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Old 05-20-2006, 12:51 PM   #1
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Question Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hi all,

I haven't posted here in a while because I am going to try to come off of my medication and I have been getting advice over at the Addiction and Recovery board. The thing is, I have a dependance issue, not addiction, but I do want to try to get off of the meds I am on.

I am taking generic oxycodone two 5 mg 3 or 4 times a day with 500 mg Tylenol each dose. I am also taking 1 Soma and 1/2 to 1 mg Klonopin at night to sleep. This regime works pretty well for me except for 2 things. The "roller coaster" effect that goes with short-acting oxy plus the extreme daytime tiredness and fatigue which is my main reason for wanting to get off of these.

I told my PM doctor I wanted to try to get off of everything and this is what he wanted me to do: Switch the Soma for Skelaxin. Switch over to Ambien 10 mg for sleep instead of the Klonopin. Add Lyrica and try to replace the oxycodone with it.

Trouble is:
A. This would all shoot my med bill up by $100 a month (even though I have insurance now this is too much)
B. I have read bad side effects of Lyrica including daytime sleepiness.
C. I was only taking the Soma at night with 1/2 to 1 mg Klonopin. I stopped both the Soma and Klonopin and took 10 mg Ambien. Had trouble sleeping and went into w/d. No one ever told me the Soma was addictive, too.

I like Skelaxin for a muscle relaxer even though it is expensive, but I was mainly taking it with the Klonopin for sleep.

Someone suggested asking for Valium (which I used to take) to use for help in tapering down off of the Klonopin.

My goal was/is to get off of all of my meds and get a baseline idea of where my pain level is w/o the medication. (I know sometimes I am taking it to prevent w/d and not for pain).

If I do have to continue medication, I would probably go to longacting.

I had thought of asking to add a stimulant like Adderall or something because I cannot handle this daytime fatigue. Is anyone doing this and how does that work? I have to leave at 6:30 a.m. for work.

Any ideas/advice?
Thank you in advance.
wren

Last edited by wrenegade; 05-20-2006 at 12:52 PM.

 
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Old 05-20-2006, 08:50 PM   #2
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greeneyed girl HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Quote:
Originally Posted by wrenegade
Hi all,

I haven't posted here in a while because I am going to try to come off of my medication and I have been getting advice over at the Addiction and Recovery board. The thing is, I have a dependance issue, not addiction, but I do want to try to get off of the meds I am on.

I am taking generic oxycodone two 5 mg 3 or 4 times a day with 500 mg Tylenol each dose. I am also taking 1 Soma and 1/2 to 1 mg Klonopin at night to sleep. This regime works pretty well for me except for 2 things. The "roller coaster" effect that goes with short-acting oxy plus the extreme daytime tiredness and fatigue which is my main reason for wanting to get off of these.

I told my PM doctor I wanted to try to get off of everything and this is what he wanted me to do: Switch the Soma for Skelaxin. Switch over to Ambien 10 mg for sleep instead of the Klonopin. Add Lyrica and try to replace the oxycodone with it.

Trouble is:
A. This would all shoot my med bill up by $100 a month (even though I have insurance now this is too much)
B. I have read bad side effects of Lyrica including daytime sleepiness.
C. I was only taking the Soma at night with 1/2 to 1 mg Klonopin. I stopped both the Soma and Klonopin and took 10 mg Ambien. Had trouble sleeping and went into w/d. No one ever told me the Soma was addictive, too.

I like Skelaxin for a muscle relaxer even though it is expensive, but I was mainly taking it with the Klonopin for sleep.

Someone suggested asking for Valium (which I used to take) to use for help in tapering down off of the Klonopin.

My goal was/is to get off of all of my meds and get a baseline idea of where my pain level is w/o the medication. (I know sometimes I am taking it to prevent w/d and not for pain).

If I do have to continue medication, I would probably go to longacting.

I had thought of asking to add a stimulant like Adderall or something because I cannot handle this daytime fatigue. Is anyone doing this and how does that work? I have to leave at 6:30 a.m. for work.

Any ideas/advice?
Thank you in advance.
wren

 
Old 05-20-2006, 08:52 PM   #3
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greeneyed girl HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Try Provigil 100mg. Ask Your Doc. For It. It Has Really Helped Me.

