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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by HoosierDaddyTim on October 26, 2003, at 20:02:16
Hi folks.. I have Fibro or CFS I've been told and have been ill about 3 years.. I take Paxil 20mg twice daily which helps with the fog and spacey feelings, and helps a tad with the pain, but I also take pain meds from a killer pain doc.. who really cares.. I was in suicidal pain. It was terrible.. Before getting ill I had only taken stomach meds from my regular doc.. then I suddenly get struck down with this awful illness.. Anyway, I am curious about the harmful effects of SSRI'S? I can't seem to get off the paxil.. To me it's harder to quit than the pain meds by far..
Posted by Elle2021 on October 27, 2003, at 3:07:10
In reply to Have Fibro, can SSRI's hurt me over long period? , posted by HoosierDaddyTim on October 26, 2003, at 20:02:16
Hi,
My mother also suffers from Fibromyalgia and CFS. How do you deal with it day to day? What type of meds do you find helpful for treating it. My mom has had it for quite some time and usually can only get out of bed and go out once a week, if even that. Any advice you can give me to give her would be much appreciated.
Elle> Hi folks.. I have Fibro or CFS I've been told and have been ill about 3 years.. I take Paxil 20mg twice daily which helps with the fog and spacey feelings, and helps a tad with the pain, but I also take pain meds from a killer pain doc.. who really cares.. I was in suicidal pain. It was terrible.. Before getting ill I had only taken stomach meds from my regular doc.. then I suddenly get struck down with this awful illness.. Anyway, I am curious about the harmful effects of SSRI'S? I can't seem to get off the paxil.. To me it's harder to quit than the pain meds by far..
Posted by Bill LL on October 27, 2003, at 9:18:11
In reply to Have Fibro, can SSRI's hurt me over long period? , posted by HoosierDaddyTim on October 26, 2003, at 20:02:16
The SSRI's have been used a lot since 1989. There is no evidence of any harm resulting from long term use. On the contrary, brain scans indicate that long term SSRI use make brains of depressed people look more normal.
If an SSRI is working for you, there is no reason to want to discontinue it.
Posted by HoosierDaddyTim on October 30, 2003, at 12:54:15
In reply to Re: Have Fibro, can SSRI's hurt me over long period? , posted by Bill LL on October 27, 2003, at 9:18:11
Thank you so much.. The reason I asked is that I saw somewhere awhile back that there was a huge law suit against the company that manufacturs Paxil I thought because of with drawel. I can tell you that it's harder to get off of the paxil for me than it is the pain meds.. and I take loads of the same, but of course, pain meds are much easier on the body.. Not NSAIDS, but true opiads that is..
Thanks again..
Tim
> The SSRI's have been used a lot since 1989. There is no evidence of any harm resulting from long term use. On the contrary, brain scans indicate that long term SSRI use make brains of depressed people look more normal.
>
> If an SSRI is working for you, there is no reason to want to discontinue it.
Posted by HoosierDaddyTim on October 30, 2003, at 12:59:49
In reply to Re: Have Fibro, can SSRI's hurt me over long period? » HoosierDaddyTim, posted by Elle2021 on October 27, 2003, at 3:07:10
Hi Elle,
Boy, those are tough questions. For me it was just something that hit me all at once. I had to go to something like 8 docs before I got DX'd.. The pain can be killer, and your mother needs to be treated for it to be able to move probably.. also the SSRI's help for some folks like me.. I'm a guy though and from my experience at least, guys seem to suffer differently as we don't have things like Periods, etc.. to worry about, but it's still very hard.. The paxil helps me with the fog a lot.. and some with the pain, although that's the big thing to over come.. for me or most.. Also, I would highly recommend that she look into Canadida.. Have her join a local Fibro support group.. They can help.. and most are women.. It's a terrible disease, and even worse because of the war on drugs seems to be a war on patients now days because of the fear assoicated with pain killers.. It's interesting to me that more folks die each year of NSAIDS than do Oxy Contin, yet it's considered the evil of all evils.. We need to stand up to this garbage..
Well, I'll get off my stump, but I hope she gets the help she needs.. Above all have her take control of the docs.. They can be inflicted with the "God Complex" I call it.. Thank god I'm not a woman and not over weight as I think that made them take me serious and not just think I was depressed.. I told my old doc that sometimes when you have only a hammer, everything starts looking like a nail!Good luck.. I mean that..
