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Antidepressants
#270453 03/01/15 09:27 PM
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Hello,

How many of you are also on antipressants and which ones and dosage? I have been on Prozac 40 mg for over 5 years and I wonder is there another one geared towards pain management with minimal side effects? Also do they tend to stop working at a certain amount of years? I don't have any horrible side effects but I'm beginning to think its not working as good as it use to. Any input would be great.

Re: Antidepressants
jpwilson #270457 03/02/15 03:09 PM
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Several thoughts to consider: There are several new classes of antidepressants a couple of which address pain or neuropathy. Any changes or advice should come from an MD who knows these medications well as changing or stopping the SSRI (proazac is one) can be a little tricky. Don't stop taking it as some have experience withdrawal and as serious as seizures. I would chat with you doctor about your concerns and make a decision or perhaps even speak with a Psychiatrist before making and decisions.


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Re: Antidepressants
jpwilson #270511 03/07/15 07:58 AM
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Endep is used in high doses as an anti-depressant, and low doses for fibromyalgia pain

http://umm.edu/health/medical/reports/articles/fibromyalgia

Re: Antidepressants
jpwilson #270519 03/07/15 11:28 PM
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I agree with the above poster: don't stop your antidepressant without talking to your doctor. Before I got pregnant, I was taking lyrica 150 mg twice daily and savella 50 mg twice daily. It really helped my pain and my depression! I didn't realize it helped so much until I had to come off of them because I got pregnant.


Kay (28 years old)
Diagnosis: Ankylosing Spondylitis (January 23, 2012), HLA-B27+, Fibromyalgia (July 27, 2012)
Current Medications: Enbrel, Flexeril, Prilosec, Tylenol, Ibuprofen, Savella, Zanaflex, Zoloft, Neurontin.
Re: Antidepressants
jpwilson #270521 03/08/15 03:09 PM
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Yes, don't just stop it.

Cymbalta is labeled for chronic pain now. I have taken it for years and it really helps with my spine. 20mg once a day for depression it is twice a day. It now has a generic too.

Anna


Actema IV once a month (with pre loading for allergic reaction), Cymbalta x1 daily, Arava 20mg daily. Diagnosed with AS in 2004, suffered undiagnosed since 1982.
Re: Antidepressants
jpwilson #270524 03/08/15 11:03 PM
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Hi jpwilson,

After I gave birth to my girls 5 years ago, I simultaneously flared horribly and experienced fairly serious depression and anxiety.

The pain, anxiety and depression are all very interrelated and I have been treated for both with slowly increasing doses of medications. Treatment by a psychiatrist has been very important for maintaining functionality. For whatever reason, ever since the inflammatory bowel and blood clotting began in my life, I have required enormous a lot of medication to feel an effect so my regimen might be atypical.

Current regimen for pain and depression/anxiety:

Cymbalta 60mg twice daily
buproprion 100mg twice daily
alprazolam 0.5mg ER twice daily as needed
currently appealing a denial for Lyrica as an add-on for pain

My suggestion would be to make an appointment with a recommended psychiatrist as they can follow and change the regimen more closely than the GP, in my experience.

Best regards,

SNova


Humira, colchicine, duloxetine DR, bupropion XL, bisoprolol, low dose naltrexone, Botox migraine protocol
IBD, AS, thrombophilia, cutaneous Crohn's
Re: Antidepressants
jpwilson #270527 03/09/15 11:04 PM
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Thank you. I see my doctor tomorrow.

Re: Antidepressants
jpwilson #270528 03/09/15 11:06 PM
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Can you all who mentioned what you take tell me what side effects, if any, you have experienced?

Re: Antidepressants
jpwilson #270536 03/10/15 05:43 AM
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Hi jp,

Side effects:

Cymbalta - dry mouth, must take regularly as scheduled or get 'zappy' feelings.
bupropion - dry mouth, with dose increase can feel tightness in chest and a bit of anxiety. Subsided within a week or two.
gabapentin - initially none and then I realized I was experiencing 'cognitive side effects' meaning I felt 'dull' when I usually was 'sharp'. Urinary hesitancy. Sexual side effects. Decreased anxiety (this was a bonus). Fatigue during the day even if I only took dose at night.

The Cymbalta works wonders for my sciatic, sacral pain and really helped with associated depression. Bupropion has been wonderful for alertness, scatterbrain prevention and overall well being. In the past I have tried Zoloft (max dose) and Lexapro without success for depression anxiety related to pain. Gabapentin works well to sleep at night no matter what is going on physically.

Because gabapentin has worked so well for the neuropathic pain and pain in general, I am looking forward to trying Lyrica and avoiding the fatigue and cognitive side effects. When I am in pain I get really agitated and this interferes with everything in my life.

Cymbalta has been wonderful and I have been taking this for 5 years. I thought it was becoming less effective for both pain management and depression right around a year ago. It is hard for me to tell what is what as I mentioned that the emotional and physical go hand in hand.

Best wishes for your doctor's appointment. Hopefully you will have a thorough discussion with your doctor and come up with a good plan to address your concerns. Let us know how it goes.

Regards,

SNova


Humira, colchicine, duloxetine DR, bupropion XL, bisoprolol, low dose naltrexone, Botox migraine protocol
IBD, AS, thrombophilia, cutaneous Crohn's
Re: Antidepressants
jpwilson #270545 03/10/15 05:03 PM
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Hi,

Zoloft (generic sertraline) 50 mg and then reduced to 25 mg (half pill), made initially made the big difference in pain and helped with anxiety and depression about the diagnosis. I eventually came off 25 mg after 6 months because of sexual side effects, plus the pain was under control with sulfasalazine 2 gr/day. Tapered off, taking 12,5 mg/day then 12,5 mg/every other day, with minimal side effects beyond the usual "brain zaps".

While on Zoloft, I used Wellbutrin (bupropion) XR 150mg/day, which helped a lot with fatigue and counteracts some of the side effects of Zoloft while having no major side effects itself. Generic bupropion extended release doesn't seem to be very effective, BTW, try to get the original. Bupropion has been known to have some Anti-TNF effects in of itself; can't hurt, right?

I'd definitely give Cymbalta a try, or even Zoloft; the combination with Wellbutrin could be helpful if the other antidepressant makes you feel drowsy or scatterbrained. Beyond just the pain, I think these anti-depressant drugs can really help with accepting the diagnosis and taking perspective on your life.

Last edited by aks; 03/10/15 05:05 PM.
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