In a previous discussion the topic of antidepressants working effectively for pain as well came up. I have never heard this before but would love some more discussion and info about that. Anyone? Tntlamb? This could be so benificial. The appt I had when I was diagnosed included several tears about not being willing to accept a life on pain meds and have been very aggressive on treatment to avoid use long-term so this is extremely interesting to me. Any other med options other antiinflammatory meds (no brainer they help) that would be wonderful to know about too!
The front-runner that works for me for both night-time pain relief (especially neuropathic pain) and sleep is amitriptylene. My rheumy prescribed this for me when I was in a spiral of what felt like endless pain and tiredness. I wasn't getting enough sleep because the pain as I stiffened up would wake me and stop me being able to return to sleep. Just a small 10mg dose taken a couple of hours before bed makes me drowsy enough to nod off easily, acts as a muscles relaxant as well (I believe), eases pain and most importantly enables me to get back to sleep if I wake. With a good nights sleep I am much better able to face the daily fight that is PsA.
I ran out of Lexapro the first part of May last year. What with one thing and another, I wasn't able to get to my primary care guy until three or so weeks later. I didn't have Lexapro withdrawal in terms of depression/anxiety but the PsA pain was worse.
I finally got the refill and noticed an almost immediate difference. I talked to my rheumy about it when I saw him in June. He said he wasn't surprised--he had used Lexapro, Cymbalta and the like for his PsA patients and told me he was happy it worked for me.
I’ve heard of lots of people who have taken anti-depressants like amitriptylene for both pain and for sleep. And I think they’re closely connected – if you’ve slept well, you seem to have less pain or at least you can cope with it better. Or at least that’s the way it iss for me.
Trazodone (Desyrel) is another anti-depressant that works welll as a sleep aid, when taken in the evening, according to some people. When my dementing mother was up during the night and acting strange, that’s what they gave her in the evening. It did her all kinds of good, even though it was a tiny dose, evening only.
I’ve been known to take an OTC anti-histamine, like Benadryl, for nighttime “busy-ness” too. Especially when I have a stuffy nose. (LOL)
Good thread, Rachael – pain relief doesn’t always mean opiod-type drugs.
I have script for welbutrin that I have not filled for using to stop my nasty smoking habit. Was trying to wait for better pain PSA management before totally taking that on but may just fill it and try. Will look into the active ingredients and see. Anyone familiar with it? I used it 2x before once to quit smoking and another for depression after a horrible car accident 12 yrs ago that kept me off work a whole month plus tons of PT to recover.
Seenies post has just reminded me of another product. It's not a drug but a solid levomenthol stick which is marketed for applying to the forehead to ease tension headaches. It's called 4Head. Not sure if it is a UK only product or whether it is available worldwide by this or another name. I find it is helpful for headaches if applied across the forehead and temples (keep well away from eyes!) but it is also great in the middle of the night for hot flushes and just to distract the mind from "busy-ness". I have also been know to apply it to hot, swollen joints to good effect ....it's effect is the same as cooling gels.
Hello everyone,
I'm using Desyrel (trazodone) as a sleeping aid and it's worked wonders! I only take 50 mg per night, and it pretty much knocks me out in half an hour. Before I started using it I was in a really rough spot - I was in so much widespread pain and was an emotional mess. I don't remember ever being that neurotic, and believe me I'm not the sanest person around! It took away almost half of my pain instantly. The only pain I was left with were my right foot, my left SI (which never stops hurting actually), and a little pain in my right wrist. And they were much more bearable.
I had declined the "sleeping pill treatment" for almost a year and now I wish I hadn't. I could've spared myself so much unnecessary pain. And as for why it works... here's what my rheumy told me: Apparently, endorphins are the great pain killers of nature and being sleep deprived means less and less endorphins in your body - maybe even none. So the pain you are already feeling is much more amplified. Because there's nothing in your body to help ease it. That's the explanation he had given me when he was trying to convince me. Maybe he was trying to make it easy to understand why I needed them or give me a reason. I'm sure tntlamb has a much better explanation then mine!
Another interesting thing about this whole thing is... having sleeping problems and being in depression (not being depressed, but being in full force major depression) has always been like that question of eggs and chicken for me: I don't really know which came first, and I often wondered. At one point both my sleep problems and my depression were so severe I was actually hallucinating when I was awake because I was so sleep deprived! That's how bad it was. Of course that was years ago and I've found ways to manage my sleeping problems and my depression - at least I thought I did until I started Desyrel. It is an antidepressant, but with the funny amount I'm taking, I'm basically taking it for its sedative side effect! And even with my ongoing pain and the emotional toll of it, I think I'm doing pretty good emotionally! My brain fog is mostly lifted, my memory is much better, I'm much less neurotic, I mostly feel at ease... And to tell you the truth, knowing that you'll be able to sleep when you go to bed, no matter how bad you felt during the day, no matter what upsetting thing happened, no matter how fast your brain is working and how fast the thoughts are racing in your head, and no matter how much physical pain you're in is priceless. Moral of the story: sleep is important, don't go years sleep deprived like I was :)
The tricyclics have been extensivley for pain management for arthritis pain (amytiptline types) but similar results with some of the SNRIs have been found effective Lexapro is king: (the others not so much)
Here is a couple of general articles:
http://www.webmd.com/pain-management/tricyclic-antidepressants-for-...
http://www.mayoclinic.org/pain-medications/art-20045647
http://www.hopkinsarthritis.org/patient-corner/disease-management/m...
