Hi guys, I'm just wondering if there r others here who experience mood swings on oxycontin? I get really irritable and interestingly enough, it tend to happen most often about an hour or two after I take my late afternoon tablet. I can get quite snappy & that isn't really like me.
What can u do to dampen these reactions & why is it likely to happen AFTER taking meds rather than before? (Although I can get irritated then too). This does coincide with my pain levels increasing at that time of the day, so I often wonder if that's the cause. I find propanalol helps but it's no cure for the snaps! I guess we can't be sweetness & light all the time but it does upset me...and those around me
I would bet that the mood swings are due to the pain and not the medication although the medication can make you depressed which can lead to mood swings. If you are not on an anti-depressant I would seriously consider one. There are many CP people that need to be on one or more of them for this specific reason. I know that there are quite a few people on these boards that benefit from Cymbalta which helps pain as well as depression. It might be something to consider and I would definitely tell your doctor about it. If you are on an anti-depressant then it could be time for an adjustment or change. Let us know
Yes, Juliet....What you are experiencing is fairly normal. For those of us on pain meds, our BPL (Blood Plasma Level) is always rising or falling, which invariably can cause mood swings. At the very least, one's rising and falling BPL will impact on how we feel (pain). LA meds attempt to stabilize one's BPL, but in reality, it still rises and falls a bit...Not nearly as much as SA meds, however.
Just the chemical fluctuations themselves are enough to cause issues, not to mention the variation in pain. Factor them both into the equation, and it wouldn't be normal is one's mood didn't change.
Ever notice that most PM offices have lots of pamphlets and literature for depression? This is because narcotics suppress one's natural endorphin levels. This happens very gradually and slowly, and the changes are usually noticed by others before you notice them yourself.
You may recall conversations on this board in the past about constipation & other bodily functions & etc....Pain meds effect the Pit. gland, which effects almost all bodily functions. The meds "depress" the Pit gland which then depresses bodily functions....Slows down heart rate, digestion, metabolism, endorphins....And many others functions.
In a few patients, pain meds have a "paradoxical" effect, or opposite effect, where they create euphoria and speed things up....This is what makes them addicting to a small percentage of people. Paradoxical effect means "like creates or treats like"......For example, giving amphetamines to ADHD patients. For some unknown reason, amphetamines "depress" a hyper active person....The medical community still does not know exactly why, but that's for another conversation.
So....In summary, Pain meds cause all sorts of side effects, which invariably causes the issues you describe. Personally, I just try to deal with it as best I can, and have learned how my body reacts....Triggers and etc. And most importantly, since I have learned how my body reacts & etc. I try to schedule things around my meds, or make sure I have enough meds for whatever I'm trying to do. By avoiding certain things, or activiites, or conditions, I have improved things quite a bit for myself. It took me a while, however, to learn this concept, and even longer to come to grips with it. But, I have accepted it, and my life is much better now.
Best of luck to you, and I hope some of this helps.
Thanks Ex and Brian, without doubt you are both right. I tried to get my gp to agree to a 4 x dosing schedule rather than a 3 x (by splitting 60mgs into 4 rather than 3 - no overall increase) but he wasn't keen. I'm going to chat to my pm about it though. They're both wonderful but my gp is conservative, probably better that way, I guess.
Brian, I'm not taking an anti-d anymore. I used to take endep (elavil) but the weight gain (and my fear of it) was greater than the sleeping/mood stabilising benefits. Very silly, I know but I used to be a ballet dancer and I just can't take it. My gp has said to ask my pm about cymbalta, just released here but to be honest, it hasn't performed so well in clinical trials for depression, better for pain management. I'm also fearful because I don't tolerate many anti ds, mainly ssri's - they give me terrible anxiety and nausea.I desperately need something to give me more energy during the day - but without anxiety. There is nothing to be lost in trying it though and it's not an ssri. Thanks as always, Brian, I appreciate it.
Ex, you may be best placed to help me with this as I think we have similar knowledge, though mine relates more to mechanics than application, I think. As I said above, I have little energy during the day, when my pain is less but once about 4pm comes around my pain goes up and so does general anxiety, and a couple of hours later energy. I find that my hands and toes move constantly and I'm hypervigilant. My ability to concentrate is low but clarity of thinking is high. They feel like adhd symptoms but I'm not sure because my nerve pain is 'shock' type pain which keeps me on edge. It is frustrating because I can't utilise any of this energy and it drives those around me mad. Elavil helps but then I'm just dopey all the time. Do these symptoms ring any bells with you, or anyone else? I can take benzo's, I use xanax to help me sleep (valium and temazepam don't work at all. I am also extremely allergic to phenothiazines - stemetil, maxalon, largactil etc. Wow, talk about an essay, am just getting frustrated with blank stares from my pm.