Tim
> Hi,
> My mother also suffers from Fibromyalgia and CFS. How do you deal with it day to day? What type of meds do you find helpful for treating it. My mom has had it for quite some time and usually can only get out of bed and go out once a week, if even that. Any advice you can give me to give her would be much appreciated.
> Elle
>
> > Hi folks.. I have Fibro or CFS I've been told and have been ill about 3 years.. I take Paxil 20mg twice daily which helps with the fog and spacey feelings, and helps a tad with the pain, but I also take pain meds from a killer pain doc.. who really cares.. I was in suicidal pain. It was terrible.. Before getting ill I had only taken stomach meds from my regular doc.. then I suddenly get struck down with this awful illness.. Anyway, I am curious about the harmful effects of SSRI'S? I can't seem to get off the paxil.. To me it's harder to quit than the pain meds by far..
>
>
Posted by Elle2021 on October 30, 2003, at 19:34:10
In reply to Re: Have Fibro, can SSRI's hurt me over long period?, posted by HoosierDaddyTim on October 30, 2003, at 12:59:49
Tim,
Thanks so much for your response and advice. I will let my mom know the info! Thanks again and good luck to you too. Bless you.
Elle
Posted by HoosierDaddyTim on October 30, 2003, at 21:00:41
In reply to Re: Have Fibro, can SSRI's hurt me over long period? » HoosierDaddyTim, posted by Elle2021 on October 30, 2003, at 19:34:10
Elle,
You are quite welcome. I hoped it helped. I'm in terrible pain or I'd add more, but it's off to lay down and not move..
Tim
> Tim,
> Thanks so much for your response and advice. I will let my mom know the info! Thanks again and good luck to you too. Bless you.
> Elle
Posted by Ame Sans Vie on October 31, 2003, at 8:12:38
In reply to Have Fibro, can SSRI's hurt me over long period? , posted by HoosierDaddyTim on October 26, 2003, at 20:02:16
I was taking Ultram (an opioid with SNRI properties) for depression and OCD for about five or six months, until just a week ago. I also have debilitating fibromyalgia, and although Ultram is, first and foremost, an analgesic, it ended up doing more physical harm than good. It drastically worsened my fibromyalgia pain, and I'm sure this is due either to the serotonin or norepinephrine reuptake inhibition, since other mu-opioid agonists don't exert this effect on me. Nevertheless, I quit Ultram and switched to Prozac (the only med of about 50 I've tried that was never given a fair trial) and it's most certainly helping my sleep, decreasing my appetite, ridding me of my depression, and even rid me of *all* the fibro pain. Certainly a weird thing, considering my Ultram response, but I guess I'm just saying be careful -- you never know how meds are going to affect you as an individual. It took months for the pain to build up while I was taking Ultram, so at first I didn't associate it with the drug -- just watch out for signs like this should you try an SSRI.
Michael
Posted by Ame Sans Vie on October 31, 2003, at 8:32:28
In reply to Re: Have Fibro, can SSRI's hurt me over long period? » HoosierDaddyTim, posted by Elle2021 on October 27, 2003, at 3:07:10
There is a pretty vast array of drugs used to treat the condition, widespread in the way they affect the body. Often, the first things tried are antidepressants, especially amitriptyline, which may relieve pain. Flexeril, a muscle relaxer very closely related to amitriptyline, can also be very helpful. Another muscle relaxer, Soma, works especially well on an as-needed basis, when the pain is too bad to bear; taking it regularly will cause tolerance to build. Other drugs of this type (i.e. Robaxin, Parafon, Skelaxin, Zanaflex) often aren't of much help.
Benzodiazepines (especially those with strong muscle relaxation qualities, like Valium) can be a very good adjunct to other medication. If CFS is also present with the fibromyalgia (which it quite often is), a bit of a CNS stimulant should help.
If your mom takes OTC pain meds for her fibro, I'd suggest she take acetaminophen -- there is no inflammation involved with fibromyalgia, so she doesn't need the anti-inflammatory actions of aspirin, ibuprofen, naproxen, et al.
The opioids are definitely warranted, in my opinion, at the very least during the beginning of therapy, while trying other drugs to find what works for you. A lot of people report that Percocet, Vicodin/Lorcet/Norco/Zydone, and Ultram are the best ones for fibro pain, though some require stronger meds such as OxyContin, Duragesic, or morphine.
