Shoreline

I Think the guys pretty much covered it. For some reason they don't make the depression aspect of withdrawal as well knwn as the cold shakes but it can be equally severe.

A far as using another med to increase or speed up serritonin or physiological changes, I's realy your docs call hopefuly based on experiernce and patient reporting. If it helps and he thinks it will help, I don't see the harm in a short course of antiD's to move things along and help with sleep. You will feel better if you seep better.
Take care and congrats on your surgery, Dave

Hey Dan as faras using a med for an unintended purposes, we would all b SOL if theat wasn't standard practice. You mgt want to explain a littler better what you mean by relapse. True this is not organic depression, but there was a time where anti depressants were used as the primary med to combat chronic pain and sleep problems.

Your right you won't see imediate benefits with Paxil as you would using elevil to improve sleep but we can't really have it both ways, It's OK to use a med off label if it suites my purposes but when t's done for another reason your suugesting it's putting someone at risk. Yes Paxil can be tough to discontinue when used in higher doses for prologed periods of time, But Neurochemicaly and bio chemically we are a bit out of whack after 3 months of post op meds. Whether it's paxil for 2-6 months or Elevill, Who is supposed to dictate when a med should be used for off label use? People really don't seem to like it when non medical personal start dictating medical treatment or restricting a med to it''s aproved use. I would assume in the docs experience it did help, and that's why he's using it.

I have never heard of rebound depression in the abscence of true oraganic depression, I think what your describing is more abstinence syndrome as Paxil can be extremely tough to discontinue in a % of the population that takes it, please be clear when your message is cryptic. You think she will be stuck needing antiD's for years if she uses them for a few months?? I don't agree, I think there are meds better suited that would be more effective quicker without waiting for serum levels to build up.

Perhaps I just missed your point Dan? What is that your fear will happen, that she won't be able to report, adjust or change during the course of treatment over the next few months. AntiD's reduce substanc P in your spinal fluid, a potent neuru inflamatory agent,Using them in PM is an off label use, Using anti-siezure meds for neuro pain is an off label use, but these meds do work for problems that haven't been FDA aproved and have been the mainstay and only option in PM prior to the invention of OxyC just 10 years ago. Why is that she shouldn't use Paxil at the lowest dose made for a few months post op after opiates are discontinued?

I would hope the doc is making his selction based on patient experience and reporting and the good he has seen it do during that last phase of discontinuing opiates. Her alternative is???
Just curious, Dave