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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by SheilaC on July 26, 2009, at 9:34:33
I have a bladder problem (interstitial cystits) and serotonin drugs (SSRIS and SNRIs) cause me pain. My doc has tried some other drugs, but so far the only ones that seem to help me sleep and with anxiety are Klonopin and Seroquel.
Problem is, I feel a little blah and need a jump start during the day. I had a bad reaction to Lamictil, so my doc tried Abilify. Even at small doses the Abilify causes weight gain (severe water retention), but it did help with my depression.
I'm running out of drugs to try. I would love to take a drug that hits serotonin, but can't stand the pain. Are there other drugs that hit dopamine?
I have taken Tramadol (Ultram) for my bladder pain and it has been the best thing for my depression & anxiety. My mood is fine when I take it. But, because its a pain med, docs won't prescribe it.
Not sure what neurotransmitters Tramadol hits, but are there other meds that are similar in action that a doc would prescribe for depression and anxiety?
Thanks!
Posted by Phillipa on July 28, 2009, at 16:50:28
In reply to Dopamine / Serotonin?, posted by SheilaC on July 26, 2009, at 9:34:33
Can you take cymbalta good for pain? SNRI? Phillipa
Posted by SheilaC on July 29, 2009, at 16:16:25
In reply to Re: Dopamine / Serotonin? » SheilaC, posted by Phillipa on July 28, 2009, at 16:50:28
It's been a long time since I tried Cymbalta. I think the problem I had with it was that it was causing urine retention (I couldn't go). I had the same problem with elavil and other TCIs.
My doc had me trying Geodon right now. For some reason, Seroquel, Abilify, Geodon, etc. seem to calm my bladder without causing retention or pain. Maybe that has to do with how those drugs effect serotonin? Or don't effect serotonin?
Posted by Brainbeard on July 29, 2009, at 16:26:24
In reply to Dopamine / Serotonin?, posted by SheilaC on July 26, 2009, at 9:34:33
How much time have you given the SSRIs? They tend to aggravate pain in the beginning of treatment, along with anxiety. After a couple of weeks, they are known to be effective pain-relievers.
Some drugs that work like Tramadol (SNRI) are the TCA imipramine (aka Tofranil) and especially Effexor (venlafaxine), which is very similar to Tramadol in chemical structure. For some reason Effexor, just like Tramadol, has a more immediate effect on pain than the SSRIs. Imipramine also has an immediate effect on pain. For the bladder, you would need to take Effexor in a higher dose of 75mg and up, because else you wouldn't have much noradrenergic action going on. Imipramine would possibly do the trick on lower does already.
Yep, Effexor and imipramine: these are the drugs that I would suggest for you. Effexor, like Tramadol, has a bad withdrawal syndrome for many. Imipramine could also be taken as needed, perhaps more so than Effexor.
Good luck!
Posted by SheilaC on July 29, 2009, at 17:30:18
In reply to Re: Dopamine / Serotonin?, posted by Brainbeard on July 29, 2009, at 16:26:24
How interesting you say that. I used to take Effexor, but only 75mg. I guess if I had gone up to 150mg or higher maybe it would have helped me without bothering my bladder.
I took SSRIs for at least 10 years. At one point I took 40mg of Prozac, another time I took 100mg of Zoloft. I also took 75mg of Trazadone at night for sleep.
Then my bladder starting hurting. Every SSRI I tried gave me urgency, urine frequency and pain. My bladder doc even said that drugs that effect serotonin may hurt my bladder (and they did).
My bladder doc had me try neurontin (for pain), but it hurt too.
Usual pain meds like hydacodone didn't help my bladder pain, but Tramadol did and it helped with my depression.
Which is why I was curious if there were a drug similar to Tramadol I could take.
Would high dose Effexor (150mg or higher) effect serotoinin?
I really should mention this to my doc.
Posted by Brainbeard on July 30, 2009, at 2:57:55
In reply to Brainbeard - Re: Dopamine / Serotonin?, posted by SheilaC on July 29, 2009, at 17:30:18
> > Would high dose Effexor (150mg or higher) effect serotoinin?
Yeah, it would. That's the nasty thing about Effexor; you can't reach noradrenaline-significant levels without disproportionally boosting serotonin (although this may be beneficial for some).
I'm wondering if it's really the serotonin reuptake inhibition that's causing the pain though. Neurontin, for instance, doesn't touch serotonin at all, and still it made your pain worse.
An option I forgot to mention is Geodon. Geodon is actually a mild SNRI. It can sure help with the type of pain you have, without affecting serotonin too strong. Only drawback is you would also get D2-antagonism, which you probably don't need if you're not psychotic.
You could try a low dose of imipramine, say 25mg. I think that may be enough for the bladder problem yet be mild on the serotonin.
Posted by SLS on July 30, 2009, at 5:52:50
In reply to Re: Brainbeard - Re: Dopamine / Serotonin?, posted by Brainbeard on July 30, 2009, at 2:57:55
> You could try a low dose of imipramine, say 25mg. I think that may be enough for the bladder problem yet be mild on the serotonin.
Is the anticholinergic property important to treat this bladder problem?
- Scott
Posted by Brainbeard on July 30, 2009, at 6:08:56
In reply to Re: Brainbeard - Re: Dopamine / Serotonin?, posted by SLS on July 30, 2009, at 5:52:50
> Is the anticholinergic property important to treat this bladder problem?
>
>
> - ScottProbably not - anticholinergic drugs can reduce the overactivity of the bladder muscle and thus help with incontinency (http://www.cochrane.org/reviews/en/ab005429.html).
But they tend to aggravate bladder pain (http://books.google.nl/books?id=TW937x75xUsC&pg=PA81&lpg=PA81&dq=anticholinergic+%2B+bladder+pain&source=bl&ots=wNb9lRnRBr&sig=JUVdGMqRHMKMFYV3d9ocx-oY-Ns&hl=nl&ei=GH5xSsKCEdyOsAbE3omRDA&sa=X&oi=book_result&ct=result&resnum=7).
I don't think low dose imipramine would be a problem though, it's not that anticholinergic.
Posted by SheilaC on July 30, 2009, at 7:12:38
In reply to Re: Brainbeard - Re: Dopamine / Serotonin?, posted by Brainbeard on July 30, 2009, at 6:08:56
I tried only 20mg of Geodon last night along with .5mg of Klonopin. After about 2 1/2 hours I fell asleep.
The Geodon doesn't bother my bladder. I don't have any pain with the Geodon.
I'm just wondering if maybe I need a higher dose, like at least 40mg at night.
I haven't liked the tiredness I get from the Geodon during the day (only 20mg in the am).Possibly I should just take 40mg at night and that would help me sleep. I realize in time I may need to go up higher.
I am not psychotic, just bipolar. Without a mood stabilizer I tend to have fits of rage.
Even though I had teeth & gum problems with Lamictal, it gave me fits of rage (possibly serotonin kickin in?). I tend to lose control of my anger with serotonin.
This is the end of the thread.
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