 
Old 05-28-2006, 07:59 AM   #4
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wrenegade HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hi Greeneyed girl,

Thank you for your suggestion. I am feeling kind of discouraged today. I was thinking that I would be able to get off of all my medications, but I am now wondering if I'll be able to get off of any of them. Since school's been out (I started work as a teacher's aide last Dec.), I've tried to be more active, doing a little gardening, sitting more at the computer, and now I am in more pain.

Last Tuesday, my PM doc switched me to generic Percocet with just 325 tylenol. It does seem to last longer than the generic Oxy IR so that is good.

I feel like I should just quit fighting the fact that I do have pain, stop trying to get off the medication, go ahead and get on something longacting, and get some relief.

I am glad to know about the Provigil. I had heard of it, but never heard any personal experiences. Does it give you the "jitters" like amphetamines can? Do you have any trouble sleeping or do you take something for sleep, too?

Can you share what you take for pain and what kind of pain you have? If that's being too personal, don't feel obligated. Thanks again for your help.

wren

 
Old 05-28-2006, 08:39 AM   #5
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ARANGER HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hey Wren,

I guess the question you need to answer for yourself, is do you want to get of pain meds because you don't have pain that requires medication?? Or is it because of the current regime and being sleepy, but you have pain that requires medication??

I'm sorry, I don't know about your medical history. However, if you are taking pain meds for pain, there are many options out there that may be better for you.

You mentioned soma and addictive. I know many docs are saying this, but Soma actually causes no WD symptoms when stopped. I have stopped soma CT and never went into wd's.

Klonopin on the other hand can cause WD. In you case, a LA med may be the best route to go if you are taking these meds for pain. Maybe Oxycontin with Oxy IR for BT pain. You should notice a little more energy.

By swapping out the Ambien for Kolonopin, that should also help your daytime drwosiness. Kolonopin is a longer acting benzo. Where just regular ambien is short-acting and is not a benzo.

You're right about the Skelaxin, it is an expensive drug. But check with you doc, many of them have tons of samplees of that drug they will give out.

Hope everything works out for you. Take Care

 
Old 05-29-2006, 02:55 PM   #6
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wrenegade HB User
Talking Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hi Aranger!

Well, to answer the question you posed. . . last fall, my pain was very bad even with the medication, but I was "fighting" going to a LA because of my fears. You see, about 25 years ago I was a drug addict. However, my addiction was primarily psychological although at different times I did have some symptoms of w/d. My "drug of choice" was PCP, but I used a lot of barbs, qualudes, benzos, whatever I could basically get my hands on. During that time period, I was in an auto accident which left me with spondylolisthesis. I was prescribed Wygesic, Robaxin, and a brace. The PCP was a much more effective pain killer than the Wygesic (said wryly). When I got off of drugs, by the grace of God, I got off all medications, too. I didn't take any until a couple of years ago when the pain increased.

It has been a blessing to me to discover that I have been able to use these medications without abusing them, but there have been those fears in the back of my mind. I think I am finally about to lay them to rest and "allow" myself to get some decent pain relief.

But back to last fall, I had been working from home as a medical transcriptionist and all the sitting was killing my back. I was able to find a different job as a teacher's aide and started that in Dec. The work is perfect for my back~a variety of walking, sitting for short times if I need to, not much bending or lifting, etc. It is with Special Ed children, though, and leaves me totally drained at the end of the day (I had once been dxd with chronic fatigue syndrome), still, at this point, I think it is better than the physical pain.

The thing is. . . now that school is out, I have been trying to do some much-needed catching up on housework and enjoying gardening again and, OUCH! the back pain is back! My energy level seems better overall, but I am in pain again.

I think I have finally decided to go with the LA which my doctor is willing to do and next school year, if I need to add something like Provigil, I will ask him about that. I am ready to get over those fears of the past and make my life as comfortable as possible. I do still want to get off of the Klonopin and down to Ambien if possible, because I think the Klonopin sounds like a very strong and potentially dangerous drug. However, it has worked very well for me for sleep and I have not increased my dose in over a year.

Well, now you know my medical history (or some of it~probably more than you asked for ) If you have any additional thoughts or can tell me anything about the Provigil, I would like to hear. Oh, and if you know about what the OxyContin and/or the Provigil costs? I do have insurance, so that is a hugh help. I suspect he will start me off on the 10 mg? I hear it takes a bit to get adjusted? Are you on any meds?