When everything went to hell in hand basket for me this year We ended up with a therapeutic dose of Lexapro daily AND a 25mg PRN dose of amitriptylene for sleep.
I take lexapro and trazadone and they help immensely. I also take 5 mg of flexed il at bed time as my spine gets so tight I have trouble laying down! I Also take Celebrex and Tylenol twice a day. Each by themselves doesn’t seem to help much but together do help. I also do hydrotherapy and use Salonpas on the areas that hurt with tendinitis and bursitis. When my jaw hurts I chop food up more finely. I do have a prescription for Vicodin but I do not use it very often as I have other things in my pain arsenal. I have used it in the past for a few weeks at a time when I have a very bad flare
I took Nortriptyline 10mg at bedtime for my foot neuropathy. Over time--a few months--it "cured" the neuropathy, and while I was on it I could fall asleep easily without having a "worry spell" first. I stopped taking it after about a year. I'd take it again, but hated the dry mouth SE it gave me. I'm also wondering if it fried my brain somewhat because I now have a problem of songs being played over and over in my head!
Thanks everyone for your replies! So helpful especially the articles tntlamb! I had to read a couple twice but it makes sense. I have appt with GP in about a month and will discuss this. Also going to fill the welbutrin and give it a try. At least I know my body tolerates if fine so no worries there! I’ll post back how it goes.
Haha, don't worry Grandma J, I don't think it's about the medicine because I have that problem too... They especially start playing in my head just when I'm about to fall asleep... so that's another reason to use trazodone :P
Grandma J said:
I'm also wondering if it fried my brain somewhat because I now have a problem of songs being played over and over in my head!
I was giving tremadal but was recently told to stop because it may be lowering my blood sugar. We actually had a stranger call emergency 2 weeks ago when it happened while my husband and I were walking. What I mean by that, is a stranger driving by saw me on the ground and my husband standing over me so they just called - we think it was because they though I was being attacked
I take a fairly old anti-depressant called imipramine. It is in the same class as amitryptaline. It did a LOT for my pain. It made my brain feel a little insulated to the pain. It was still there, but I could ignore it more easily. I do take narcotics along with it. I am sadly allergic to NSAIDS (as some asthmatics are)and also to aspirin, so that skipped a large chunk of treatments. Also, I have had PsA, we now realize, for over 40 of my 41 years of age, but they had no diagnosis they could figure out until I was 25. That means I am way ahead of most on the treatment road for pain and treatment drugs. Therefore, the fact that imipramine did something for me says a lot, I think. Cymbals did absolutely nothing for me, so I was very happy to find an older drug that is relatively cheap that did work.
Wow, Robin that sound scary are you diabetic? Talk about a situation misread but can’t blame someone for “attempting” to do the right thing!
To everyone thank you for your responses, still welcome more. I have a nice list of meds to look into and an entire subject to open with my doctors. How great is it to know there are options in “the gap” that are not just NCAIDs or opiates. Ones that can be used long-term as well!
No I'm not but for some reason both my BP and sugar just randomly drop. They tried and the officers were very kind, It got nuts though because when they realized it was medical they called out all the emergency crew. I told them it wasn't necessary. Since we were home the entire crew just came into my house so I could get some juice
That is SO funny, LL! We have so much in common--now the songs in our heads!!!! Maybe I need trazodone--but my songs don't bother me at night--just mostly during the day when I hear a song (and I love to listen to music in the car) it'll start playing in my head and I'll actually have to work hard to think over the song!! It's crazy. I've sometimes even wondered if it's a start of alzheimer's or something. (I've only repeated myself a million times on this site--so you guys probably all think I have alzheimers!!!)
ladylazarus said:
Haha, don't worry Grandma J, I don't think it's about the medicine because I have that problem too... They especially start playing in my head just when I'm about to fall asleep... so that's another reason to use trazodone :P
Grandma J said:I'm also wondering if it fried my brain somewhat because I now have a problem of songs being played over and over in my head!
I've been taking Trazodone for well over a decade for insomnia and it works very well for me. The nice thing about it is I don't have any noticeable side-effects.