This is definitely what *I* would do in her position -- Xyrem -- GHB (the "date rape drug") now available by prescription for $220/bottle (each bottle tends to last anywhere from 20-30 days). It's expensive, but it's most certainly worth it as it gets to the root of the fibro problem rather than just mask symptoms. It's a liquid taken before bed (*while in bed*, actually, because it begins to work almost immediately) that puts you right to sleep and allows for more restorative rest. Fibro patients tend not to go into stage 4 sleep very often, which is a quite possible cause for the disorder -- Xyrem corrects this. The first dose puts you to sleep for 3-4 hours, at which point you awaken with a dopamine rush; then you take your next dose which you should already have prepared and sitting next to your bed. All considering, six-eight hours of Xyrem sleep and the ensuing feelings of vitality and freedom from pain would be worth way more than 220 bucks a month, and once I'm financially a bit more stable, I'm going to begin treatment with it.
Michael
P.S. Look in your local health food store for supplement items marked as fibro support formulations -- they're also a great adjunct.
Posted by Ilene on November 2, 2003, at 21:19:36
In reply to Re: Fibro suggestions for mom » Elle2021, posted by Ame Sans Vie on October 31, 2003, at 8:32:28
> There is a pretty vast array of drugs used to treat the condition, widespread in the way they affect the body. Often, the first things tried are antidepressants, especially amitriptyline, which may relieve pain. Flexeril, a muscle relaxer very closely related to amitriptyline, can also be very helpful. Another muscle relaxer, Soma, works especially well on an as-needed basis, when the pain is too bad to bear; taking it regularly will cause tolerance to build. Other drugs of this type (i.e. Robaxin, Parafon, Skelaxin, Zanaflex) often aren't of much help.
>
> Benzodiazepines (especially those with strong muscle relaxation qualities, like Valium) can be a very good adjunct to other medication. If CFS is also present with the fibromyalgia (which it quite often is), a bit of a CNS stimulant should help.
>
> If your mom takes OTC pain meds for her fibro, I'd suggest she take acetaminophen -- there is no inflammation involved with fibromyalgia, so she doesn't need the anti-inflammatory actions of aspirin, ibuprofen, naproxen, et al.
>
> The opioids are definitely warranted, in my opinion, at the very least during the beginning of therapy, while trying other drugs to find what works for you. A lot of people report that Percocet, Vicodin/Lorcet/Norco/Zydone, and Ultram are the best ones for fibro pain, though some require stronger meds such as OxyContin, Duragesic, or morphine.
>
> This is definitely what *I* would do in her position -- Xyrem -- GHB (the "date rape drug") now available by prescription for $220/bottle (each bottle tends to last anywhere from 20-30 days). It's expensive, but it's most certainly worth it as it gets to the root of the fibro problem rather than just mask symptoms. It's a liquid taken before bed (*while in bed*, actually, because it begins to work almost immediately) that puts you right to sleep and allows for more restorative rest. Fibro patients tend not to go into stage 4 sleep very often, which is a quite possible cause for the disorder -- Xyrem corrects this. The first dose puts you to sleep for 3-4 hours, at which point you awaken with a dopamine rush; then you take your next dose which you should already have prepared and sitting next to your bed. All considering, six-eight hours of Xyrem sleep and the ensuing feelings of vitality and freedom from pain would be worth way more than 220 bucks a month, and once I'm financially a bit more stable, I'm going to begin treatment with it.
>
> Michael
>
> P.S. Look in your local health food store for supplement items marked as fibro support formulations -- they're also a great adjunct.
This is interesting to me because I am just pulling out of nearly 4 weeks of chronic fatigue syndrome with nearly constant pain. I don't have the tender points so I don't fit the definition for fibromyalgia. I was suicidal most of the time, but I couldn't let the kids find me dead....I used to keep the cfs under control by not getting hot, but now my anxiety is a lot worse and it triggers cfs symptoms. My doc & pdoc think it's because I weaned myself all my ADs & mood stabilizers. Mebbe.
Advil (ibuprofen) didn't do anything. Neither did Klonopin. I finally got some Ultracet over the weekend and took it a couple of times; it was helpful.
What you said about Xyrem is interesting! I already have a sleep disorder ("delayed sleep phase syndrome"). I have a hard time getting to sleep at a normal time and waking up at a normal time. My body wants to sleep later and later, and wake up later and later.
One night I did not sleep *at all*. I wasn't ruminating, or anxious, or anything. Just not sleeping. Most days I took at least one nap. It makes sense to me that "sleep architecture" could underlie the symptoms of fibro or cfs.
Thanks for the info.
