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Old 10-31-2007, 04:12 PM   #1
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Question Managing the Depression from pain/meds

I don't know whether to post in here or not. I thought that I would go ahead since a lot of you know my story. Also, most chronic pain patients deal with depression in one level or another.

I am having a very hard time cutting down on my Ultram. The depression that has hit dropping it down to 1 1/2 pills/day from 2 has been bad. Of course it could be the fact that I am dropping it down too fast. However, I have depression and probably need to be on anti-depressant. I believe that I have reached the point of needing one becauase I can't stand to drop the Ultram anymore.

My question is what has anyone done to manage the depression? Any natural alternatives like MSM or 5-htp that have helped. I just hate to have to add another prescription drug to the mix.

Brian

 
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Old 10-31-2007, 04:20 PM   #2
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Re: Managing the Depression from pain/meds

Its script but it helps a lil w/ pain, cymbalta has done wonders for my mood too,
might be worth looking at,

Strive to live in a peacfull way, Capn

 
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Old 10-31-2007, 04:23 PM   #3
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Re: Managing the Depression from pain/meds

I agree. If I had known Cymbalta would help me as much as it has, I would have tried it MUCH sooner! It has also helped my pain, which is a definite plus. I would ask your doctor ASAP if you can give it a try. I pray it's the answer you're looking for!

Amanda

 
Old 11-01-2007, 07:09 AM   #4
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Re: Managing the Depression from pain/meds

Just curious but if you still have pain why would you be dropping your pain medicines? Cymabalta will not make the pain go away? And you said 2 Ultrams what mg were you taking? I went cold turkey when I got pregnant since Ultram is not allowed without a problem and have even tried a day here and a day there using as low a dose as possible and have not had a problem. I do hear great things about Cymbalta however my PM told me not to use it with the high doses of ultram i take.

 
Old 11-01-2007, 09:21 AM   #5
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Re: Managing the Depression from pain/meds

Quote:
Originally Posted by Backinthesaddle View Post
Just curious but if you still have pain why would you be dropping your pain medicines? Cymabalta will not make the pain go away? And you said 2 Ultrams what mg were you taking? I went cold turkey when I got pregnant since Ultram is not allowed without a problem and have even tried a day here and a day there using as low a dose as possible and have not had a problem. I do hear great things about Cymbalta however my PM told me not to use it with the high doses of ultram i take.
Cymbalta is indicated for both depression and neuropathic pain. It can and does help a great deal with some folks' pain. It is in many ways very similar to Ultram except that it does not have an affinity for the mu (opioid) receptor.

One reason that some docs don't like to rx Cymbalta and Ultram together is that both inhibit the reuptake of serotonin, making it possible for the patient to suffer serotonin syndrome, and to prevent potential seizures.

steve

 
Old 11-01-2007, 04:00 PM   #6
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Re: Managing the Depression from pain/meds

Backinsaddle:
I have been taking Ultram since May 2006 and was up to 400mg/day. I am currently taking 100mg/day. The reason that I am trying to get off the Ultram is that I do not like the way it makes me feel. I do not function on it very well at all. When I started on the patch the deal was that I would work myself off of the Ultram. I started around Sept 1 taking 8/day and now down to 2/day. I have done quite well and am proud of that accomplishment. I phoned by psych and told her that I need an anti-depressant in order to get off of the Ultram. I do have underlying depression/bipolar and the depression was completely gone when I was on the high dose of Ultram. I do not want to stay on the Ultram for the anti-depressant effects.

As for the Cymbalta, I was taking that and up to 60mg. However, I could not tolerate the side effects that it was giving me. I was having uncontrollable rage, irritability, increased depression, suicidal thoughts. My girlfriend said either get off the Cymbalta or she was leaving. I have been clear of the Cymbalta for about a month and a half. I started titrating down the Ultram as soon as I was nearly off the Cymbalta. I may be trying to do too much. I am considering some natural alternatives such as MSM or SamE. I was just wondering if anyone had tried those alternatives or if anyone was on anti-depressants besides the Cymbalta. I did go back up on the Ultram to 2/day instead of the 1 1/2 that I had dropped it down to. I just need help to get off the Ultram without suffering nearly incapacitating depression.

