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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by MidnightBlue on February 24, 2007, at 0:21:27
Okay,
I have a long history of major depression that is somewhat in remission. I have high blood pressure. I also have classical migraines (rarely) and nerve pain.
I do NOT want to gain more weight, become more confused, or have worse blurred vision. I'm already dizzy. All three of the above drugs have been suggested to me. I'm to the point where I need to try and do something about this nerve pain. And the depression is getting worse because of the pain. I do NOT want to make anything else worse. Oh yeah, add GERD to the list! I have that, too.
Suggestions? I go to the doctor early next week. What would have the least side effects?
MidnightBlue
Posted by med_empowered on February 24, 2007, at 0:39:22
In reply to Neurontin? Lyrica? Cymbalta? or?, posted by MidnightBlue on February 24, 2007, at 0:21:27
The only real difference between lyrica and neurontin is potency--lyrica is a lot more potent. Also, Lyrica is a schedule V controlled substance, so you'll have to deal w/ your doc more in getting refills.
If you have high blood pressure, cymbalta really shouldn't be on the table. It can raise blood pressure at therapeutic doses.
Can you take a benzo? For mixed anxiety/depression like yours, xanax would be good, or maybe Klonopin plus ((antidepressant, anticonvulsant, possibly Provigil).
Back in the day, Phenobarbital was used in cases of anxiety w/ hypertension. I doubt its all that common now, but since pheno can also help gastrointestinal issues...maybe its an option?
Anyway, like I said--I think the Benzo-type tranquilizers should be your first line of attack. They're very safe and non-toxic, cheap, a relatively predictable. Plus, they're really good in terms of drug-drug interactions, which might be an issue. Also, if you were to add in some propranolol, you could get more tranquilizing action PLUS blood pressure reduction. Antidepressants kind of suck, really--they interact with other meds, they don't work that well, they can cause unusual side effects, and weight gain is pretty common.
Lyrica I guess would be kind of close to benzos, but its expensive and new, so really don't see why you can't just give a BZD a try. Xanax even comes in a fun new XR flavor.Good luck.
Posted by MidnightBlue on February 24, 2007, at 0:44:03
In reply to Re: Neurontin? Lyrica? Cymbalta? or?, posted by med_empowered on February 24, 2007, at 0:39:22
I don't think I have anxiety. I have a nerve problem. Not a nervous problem. :-) I have numbness and pain shooting down my legs/back.
Actually my doctor has been trying to get me to take one of those three meds for the last two years. I'm just now getting desperate enough.
Midnightblue
Posted by dbc on February 24, 2007, at 2:12:32
In reply to Re: Neurontin? Lyrica? Cymbalta? or? » med_empowered, posted by MidnightBlue on February 24, 2007, at 0:44:03
If you can sacrifice the gaining weight thing for a shot at basically the strongest ssri/snri/nri combo possible then cymbalta or effexor + remeron is it. There is nothing that potent, its impossible to describe feeling that many neurotransmitters in your brain.
Posted by MidnightBlue on February 24, 2007, at 9:24:36
In reply to Re: Neurontin? Lyrica? Cymbalta? or?, posted by dbc on February 24, 2007, at 2:12:32
I don't think I could handle two weight gaining meds! I don't do well on SSRIs. They kill my stomach and give me headaches. Propananol made me very depressed and slowed down. I've been saying no to Remeron for longer than Effexor or Cymbalta. Two of my doctors were disgusted with me for not wanting to try Effexor because of my high blood pressure. One of them even acted like I was making up the problem. He was a pdoc.
MB
Posted by Phillipa on February 24, 2007, at 11:37:08
In reply to Re: Neurontin? Lyrica? Cymbalta? or?, posted by MidnightBlue on February 24, 2007, at 9:24:36
MB try the cymbalta. I didn't gain weight. First time no side effects. When I stopped it noticed I had back pain. Second time didn't trust the pdoc new or my chemistry had changed as I couldn't tolerate even 30mg and had taken 60mg first time. I'd suggest starting low though. Good luck ps a benzo with it in the beginning? Maybe? Love Phillipa
Posted by MidnightBlue on February 24, 2007, at 13:19:51
In reply to Re: Neurontin? Lyrica? Cymbalta? or? » MidnightBlue, posted by Phillipa on February 24, 2007, at 11:37:08
Why would I need a benzo? I'm not anxious. Please see above posts.
MB
Posted by Phillipa on February 24, 2007, at 19:56:33
In reply to Re: Neurontin? Lyrica? Cymbalta? or? » med_empowered, posted by MidnightBlue on February 24, 2007, at 0:44:03
MB sorry. Love Phillipa
Posted by MidnightBlue on February 28, 2007, at 12:50:28
In reply to Re: Neurontin? Lyrica? Cymbalta? or?, posted by MidnightBlue on February 24, 2007, at 9:24:36
Tried the generic for Neurontin Monday night. Within an hour I had a bad headache and it is still bothering me. Didn't take it last night and I'm waiting for the doctor to call back. Just a co-incidence or side effect?
MB
This is the end of the thread.
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