Ilene
Posted by Elle2021 on November 3, 2003, at 1:58:31
In reply to Re: Fibro suggestions for mom » Elle2021, posted by Ame Sans Vie on October 31, 2003, at 8:32:28
I'm sorry to be so late in thanking you for all the info. Thats great! I'll share it with my mom. You have been a wonderful help to me. :)
Elle
Posted by HoosierDaddyTim on November 7, 2003, at 11:41:32
In reply to Re: Just a little warning... » HoosierDaddyTim, posted by Ame Sans Vie on October 31, 2003, at 8:12:38
Hi Michael,I'm glad to here your Fibro is gone for the most part.. I think you are in correct in that you say "Ultram" is an opiad.. I believe it's not really a true Opiad..It's a synthetic of some type, but it's not habit forming, etc.. and doesn't come from the Poppy flower, etc..etc.. It is a pain killer though, but so are NSAIDS for instance but they also are not opiads..
By the way, I tried Prosac and I became sick.. It made me stay dizzy.. I was on it for about 5 weeks when the doc finally said "Try something else".. I take methadone for the extreme pain in my legs and joints.. and it works to a point.. but I'll probably have my doc put me on Morphine as it worked better.. I still though would never get off my Paxil as it for sure helps with some of the pain, although just a tiny bit, and it for sure helps with my thinking as I have the Fibro Fog bad and this for sure is helped with Paxil.. as well as some energy is helped, although again, not much..
Tim
> I was taking Ultram (an opioid with SNRI properties) for depression and OCD for about five or six months, until just a week ago. I also have debilitating fibromyalgia, and although Ultram is, first and foremost, an analgesic, it ended up doing more physical harm than good. It drastically worsened my fibromyalgia pain, and I'm sure this is due either to the serotonin or norepinephrine reuptake inhibition, since other mu-opioid agonists don't exert this effect on me. Nevertheless, I quit Ultram and switched to Prozac (the only med of about 50 I've tried that was never given a fair trial) and it's most certainly helping my sleep, decreasing my appetite, ridding me of my depression, and even rid me of *all* the fibro pain. Certainly a weird thing, considering my Ultram response, but I guess I'm just saying be careful -- you never know how meds are going to affect you as an individual. It took months for the pain to build up while I was taking Ultram, so at first I didn't associate it with the drug -- just watch out for signs like this should you try an SSRI.
>
> Michael
Posted by Ame Sans Vie on November 7, 2003, at 12:06:26
In reply to Re: Just a little warning..., posted by HoosierDaddyTim on November 7, 2003, at 11:41:32
Hi Tim,
Ultram is actually an opioid, albeit a rather unusual one. There are only two opioid analgesics that come straight from the opium poppy, morphine and codeine, and semisynthetic opioids are generally manufactured from morphine, codeine, or thebaine. The fully synthetic opioids, which include Ultram, Darvon, methadone, and fentanyl, all have a very real action on the opioid receptors just as the others do. Ultram is often considered to be a rather weak opioid (it is about 1/6,000 as potent as morphine at the mu-opioid receptor), but one of its metabolites is about 20 times stronger than the parent drug itself. I don't believe that its opioidergic activity is as responsible for its effects as are its actions on serotonin and norepinephrine, but that mu-opioid activity is most certainly there, making Ultram an opioid. Ultram is most definitely habit-forming -- its non-scheduled status under the CSA is currently being reconsidered on federal and state levels. Many cases of dependence, addiction, and abuse have been reported, and I know I for one can attest to the fact that it's a very hard drug to kick. Without Prozac to replace it, quitting Ultram would have been something I most certainly would have had to have done on an inpatient basis.
I'm glad the Paxil works for you -- it was one of the first meds I ever tried and I found it to be a complete nightmare personally. Now that you mention it, I do recall feeling a bit less of the "brain fog" on Paxil than I usually do, but along with that came horrible apathy and completely sapped mental energy. Prozac seems to be ridding me of the fog just as well, without the side effects.
Posted by HoosierDaddyTim on November 7, 2003, at 19:30:05
In reply to Re: Just a little warning... » HoosierDaddyTim, posted by Ame Sans Vie on November 7, 2003, at 12:06:26
Thanks so much for the info.. I'm glad Prosac worked for you.. I've thought about trying another SSRI, but don't know which one to ask for.. and I like Paxil so well, that I'm afraid if I try another and it doesn't work, that I'll have terrible withdrawel from Paxil as I've heard that there was even a lawsuit because of the withdrawel being terrible with Paxil.. I'm feel like I'm in a quandry..