Brian

 
Old 11-01-2007, 05:27 PM   #7
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Re: Managing the Depression from pain/meds

hi..yep, I'm on something different. Wellbutrin, sometimes a xanax or two when I "peak" and I take Ultram twice a day. I have no complaints about the way I feel. I'm not suicidal anymore...that REALLY scared me.... I have no problem taking any of it. Sometimes I take a lortab too, if the pain is really bad. My dr. doesn't really want me to take more Ultram than I am, but don't know if it's cause I'm taking Ultram or not.

 
Old 11-01-2007, 06:13 PM   #8
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Re: Managing the Depression from pain/meds

Brian...All I can offer is a prayer for you--- since you and I have another kind of history we share, I KNOW how you feel about getting tangled up with meds to get thru a day!!!

I also take back all that praise I gave my PCP since the recent SNAFU he and our drugist pulled on me!!
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Old 11-01-2007, 06:40 PM   #9
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Wink Re: Managing the Depression from pain/meds

Thank you chiapatchie. I definitely realize that I can not stay on the Ultram for the "anti-depressant" feel good effect. With our histories you know how much trouble that can get us into. I am being careful though and getting input from my psychiatrist and well as my PCP and monitoring by my girlfriend.

Brian

 
Old 11-02-2007, 03:31 PM   #10
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Re: Managing the Depression from pain/meds

Quote:
Originally Posted by chiapatchie View Post
Steve...Hope you're doing well!...

QUESTION: WHAT IS SEROTONIN SYNDROME??? The way my mind doesn't seem to want to work half the time, I've often wondered why or what causes me to forget words when I'm trying to have a conversation with someone. I tried to ask my shrink...but, he always just fluffed me off!
I also suffer with awful PANIC ATTACKS and take XANAX when one of those suckers hits me like a ton of bricks. He swore I liked them because they "worked just like drinking a can of beer!" And, HE was the HEAD for the drug/alcohol program!?! I often told him if he needed a little clarification between DRINKING and-or PANIC ATTACKS, I had a wealth of info for him whenever he needed it on those two subjects!!
I'm doing real well today, thanks!

"Serotonin Syndrome - Serotonin syndrome is caused by increased serotonin in the central nervous system. Serotonin syndrome encompasses a wide range of clinical findings. Mild symptoms may only consist of tachycardia, and shivering, diaphoresis, mydriasis, intermittent tremor or myoclonus, as well as overactive or overresponsive reflexes. There is no antidote to the condition itself, and management involves the removal of the precipitating drugs, the initiation of supportive care, the control of agitation, the administration of serotonin antagonists (cyproheptadine or methysergide), the control of autonomic instability, and the control of hyperthermia."

Take my experience for example. I was taking Celexa, an SSRI, or selective serotonin reuptake inhibitor, similar to Paxil, Prozac, Serzone, etc. These drugs prevent too much serotonin from leaving our systems. I was also taking Ultram, which also is a mild serotonin reuptake inhibitor, among other things. I also too Methadone, which can serve to retain serotonin in our systems. Then my doc prescribed Imitrex for migraines. My pharmacy said red alerts came up from the computer at this combo of drugs because of the potential for serotonin syndrome. My doc stopped the Celexa and we switched to Cymbalts which is less of a serotonin reuptake inhibitor. All is well and I'm glad my pharmacist was looking out for me.

Hope this helps.

steve

Last edited by forginon; 11-02-2007 at 03:33 PM.

 
Old 11-02-2007, 05:06 PM   #11
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Re: Managing the Depression from pain/meds

Brian, why do you have to cut back on your Ultram? If it is working for you won't your doctors let you keep taking it? Another antidepressant is Wellbutrin XR. I take 300 mgs. a day and 2 Ultram 50mg. You really have been struggling with cutting it down to 1 1/2 a day. Are they 50mg.?

Please keep us posted about your depression. That can be just as bad as the pain at times! Good luck!

