil
> - 5-htp
> - DMAE
> - Zoloft? (havent tested)
>
> Prior to this even without taking something that
> triggered severe myofacial pain, I would have at least
> a mild chronic pain. Klonopin was the only thing that
> helped and the neurologist were clueless until we
> hit the Topamax majic bullet.
>
> So now I take:
>
> - Lamictal 150 mg
> - Topamax 400 mg
> - Zyprexa 5 mg
> - Klonopin ~5 mg
>
> I still feel anxious and have compulsive type behaviour
> and am wondering if giving Zoloft a 2nd try would not
> be a bad idea before tapering the Klonopin. My mood is
> not horrible. But I do feel persistant anxiety and
> I am extremely restless and wouldn't claim to feel
> anywhere near euthymic.
>
> I have tried Zoloft twice. The 1st trial was standalone.
> That was a disaster. The drug me me instantly numb and
> caused myofacial pain. It then triggered hypomania and
> pooped out. The 2nd time was only for 1 week, but I
> was on Klonopin, and the Zoloft did not make me emotionally
> numb and after one week I actually felt pretty good.
> (Clearly the klonopin was acting as a bipolar mood
> stabilizer and fixer for the myofacial pain).
>
> So now that I have the topamax in the fray, I need to
> dump klonopin. I've done this before with the help
> of Neurontin. But I'm wondering if it might be a little
> easier and if I might feel a bit less anxious if I
> got onto Zoloft 1st. Any thoughts? I think I would
> respond to Zoloft in 1.5 weeks based on my experience.
>
> The 2nd choice is focus on dumping the klonopin and
> then seeing how I feel and seeing if I want to add
> in an AD. I'm predicting the Klonopin tapering will
> take upto 2 months based on my last try.
>
> thnx,
> John
Posted by Mitch on January 4, 2002, at 23:44:57
In reply to Re: To Zoloft or Not To Zoloft, That is the Question?, posted by JohnX2 on January 4, 2002, at 19:58:00
>
>
> I wanted to add that I get an appreciably strong
> response from taking 5-htp,flax oil, and fish oil.
> Very anxyiolytic and weird dreams.
> If the pdoc won't give me aids like Neurontin
> to help with the Klonopin withdrawal then I
> go for the OTC shit 'cuz I don't like the pain.
> Curiously when I have tried 5-htp it generally
> releaves my anxiety substantially but makes me
> depressed, but this go around I actually feel
> a bit better....which is why I am wondering about
> the SSRI addition....
>
> Anyways I don't recommend mixing these OTC
> stuff with meds, although flax oil and fish oil
> are ok.
>
> -john
John, I think it is a good idea generally. I just wonder if Zoloft would be the best SSRI given your myofacial pain. I got jaw-grinding/teeth clenching on it more than the others, it also seemed to aggravate arthralgia in my ankle from an old car-wreck injury and aggravated tremor when taking Depakote more than others did.
Posted by jimmygold70 on January 5, 2002, at 2:59:46
In reply to To Zoloft or Not To Zoloft, That is the Question?, posted by JohnX2 on January 4, 2002, at 19:48:41
Well, the best known combination for severe OCD is Zoloft (or any other SSRI in high doses/Anafranil) combined with Risperdal or Zyprexa. Well, try to give Zoloft a chance of 200mg/day for a couple of months, along with the Zyprexa.
Why do you want to get of Klonopin ? I don't think the anxiety would improve if you do that. Anyway, if you still wish, do it VERY SLOWLY over 3-4 months. You can buy Rivotril which is like Klonopin but comes in liquid, so you can taper off the doses in greater comfort.
Jimmy
Posted by ben on January 5, 2002, at 10:27:41
In reply to Re: To Zoloft or Not To Zoloft, That is the Question? » JohnX2, posted by jimmygold70 on January 5, 2002, at 2:59:46
Why do you choose an SSRI for myofascial pain syndrom ? Tricyclics like (esp. amitryptiline, trimipramine, clomipramine and doxepin) are often helpfull in low dose (max. 75 mg). SSRI seems not to modulate pain so much (paroxetine eventually at most). Did you tried Efexor or Wellbutrin ? Theoretically Zoloft could be a try worth because it is involving dopamine at most of the SSRIs. I tried Paxil (with good effect on depression) but it def. triggered bruxism, restless legs, myoclonias .
