Posted by Fgetmenot on February 1, 2010, at 21:53:22
Hello and thank you for having this site available. I am a chronic pain patient with both orthopedic and fibromyalgic pain components that include migraines about 3 to 4 x times a week on average. I have a question about using together Savella, Wellbutrin and Nortriptyline.
For several years I had been on a "cocktail" of various SNRI, DNRI, and NaSSAs. During that period of time I was stablized on Effexor SR 450mg daily, Wellbutrin SR 150 twice daily, Buspar 15mg bid, and Remeron at bedtime. All seemed to help with pain and my migraines were okaynot good but not as frequent as they are now. Sometime during this period, I also took Nortriptyline 10mg but I can't remember if I was on ALL of the other meds listed above or just a couple of them. That was about 8 years ago. Then I decided to taper off of everything and take only Wellbutrin SR 150mg twice daily which I did for about 6 years. Last February I decided to d/c the Wellbutrin (more complicated reasons but to keep it short) My pain however got to be progressively incapacitating over a period of 7 months. I took and continue to take Percodan 5/325mg no more than 1/4 tablet at a time and no more than about 3/4 total during a day or I get rebound migraines I also can't take NSAIDS because it gives me severe mouth ulcers.
My doctor started me on Savella last October and I've had a positive effect with it. Initial side-effects were challenging (included weight loss and full body rash) but the second day I noticed a positive change. I'm determined to make this work. My pain had been around a 9- 10 and by the end of 6 weeks it had stabilized between a 4-5 with some blips here and there.
Yet I feel like I'm not quite there with pain relief. AND I don't feel as "full" or vibrant as I did while taking Wellbutrin. Probably because of the dopamine component. Additionally my headaches (since my pain has lessened) seem more painful or more frequent. I know that I'm sensitive to certain foods and in the course of looking at those foods discovered that I'm naturally attracted to foods high in Tyramine. It was a major part of my diet. I'm trying to eliminate Tyramine foods but I feel like I'm starving all the time.
I wanted to increase the effect of the Savella and yet have some of the "fullness" I felt while on Wellbutrin and I know that Nortriptyline is effective at blocking tyramine.
Individually I tolerate all of the following three meds at the dosages stated well. However , can Savella 50mg twice daily, Wellbutrin SR 150mg twice daily and Nortriptyline 10mg at bedtime be all on board at the same time? I'm concerned that I might overload with the norepinephrine reuptake inhibitors. My husband thinks that if we titrate with Wellbutrin first and then the Nortriptyline second and make sure that I'm taking Tyrosine that I should be okay. To be clear, I got RX's from my doctor today after I told him what I wanted to do but then I started questioning my judgment. Does anyone have research or experience with these three meds together? I'd appreciate any input. Fget
poster:Fgetmenot
thread:935677
URL: http://www.dr-bob.org/babble/20100122/msgs/935677.html