New Med & Pain Doc visit.

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 3/26/2012 12:26 PM (GMT -6)   
Hey everyone, hope your week is starting off well.

I just got back from my appointment with my pain doctor. I've been on Tramadol for a year now with no real improvement, so I wanted to try something new medication wise. He had previously mentioned putting me on the next 'level' of medications in the narcotic category, but when I went in today he actually said that he wanted to try Cymbalta. He gave me 3 weeks of trial pills and told me to try it and report to him in 2 weeks, unless I had some bad side effects, and then I should just stop taking it completely and call back.

He's just having me take 30mg at bedtime right now, for the two weeks. I hadn't actually heard of Cymbalta being used like this, though it sounds similar to some other meds that I have heard people using for things like fibromyalgia.

I did make sure to stress to him that I was on meds already, such as my prozac and xanax, etc. I'm not sure how the meds will work, but I'm willing to try this and am hopeful. Another hope is that my insurance will pay for it if I need a prescription eventually, because I get medical assistance and having 3 drugs that they consider to be in the 'same' category (anti depressant) might not fly with them. So, I guess I'll see.

Anyone else take this or similar meds for pain?

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 3/26/2012 12:44 PM (GMT -6)   
Cymbalta is being used for fibro and depression...but ask your
pharmacist it if will interact with your other medicines, I wonder if your
doctor forgot what he told you on your last visit or he was to afraid to prescribe
anything else...maybe time to look into finding another pm doctor...
More and more pm doctor are getting afraid to prescribe the higher
medicines...some in part due to bad doctor's, but that would start
a heated debated, sorry....
Look up www.drugs.com to make sure cymbalta won't interact with your other medicines,
only reason I say this is because of seratonin syndrome can come from too many anti depressants
Many many well wishes to you and keep us posted...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 3/26/2012 1:10 PM (GMT -6)   
As Chartreux mentioned, there is a risk of serotonin syndrome with tramadol and Cymbalta.

I had a very bad experience with Savella last year and according to my PM, he thinks Cymbalta could be worse for me since it focuses more on serotonin than Savella does.

Since you're already on Prozac, maybe you'll be fine or maybe you'll find it too much.

I started with a low dose and after a few days, developed a head pressure that got worse and worse. After about 5 days, I stopped the Savella. So you might want to read up on the signs of serotonin syndrome and be on the lookout.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 3/26/2012 10:42 PM (GMT -6)   
Thanks, both of you. :)

I just took the first dose, so we'll see what happens.

I'm not sure why he didn't try the other narcotics, but I think it was a combination of hesitation and actual curiosity to see if the cymbalta might help me since lower level narcotics didn't. Sorta a matter of 'hey maybe this will work and he wont be addicted to narcos'.

I stressed to the PM doc that I am on Prozac, and Restoril, and Xanax, AND Tramadol, all of which have some effect upon chemicals and brain-y stuff. lol! So I did state that several times, because in the past--different doctor, a psychiatrist--put me on two anti depressants and I possibly went into serotonin syndrome and had to go to the ER.

PM doc acted like it would be fine. He didn't really mention the serotonin syndrome stuff, but he did say that if I had suicidal thoughts, etc, to stop the drug immediately and just let him know.. So he wants to see me in 2-3 weeks. Plus, he wants me to keep on my Tramadol and Naproxen, and all my other meds, so it isn't like I'm left with just the cymbalta for pain. I'm not very hopeful that it will help--but whatever, I'm up to try pretty much anything right now.

I don't know other pain doctors in my area who don't operate in the same building, so my options are very limited. And it isn't feasible for me to drive 3hours out of my way to a doctor when I need refills or check ups. (I live in the boondocks. My current PM doc is 1 1/2th away...so that is bad enough.)

:: sigh ::

I just get depressed and tired. I continually feel like the doctor doesn't grasp the severity of what is going on. When I mentioned that my surgeon is sort of contemplating suicide, the PM doc said he really is against surgery because it could cause more harm than good--which I agree with in my case--but he also said that it would be bad because if it isnt helpful I'd “miss out on all the things you can do, because you're so young.”