> Well, the best known combination for severe OCD is Zoloft (or any other SSRI in high doses/Anafranil) combined with Risperdal or Zyprexa. Well, try to give Zoloft a chance of 200mg/day for a couple of months, along with the Zyprexa.
>
> Why do you want to get of Klonopin ? I don't think the anxiety would improve if you do that. Anyway, if you still wish, do it VERY SLOWLY over 3-4 months. You can buy Rivotril which is like Klonopin but comes in liquid, so you can taper off the doses in greater comfort.
>
> Jimmy
Posted by CalvaryHill on January 6, 2002, at 1:00:05
In reply to To Zoloft or Not To Zoloft, That is the Question?, posted by JohnX2 on January 4, 2002, at 19:48:41
I have myofacial pain too and have been effectively relieved by the tricyclic nortriptyline. Before nortriptyline I could never find an analgesic that helped for more than an hour.
Low-dose Amitriptyline is a common treatment for lower back pain.
Posted by JohnX2 on January 8, 2002, at 21:44:03
In reply to To Zoloft or Not To Zoloft, That is the Question?, posted by JohnX2 on January 4, 2002, at 19:48:41
Thanks for your feedback.
After tapering Klonopin from 6 mg to 4 mg
I found out a few things.- The primary withdrawl symptom is hypomania
- my Tell Tale Heartbeat went away when I withdrew
my token 100 mg Wellbutrin dose the pdoc bitched
about
- I have a bit of neuropathic tingling
- The last time I tapered Klonopin, Neurontin
cured the Neuropathic tingling and curbed the
restlessness ( need to discuss this with pdoc ).Summary:
I was never taking Klonopin for anxiety, only
to treat myofacial pain. The Topamax has fully
relieved the myofacial pain. Both Wellbutrin and
Zoloft were effective antidepressants with good
side effect profiles, but both triggered
myofacial pain. Zoloft was worse for myofacial
pain , but triggered
less mania and seemed better for OCD behavior
and reslessness. My guess is the Zyprexa and Topamax
will prevent any Zoloft induces myofacial pain.
I was thinking that Zyprexa and Zoloft should
work synergystically.
But I think I will wait until i am off klonopin
because of the klonopin withdrawal hypomania.
I prefer to get off klonopin fast as possible
and I already know I can do it 1 mg per week
based off past experience (and this experience).
I am taking time off work to do this.Best regards,
John>
> For those familiar with my case, I recently
> resolved my chronic myofacial pain syndrome which
> greatly opens the door to many medicine choices.
> For those not, I am bpii with comorbid chronic
> myofacial pain.
>
> I've tested many things that would trigger this bizarre
> obscence pain in my jaw/head, and the recent Topamax has
> them all licked hands down:
>
> - Wellbutrin
> - Flaxseed oil
> - Fish oil
> - 5-htp
> - DMAE
> - Zoloft? (havent tested)
>
> Prior to this even without taking something that
> triggered severe myofacial pain, I would have at least
> a mild chronic pain. Klonopin was the only thing that
> helped and the neurologist were clueless until we
> hit the Topamax majic bullet.
>
> So now I take:
>
> - Lamictal 150 mg
> - Topamax 400 mg
> - Zyprexa 5 mg
> - Klonopin ~5 mg
>
> I still feel anxious and have compulsive type behaviour
> and am wondering if giving Zoloft a 2nd try would not
> be a bad idea before tapering the Klonopin. My mood is
> not horrible. But I do feel persistant anxiety and
> I am extremely restless and wouldn't claim to feel
> anywhere near euthymic.
>
> I have tried Zoloft twice. The 1st trial was standalone.
> That was a disaster. The drug me me instantly numb and
> caused myofacial pain. It then triggered hypomania and
> pooped out. The 2nd time was only for 1 week, but I
> was on Klonopin, and the Zoloft did not make me emotionally
> numb and after one week I actually felt pretty good.
> (Clearly the klonopin was acting as a bipolar mood
> stabilizer and fixer for the myofacial pain).
>
> So now that I have the topamax in the fray, I need to
> dump klonopin. I've done this before with the help
> of Neurontin. But I'm wondering if it might be a little
> easier and if I might feel a bit less anxious if I
> got onto Zoloft 1st. Any thoughts? I think I would
> respond to Zoloft in 1.5 weeks based on my experience.
>
> The 2nd choice is focus on dumping the klonopin and
> then seeing how I feel and seeing if I want to add
> in an AD. I'm predicting the Klonopin tapering will
> take upto 2 months based on my last try.
>
> thnx,
> John
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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