Linda

 
Old 11-02-2007, 05:18 PM   #12
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Unhappy Re: Managing the Depression from pain/meds

I have an update for all of you.
I got a call back from my psych. and she is going to start me out on a low dose of Prozac ($4 generic at Giant Eagle
The reasons why I am trying to get off the Ultram are:
One, I hate the way it makes me feel like I am "high" at times and really slowed down. Two, I did a drug interaction checker online and it said the Fentanyl patch and the Ultram are a Major drug interaction. So I really have been trying to get off of it since I started on the patch (around Sept 1). I was down to 3/day and increased the patch which caused my to really experience a "high" and that is really not good considering that I am a recovering addict. I was honest and told my doctor about what happened and he is trying to get me off of it. I did do the stupid thing and just stopped it after taking 3/day which was an incredibly stupid thing to do. I have been treated for underlying Major Depression even before I had chronic pain. Therefore I need help to get off of the Ultram and not end up in a Major Depression and possibly getting suicidal thinking again. I am still holding some hope and taking it day by day, sometimes minute by minute. Thank you for all of you here that do care and have been showing support. I will keep everyone posted on my progress. Maybe what I am going through will help and encourage someone else. Take care.

Brian

 
Old 11-03-2007, 07:58 AM   #13
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Re: Managing the Depression from pain/meds

Thank you Brian for clarifying your reasons. Makes great sense to me that you would need to ween off Ultram. Have you never been on the slow release kind? I also had that high feeling when I took the ultram regulars, baclafen and Lyrica I felt I was flying high. It took some getting used to. I am a dispatcher and not a good feeling to be on that high. I did noticed that when I went to the slow release ones at least during the day I did not have that high feeling. I did however have to try and keep myself awake on the way home as I was so tired I could fall asleep right there.

Good luck with your new regiem and hope it works well for you.

 
Old 11-06-2007, 12:25 PM   #14
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Re: Managing the Depression from pain/meds

Quote:
Originally Posted by brianpain33 View Post
I have an update for all of you.
I got a call back from my psych. and she is going to start me out on a low dose of Prozac ($4 generic at Giant Eagle
The reasons why I am trying to get off the Ultram are:
One, I hate the way it makes me feel like I am "high" at times and really slowed down. Two, I did a drug interaction checker online and it said the Fentanyl patch and the Ultram are a Major drug interaction. So I really have been trying to get off of it since I started on the patch (around Sept 1). I was down to 3/day and increased the patch which caused my to really experience a "high" and that is really not good considering that I am a recovering addict. I was honest and told my doctor about what happened and he is trying to get me off of it. I did do the stupid thing and just stopped it after taking 3/day which was an incredibly stupid thing to do. I have been treated for underlying Major Depression even before I had chronic pain. Therefore I need help to get off of the Ultram and not end up in a Major Depression and possibly getting suicidal thinking again. I am still holding some hope and taking it day by day, sometimes minute by minute. Thank you for all of you here that do care and have been showing support. I will keep everyone posted on my progress. Maybe what I am going through will help and encourage someone else. Take care.
Brian
Hi Brian....Sometimes a MINUTE is about all any of us can handle, dear Friend...and, that's OK. All of us, I think, frequently find ourselves in that position more often than we want. NEVER GIVE UP YOUR HOPE!! HOPE sustains us and often is THE ONLY REASON we continue to move FORWARD.

My friend...You have stated that you are a "recovering addict" several times in your posts or threads. I've been "sober" for about 15years now (RECOVERED alcoholic), and, even though I am always aware of that fact, I do not continally walk around identifying myself as if THAT is the ONLY IDENTITY I HAVE!! I am much, much more than that!! I do not feel the need to do that TO MYSELF...my HOPE is that you will realize that YOU GOT SOBER USING YOUR OWN STRENGTH...nobody could have done that but YOU!! Be very proud of that FACTUAL TRUTH!! OK?? You are BRIAN...the man who decided to change his life and lifestyle!!

I deeply admire you and your strengths, Brian!!

Always your FRIEND (recovered alcoholic!!)
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Hugs...and, take care!
Ginny

 
Old 11-06-2007, 12:51 PM   #15
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Re: Managing the Depression from pain/meds

well said, chiapatchie....from one who knows!

 
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