What things? I can't work, I can't drive, I can't even go to college anymore. I barely clean, and my head is so muddled from my depression/meds/and pain that I can't concentrate to do half the stuff I used to do. I consider this condition to have put the brakes on my life hardcore, and while I don't think that cutting myself open and shoving rods up there is a cure-all, I also don't think that playing around with odd/low-dose medications for over an entire year 1/2 is really a feasible plan either. This is an every day thing for me. I'm not able to go to school on Monday and tough through it, and then have a good day on Tuesday. I feel like this all the time...but yeah. Sorry about the rant, its just that sometimes I get so...tired about this. I'm tired of having the pain, and I don't even expect it all to go away...just to be able to have a better day-to-day life coping with the pain.

So I will let you guys know if I get results-good or bad--from the cymbalta. If not, I may have to speak up a bit more at my next appointment. If I need to go back and ask about trying a higher narcotic, then I will. I'll just remind him about what he had said last time, or something, instead of asking, 'Hey can you give me ______', because I'm not a doctor and I don't wanna sound like I'm a drug-abuser/hunter.


<3 :P

Post Edited (misterkatamari) : 3/26/2012 9:48:08 PM (GMT-6)


zizz
New Member


Date Joined Mar 2012
Total Posts : 9
   Posted 3/27/2012 9:55 AM (GMT -6)   
Hi there,,,just wanted to add my good wishes, hope you make some headway with the cymbal tea...I had tried it years ago when the pain was not as bad as it is now and had some adverse reactions along with becoming extremely irritable.

I agree that a back up plan to see a different specialist for a better opinion might be a good idea.

I hope u feel better soon.

zizz

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 3/27/2012 1:08 PM (GMT -6)   
Just a little additional FYI about Cymbalta.

It is often used, or at least tried, to help control nerve type pain in addition to being used for non specific pain such as is associated with Fibro. I used it quite successfully for a few years to help with my diabetic neuropathy pain. Only reason I am not on it still is that IL medicaid will not approve it.

Nausea and feeling a little "loopy" or strange mentally is common when first starting this med. Usually these side effects are mild and go away within a week or so. They may return for a short time however anytime you get a dose adjustment.

Dose adjustments should not happen any faster than every 2-3 weeks, though many doctors wait 4-6 weeks to avoid side effects or to at least minimize them.

Cymbalta has a cumulative effect. The longer you take it the better it works....if it is going to work. Also it is not uncommon to need to go to the next dose level before knowing if it will work for you.
======================================================================================
More and more, and especially with the new and proposed narcotic prescribing guidelines, doctors are wanting and in some cases required to go through several non-narcotic medications before moving on to narcotic ones for long term pain control.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16799
   Posted 3/27/2012 1:56 PM (GMT -6)   
Hey Mister, I wanted to pop on and say hello. I am glad that Jim posted about Cymbalta and could give you some good input on it. I would give it a try, you have nothing to lose and if you do get some of the side effects they will subside in time. It is being pushed a lot here on tv for pain, not just Fibro pain either. I went thru a bad time with neuropathy in my hands & feet and it worked very well for me.

Its tough when you live out of the city which I am assuming you do because of the traveling involved when seeing a specialist. Thats a price a lot of folks pay when they live out like that.

I will keep my fingers crossed for you. Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 3/27/2012 3:17 PM (GMT -6)   
Thanks everyone. I took a dose last night, and so far I seem ok...but I also didn't take my Prozac last night or any pain meds because my pharmacy took too long to fill my scripts up. (I have them today, though.)

At first, I was fine at trying this out, and I took a dose last night...but now I am sort of worrying about it.

The reason that I am worrying is that while I was looking up information on what exactly Cymbalta does to help with pain, I found a site that listed interactions with other medications. It acted like you should never take Cymbalta with Tramadol, due to the SSRI effect they both have can trigger serotonin syndrome. I took Effexor in the past for depression and may have had serotonin syndrome then (had to go to the ER), so now I don't really want to take this Cymbalta and press my luck.

I'm also on Prozac, Xanax, and Restoril...so I have all these things working around with the checmicals/receptors in my brain, including the Tramadol. I'm scared of adding the Cymbalta to all this, when the interaction could be so big. I mad a point to ask the doctor if I could take the Cymbalta with my Tramadol and other meds, and he said yes.

The last time I asked the nurses at the clinic about something like this over the phone, they basically just said 'Well if he looked at your meds list, then I'm sure he knows what all you're on and feels that it is safe'.