All the best to you,
wren

 
Old 05-29-2006, 05:38 PM   #7
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ARANGER HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hey Wren,

I'm not sure about the cost of the Provigil, but OxyContin can be expensive. For the brand name. I pay about $25.00 with insurance but I have really good insurance. They of course now have generic OxyContin. Just be careful on which generic you get as there have been many reported problems.

If possible go wtih Watson generic OxyContin because Purdue Pharma (Makers of OxyContin), make it for Watson and they sell it as a generic. So you are getting the same drug. I use generic OxyContin from Dava Pharma and have had no problems with it. Endo, on the other hand were much bigger pills and seemed to get headaches more often.

Take Care

 
Old 05-30-2006, 07:30 AM   #8
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wrenegade HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hi Aranger,

Thank you for your reply. It was helpful indeed. $25.00 is managable. My insurance seems pretty good so far. It is Health Options through BC/BS. I hope its okay to mention that on the boards. Thank you for the heads up on the different generics. I was taking the Mallik??(sp?) generic OxyIR and when he switched me to the generic Percocet by Watson, I seemed to notice an improvement.

In your other post you said: "In your case, a LA med may be the best route to go if you are taking these meds for pain. Maybe Oxycontin with Oxy IR for BT pain. You should notice a little more energy." I'm not sure I understand why I would notice more energy. Is it because of the steady relief (getting off the "roller coaster") or because of reduced stress with better pain relief? Maybe that is redundant. . . or is there another reason?

Thanks for your help again. I am stabilized on the Klonopin at .5 mg a night. I will try to start tapering by 1/4 of a tablet soon.

Take care,
wren

 
Old 05-30-2006, 12:52 PM   #9
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ARANGER HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

You're right about the Mallinkrodt generics. They have a a bad rap. Many people report problems with them. If you can get generic Watson OxyContin then you are getting the same stuff from Purdue.

As far as tiredness, Klonopin and Soma can cause some pretty decent drowsiness. By getting rid of these meds, you should notice a difference. The other thing is, Oxycodone is pro drug. It has more of a stimulating effect than other opiates like Morphine or Codeine.

Also by being on a LA form of Oxycodone, you should be achieving a more sustained stream of the drug. Where Percocet is going to spike within about 2 hours and then start to drop off. You may feel the effects of this causing your body to go through some changes (drowsy, tired).

I take OxyContin and am fine throughout the day. I generally have plenty of energy for my conditions. Of course I also have fibromyalgia which causes fatigue, but I blame the fatigue more on the fibro than on the Oxy.

Good luck with the taper. Take Care

 
Old 05-31-2006, 12:17 PM   #10
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wrenegade HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Thanks again for the information. I took only 3/4 of a pill (1/2 plus 1/4) last night of the Klonopin. I didn't fall asleep quite as fast, but I didn't take more and I am not going to. I will continue with the 3/4 dose until I feel I can cut off another 1/4. I am not rushing this at all.

I believe you are right about having more energy once I get off of the Soma and Klonopin. I am starting with the Klonopin. Then, I will get off the Soma. I will save my pennies and get the Skelaxin. I don't have muscle spasms too often. I had used the Skelaxin before and it worked great w/o feeling sleepy. One rx should last me a long time.

Also, tomorrow I have an appointment to see my PM doctor about going on the LA. I hope he doesn't think I am crazy because when I was in a couple of weeks ago, I told him I was going to try to get off all my medication. But I realize now that won't work. With increased activity came increased pain. I think he will understand as he suggested the LA in the past, but I balked at the time.

Hope your day is going well. I am sorry you have fibromyalgia. I know a couple of people who have that and they are in a lot of pain. I hope you get some relief from your meds.

wren

 
Old 06-12-2006, 08:27 PM   #11
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Stress2006 HB User
Re: Daytime Sleepiness/Pain Control/Getting off meds (to do or not to do). . .

Hello,

I'm new here myself and read your post where you mentioned about adderall. I was having a huge problem with falling asleep because of all the meds. I heard about taking adderall and asked the dr if we could try it to see if it helps and it helped a lot. It made a very big difference but keep in mind some dr are not willing to give the ok for this.

Try explaining that you have a freind or family etc on similar meds and their doctor tried this adderall idea. I'm on 40 in the morning and 30 at night.

Remember everyones body is diffferent....


Wish you the best,
Jon

 
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