Tim
> Hi Tim,
>
> Ultram is actually an opioid, albeit a rather unusual one. There are only two opioid analgesics that come straight from the opium poppy, morphine and codeine, and semisynthetic opioids are generally manufactured from morphine, codeine, or thebaine. The fully synthetic opioids, which include Ultram, Darvon, methadone, and fentanyl, all have a very real action on the opioid receptors just as the others do. Ultram is often considered to be a rather weak opioid (it is about 1/6,000 as potent as morphine at the mu-opioid receptor), but one of its metabolites is about 20 times stronger than the parent drug itself. I don't believe that its opioidergic activity is as responsible for its effects as are its actions on serotonin and norepinephrine, but that mu-opioid activity is most certainly there, making Ultram an opioid. Ultram is most definitely habit-forming -- its non-scheduled status under the CSA is currently being reconsidered on federal and state levels. Many cases of dependence, addiction, and abuse have been reported, and I know I for one can attest to the fact that it's a very hard drug to kick. Without Prozac to replace it, quitting Ultram would have been something I most certainly would have had to have done on an inpatient basis.
>
> I'm glad the Paxil works for you -- it was one of the first meds I ever tried and I found it to be a complete nightmare personally. Now that you mention it, I do recall feeling a bit less of the "brain fog" on Paxil than I usually do, but along with that came horrible apathy and completely sapped mental energy. Prozac seems to be ridding me of the fog just as well, without the side effects.
Posted by Ame Sans Vie on November 7, 2003, at 20:27:24
In reply to Re: Just a little warning..., posted by HoosierDaddyTim on November 7, 2003, at 19:30:05
If the Paxil is working well for you, why do you want to try another SSRI? Side effects? Curiosity? If you're just curious about the effects of the other drugs or are hoping for greater symptom relief than Paxil is providing, then I wholeheartedly encourage you to try out the others. By switching to another SSRI, you avoid the Paxil withdrawal: withdrawal from Ultram felt exactly like Paxil or Luvox withdrawal to me, but *much* worse. Makes sense because of Ultram's serotonin reuptake inhibiting properties. I tried tapering down several times without any alleviation of the discontinuation symptoms; I threw caution to the wind and tried cold turkey once or twice but couldn't even make it through the first miserable 24 hours. That's why I brought up the Prozac idea to my psychiatrist -- I've read here and elsewhere that Prozac is commonly used to cheat withdrawal from SSRIs due to the ultra-long half-lives of it and its metabolites. It takes at least a week for a single dose of Prozac to completely rid itself from your body; by contrast, Paxil is in and out in under a day. Apparently this gives Prozac a rather smooth, gentle withdrawal for many people, and since it's performing similar functions in the brain to the other SSRIs it can often be substituted easily for the discontinuation period. Having gone through withdrawal from all the SSRIs, I can say with fair certainty that if an SSRI can stop the withdrawal from Ultram, it can do the same for any other SRI-type drug.
If you want to try one of the other options, I might be inclined to suggest Luvox, based solely on the fact that you like Paxil's effects, and I found Luvox to be indistinguishable in manner of effect but far stronger than Paxil. Apart from that, all I can really tell you based on my experiences is that Lexapro worked great for me even though Celexa didn't do a thing. The side effects ultimately caused me to discontinue it though. Zoloft slightly inhibits dopamine reuptake, if I recall correctly, which may be part of the reason that some people prefer it (though it threw me into a hyperagitated homocidal sort of mania when I tried it, and my aunt responded exactly the same way).
Have you tried Effexor? It's possible that it could be more effective at ridding you of some of your pain -- drugs that inhibit norepinephrine reuptake along with that of serotonin are often great for dulling chronic pain. A great example is the muscle relaxer Flexeril, which is really nothing more than a tricyclic antidepressant when you get down to it. It inhibits NE and 5-HT uptake and has strong anticholinergic and antihistamine activity, making it very similar to Elavil (which is used quite often in treating fibromyalgia).
On the other hand, if there are side effects from the Paxil that are causing you trouble, it's quite probable that you won't avoid them by switching to another SSRI (or Effexor, for that matter). Some side effects can be reversed by additional medication though -- sexual side effects and apathy may respond to some type of pro-dopaminergic drug (e.g. Wellbutrin, Buspar, amphetamines, Ritalin, Mirapex) or, in the case of sexual side effects, Periactin or bethanechol.
Posted by HoosierDaddyTim on November 8, 2003, at 20:34:29
In reply to Re: Just a little warning... » HoosierDaddyTim, posted by Ame Sans Vie on November 7, 2003, at 20:27:24
Wow, Lot's of things to consider I see..