I don't know if I should call my regular doctor and ask him maybe? I'm just getting so tired of driving 2 hours every month out to see this pain doctor for over a year and a half now and I've still gotten no relief. I feel like I have no choices. He's such a nice person, and is very smart, but I just have no idea why people would think that all these anti-depressants and stuff are safer than a narcotic? Sure, maybe Cymbalta has a low abuse rate...but it has a laundry list of side effects that are worse than any I have seen for most narcotics.

Do you think I should call and ask the pain doctor's office about it? He told me that I could stop my meds at any time, if I felt like I needed/wanted to...but he also said to call back after trying it for two weeks. Should I just call and be like, 'well I'm scared to take it because of ____'?

Ugh! :P

Post Edited (misterkatamari) : 3/27/2012 2:28:41 PM (GMT-6)


Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 3/27/2012 3:28 PM (GMT -6)   
Do you fill all your medicines at the same Pharmacy? They, better than anyone...including your Dr. should be able to give you all the advice and any warnings about drug interactions. They have sophisticated software that will run an interaction check...this should be done automatically but it is something you can request with the head Pharmacist and speak to them about any concerns.

Drs. just don't have the tools or knowledge about all the interactions of medications.....Again...that is what a Pharmacy does and what Pharmacists go to school for....

Keep in mind as others have said that Cymbalta, like other medications usually need a good few weeks to work out any side effects...Obviously this is after knowing there aren't any actual allergic reactions or red flags of concern with interactions.

I used Cymbalta for years and it worked extremely well on my nerve pain.

So...if you have all your prescriptions at one place....I would call them now and ask to speak to the Pharmacist about your concerns....

Good luck..
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 3/27/2012 3:37 PM (GMT -6)   
Thanks Snowbunny. The doctor gave me the Cymbalta in 3 weeks of trial packs, though, so I didn't have to get it filled at the pharmacy yet. I could probably still ask them, though. Then again, the pharmacy is old, but maybe they still have the same software you mentioned.
--Patrick, aka Misterkatamari

I'm active on several boards. Main issues are: Chronic Pain due to Scoliosis & 2 Herniated Discs, possible DDD and arthritic facet joints. Also active in the Depression/Anxiety boards. Meds include: Prozac 40mg, Xanax .5 mg, Tramadol 50mg

“We must let go of the life we have planned, so as to accept the one that is waiting for us.” - Joseph Campbell

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 3/27/2012 4:00 PM (GMT -6)   
Ahh...I forgot it was samples.....Than it's definitely important to speak with the Pharmacist so they can run an interaction check. I would hope they have the most up to date software....If not...than I would seriously think about switching to a better Pharmacy as drug interactions are one of the most important issues that need to be monitored with any patient.

Keep us posted..
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

misterkatamari
Regular Member


Date Joined Jan 2011
Total Posts : 374
   Posted 3/27/2012 7:11 PM (GMT -6)   
Thanks again Snowbunny.

I sorta live in the middle of nowhere, but hopefully my pharmacy is ok. They were closed early today, so I will have to call tomorrow. I'm not going to take the Cymbalta tonight...just in case. My sister said that maybe the doctor knew about the risk, but thinks that the dosage is too small to cause anything. That might be true, but I do have a history of sensitivity to psychiatric drugs...better to be safe than sorry, to me. :P
--Patrick, aka Misterkatamari

I'm active on several boards. Main issues are: Chronic Pain due to Scoliosis & 2 Herniated Discs, possible DDD and arthritic facet joints. Also active in the Depression/Anxiety boards. Meds include: Prozac 40mg, Xanax .5 mg, Tramadol 50mg

“We must let go of the life we have planned, so as to accept the one that is waiting for us.” - Joseph Campbell
New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, September 25, 2018 10:04 AM (GMT -6)
There are a total of 3,006,425 posts in 329,336 threads.
View Active Threads


Who's Online
This forum has 161833 registered members. Please welcome our newest member, LorrieL..
309 Guest(s), 13 Registered Member(s) are currently online.  Details
alephnull, BangedUp, tarhoosier, AZdiane, Dimitri71, hopenchange, LorrieL., sebreg, Admin, Uniform Charlie, Healing98, nakamura1967, (Seashell)