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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by floatingbridge on June 21, 2011, at 19:42:47
So, the game plan is depression/anxiety remittance (silly pain docs, yeah. Easy-peasy) and sleep.
They are reccommending trazdone, lunesta, & ambien as sleep contenders.
I still want to try Nardil or parnate. They said, given that cymbalta was a bust, it didn't seem to matter to them if it was ssri, snri, or maoi.
Has anyone felt physically better on either maoi? Would they be contraindicated with the sleep meds?
Thanks.
fb
Posted by Phillipa on June 21, 2011, at 21:07:20
In reply to nardil + trazdone questions after the pain clinic, posted by floatingbridge on June 21, 2011, at 19:42:47
FB the pain clinic didn't recommend an maoi nor your pdoc. Cymbalta I know you tried but do you feel that in the back of your mind it was an maoi that you really wanted as so many here do well on them? With the fibromyalgia I personally feel give the cymbalta a shot again with the trazadone, lunesta was it? or ambien? Maybe some could tell some experiences of how the maois didn't work and what their experiences were. Seriously some have great results and some not good at all. I'm hoping three in particular answer this thread? Phillipa
Posted by floatingbridge on June 21, 2011, at 21:40:18
In reply to Re: nardil + trazdone questions after the pain clinic » floatingbridge, posted by Phillipa on June 21, 2011, at 21:07:20
Hi Phillipa,
Thanks for weighing in. I gave cymbalta quite a good trial because it was so helpful for pain, but it had a deal-breaking sx that did not abate after 8 weeks and that was equal in pain to the pain I sought to treat. That was sad to let go of; I fought for weeks to make that drug work.
The clinic says however I treat the depression, as long as the treatment actually does help my depression, my pain levels
(hopefully & and theoretically) will decrease.Their opinion is to treat both depression and insomnia very aggressively for the optimal results.
Norco goes. They explained why, and as soon as I get some depression treatment up and running, the taper begins.
Trazedone is contraindicated with any maoi (had time to med check), but the other two are fine. Frankly, I think PB'rs know more about sleep meds than the docs I saw.
However, I am with them on the list of priorities. So yes, when I see some do well on maoi's, of course I want to try. My list of ssri's, snri's and add-on trials is not as long as some, but at my age, it's long enough. Plus, finally feeling that my mood was much more stable off of them.
I don't know how this will play out. Once again, I appreciate your honesty.
Right now I feel like snafu & that some of us just find ourselves f*ck*d. However, I'm not going to let that stop me.
fb
Posted by Phillipa on June 21, 2011, at 21:49:25
In reply to Re: nardil + trazdone questions after the pain clinic » Phillipa, posted by floatingbridge on June 21, 2011, at 21:40:18
A fighter I do like that!!!! True about the depression and pain getting better if fibro did they confirm this? I believe you fully. So maybe there are other options other than meds for depression? Hey thought what about samee or St John's Wort? Just thinking out loud. Long ride but sucesss. No temper tantrum tonight. Do you like Stanford? Love Phillipa
Posted by JONO_IN_ADELAIDE on June 21, 2011, at 22:22:04
In reply to Re: nardil + trazdone questions after the pain clinic » Phillipa, posted by floatingbridge on June 21, 2011, at 21:40:18
Have youtried nortriptyline?
This would help the depression and the fibro, and its side effects are different to Cymbalta, so it would be well worth a shot.
Generaly you start with 25mg at night, and build up to 75-100mg at night over a couple of weeks.
You could take Ambien or Lunestra with it if needed
Posted by floatingbridge on June 22, 2011, at 0:22:49
In reply to Re: nardil + trazdone questions after the pain clinic, posted by JONO_IN_ADELAIDE on June 21, 2011, at 22:22:04
Thanks Jono, that's good to know. You have tried cymbalta? It was wicked awful, but helped with pain. How do you know so much about meds? You really do. I would probably give amitryptline a try first.
Thanks,
fb
Posted by jono_in_adelaide on June 22, 2011, at 3:14:41
In reply to nortriptyline » JONO_IN_ADELAIDE, posted by floatingbridge on June 22, 2011, at 0:22:49
years of anxiety/depression, quite a bit of reading, and my mother was a pharmacist....... one of the old school ones, who thought she was there to help sick people, not be an agent for the drug squad.
Amitriptyline is meant to be the best for fibro, but if you're sensetive to med side effects, then it can sometimes be a bit hard to take, nortriptyline might be a bit less effective, but easier to take.
Posted by zonked on June 22, 2011, at 23:29:48
In reply to nardil + trazdone questions after the pain clinic, posted by floatingbridge on June 21, 2011, at 19:42:47
> Has anyone felt physically better on either maoi? Would they be contraindicated with the sleep meds?I took trazodone (briefly!) with Parnate without incident and with MD approval. I discontinued trazodone soon thereafter because it left me with an awful hangover (which it *also* did when I was on Zoloft - co-administration with Parnate was not the cause.)
The Z-drugs (Lunesta, Ambien, Sonata, etc) are not contraindicated with MAOIs.
Hang in there, keep us posted, you are cared about. :-)
-z
Posted by floatingbridge on June 23, 2011, at 1:15:27
In reply to Re: nardil + trazdone questions after the pain clinic » floatingbridge, posted by zonked on June 22, 2011, at 23:29:48
Thanks zonked. Trazedone gave me a morning headache /hangover, too.
I flew xyrem past my gp. I like that she's interested in meds (good quality in a doc). Like, she was both worried and excited because I was her first emsam patient. (I she hadn't heard of it and didn't hold that against me.)
Xyrem I doubt she will prescribe. She went off to look it up. I did caution her it had other uses and not to be alarmed.
Posted by Lamdage on June 28, 2011, at 8:38:13
In reply to Re: nardil + trazdone questions after the pain clinic » zonked, posted by floatingbridge on June 23, 2011, at 1:15:27
I think you can always use a baby dosage, just to be able to reduce on another sleep med. What i love about trazodone is, that there is 0 weight gain issues with it.
Im trying to jump back and forth between trazodone and a weak antipsychotic, both for sleep, to avoid tolerances.
This is the end of the thread.
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