> If the Paxil is working well for you, why do you want to try another SSRI? Side effects? Curiosity?
Yes, they make me Jittery at the 20 mg twice a day dose that I'm on now, but if I take less it doesn't seem to do anything for me.. When I first started on it, 20 mg was plenty..
If you're just curious about the effects of the other drugs or are hoping for greater symptom relief than Paxil is providing, then I wholeheartedly encourage you to try out the others.
Yes, I'd like to see if I can take less pain killers by trying another SSRI or one of the other Anti depressents.. but I worry more about the SSRI's etc hurting my liver, kidneys, etc.. as Opiods are very very safe and not harmful to the body except for some constipation maybe.. Of course one has to maintain dosage, etc, but that's easy with the right pain doc.. Of course many docs are scarred because of irrational fears of addiction, or because of prosecution, so one has to almost find a pain specialist.. I have pain that is almost suicidal at times.. even with the paxil..
By switching to another SSRI, you avoid the Paxil withdrawal: withdrawal from Ultram felt exactly like Paxil or Luvox withdrawal to me, but *much* worse. Makes sense because of Ultram's serotonin reuptake inhibiting properties. I tried tapering down several times without any alleviation of the discontinuation symptoms; I threw caution to the wind and tried cold turkey once or twice but couldn't even make it through the first miserable 24 hours. That's why I brought up the Prozac idea to my psychiatrist -- I've read here and elsewhere that Prozac is commonly used to cheat withdrawal from SSRIs due to the ultra-long half-lives of it and its metabolites. It takes at least a week for a single dose of Prozac to completely rid itself from your body; by contrast, Paxil is in and out in under a day. Apparently this gives Prozac a rather smooth, gentle withdrawal for many people, and since it's performing similar functions in the brain to the other SSRIs it can often be substituted easily for the discontinuation period.
Yes, it has a long half life I guess it's called ? Anyway, I tried Prosac and it didn't work for me, and just made me Dizzy.. Next they tried Buspar.. Same thing..
Having gone through withdrawal from all the SSRIs, I can say with fair certainty that if an SSRI can stop the withdrawal from Ultram, it can do the same for any other SRI-type drug.
>
> If you want to try one of the other options, I might be inclined to suggest Luvox, based solely on the fact that you like Paxil's effects, and I found Luvox to be indistinguishable in manner of effect but far stronger than Paxil. Apart from that, all I can really tell you based on my experiences is that Lexapro worked great for me even though Celexa didn't do a thing.I tried Lexapro, but I had some bad bad jitters with it, but it did work as well as the paxil.. but I shook like I had palsy or something.. It was awful..
The side effects ultimately caused me to discontinue it though. Zoloft slightly inhibits dopamine reuptake, if I recall correctly, which may be part of the reason that some people prefer it (though it threw me into a hyperagitated homocidal sort of mania when I tried it, and my aunt responded exactly the same way).
I've not tried it but I know a woman that uses it in addition to flexeril and has good results, although she's still bed ridden most of the time becuase of lack of energy.. They had her on Elavil which she gained like 50 lbs on and she said it worked at first, but they had to keep rasing the dose and she got to were it didn't work for her later on..
>
> Have you tried Effexor? It's possible that it could be more effective at ridding you of some of your pain -- drugs that inhibit norepinephrine reuptake along with that of serotonin are often great for dulling chronic pain.Effexor is the drug I'd like to try..
A great example is the muscle relaxer Flexeril, which is really nothing more than a tricyclic antidepressant when you get down to it. It inhibits NE and 5-HT uptake and has strong anticholinergic and antihistamine activity, making it very similar to Elavil (which is used quite often in treating fibromyalgia).
I've tried Elavil, but was too groggy with it when trying to work.. I also had terrible dry mouth with it.. I coudln't work it was so groogy in the AM.. and it took like 4 hours to get past that just in the AM.. By lunch it was gone, but I can't work with it.. Otherwise it worked pretty well.. I took it about 3 weeks.. and the Neuro changed me on it..
>
> On the other hand, if there are side effects from the Paxil that are causing you trouble, it's quite probable that you won't avoid them by switching to another SSRI (or Effexor, for that matter). Some side effects can be reversed by additional medication though -- sexual side effects and apathy may respond to some type of pro-dopaminergic drug (e.g. Wellbutrin, Buspar, amphetamines, Ritalin, Mirapex) or, in the case of sexual side effects, Periactin or bethanechol.Where did you learn so much about these meds?
Best Regards
Tim
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