Juliet - I just wanted to post a reply to your concerns about Cymbalta. I have had terrible reactions and side effects to almost every anti-d I have ever tried. I finally gave up and tried to learn to deal with the depression. However, it got so bad that my family begged me to try again. I had seen the commercials for Cymbalta and asked my doctor about it.
I am soooooo glad that I did. Not only did it dramatically improve my depression symptoms and helped to decrease the mood swings that I suffered from either the pain meds or the pain, it also helped my nerve pain.
I highly suggest at least trying this medication. It has given me back a part of myself that I really thought was gone forever. The worst that can happen is that you try it and find you can't tolerate it. In the best case, you'll be like me and have these wonderful results.
Thank you, Liz, I appreciate that. I've just been doing some clinical reserch & it seems that cymbalta may not have a great profile for depression, BUT when used in combination with other meds in cp patients, it's brilliant. I am going to try it.
May I ask if it helped you with energy during the day? Did you suffer any insomnia? And the big one, have you noticed any weight gain? Please only respond if you are comfortable answering. Thanks again Liz...
Oh, and thanks for telling me about the nerve pain benefits - that's what makes these boards so wonderful. Juliet
Ex, you may be best placed to help me with this as I think we have similar knowledge, though mine relates more to mechanics than application, I think. As I said above, I have little energy during the day, when my pain is less but once about 4pm comes around my pain goes up and so does general anxiety, and a couple of hours later energy.
When this happens around 4pm, what time have you last taken your med(s)? Also, what is your dosing schedule?
Juliet - I am glad you're going to try it. I hadn't heard about it not being a good med for depression. Like I said, for me it was almost a miracle.
As far as increased energy, once my depression lifted I found I had much more energy. I am not sure if that's a "side effect" of the med or if it was just coming out of such a black depression.
I have not gained any weight on it at all. I don't know about other folks, but I have had almost no side effects. The first week I was on it, I had a slight headache, so my doc suggested that I take it at night. That way I didn't notice the headache and I didn't suffer any insomnia at all.
I really hope you had the same results that I did. I suffered from depression long before I suffered with chronic pain and the pain, of course only made it worse. I had really almost given up on ever feeling "normal" again.
Take care and keep me posted on how it goes. Feel free to PM me if you like.
I was on Cymbalta along with Lyrica about a year ago. I was only on the Cymbalta for about 2 months and I had horrible insomina that last month which made me stop taking it. I literally did not sleep for 4 days. It was horrible. I tried taking it in the morning and at night, and I still had trouble sleeping. But there are plenty of people here who have taken this drug and have never had a problem sleeping. I never gained any weight with this either.
My advice to you is to give it a shot. It might just help you and you'll never know unless you try it.
. Thanks again Ex, you offer a great deal to these boards.
Liz, you've definitely sold me. I've left a msg with my pm and hopefully he'll get back to me soon. I don't really suffer from much 'depression', it's more frustration and tiredness and anxiety. That said I have no doubt that depression is in there somewhere and I could certainly benefit from something mood lifting, the cloudy feeling sounds a lot like what you experienced. I'm actually looking forward to trying it now. I'll let you know for sure.
Hey 10sox, how are you? The most likely adverse side effect for me is aggitation or insomnia too. My biggest fear though is akasthesia which is like terrible aggitation that is drug induced. I will just have to try it and rely on the drs if I do have an allergic reaction. Thank you, all feedback is good feedback
Last edited by Jema X; 03-14-2009 at 01:00 PM.
Reason: too much information :)
If you take you afternoon dose around 2PM and then it starts to happen and hour or two later....Then, it's probably related to the OC....For whatever reason, it's your body's reaction to the chemical. It's certainly not mini WD, or anything like that.
Exactly, well, how exactly can one know oneself. Basically, as a cp patient, I am different from the person I was before and it bothers me - and if it's medication or mood related, I'd like to be able to treat it. During the day, whilst my pain sits around 5/10 (from 9am till about 2pm), I feel ok but I'm tired and lethargic. Then at about 4pm or so (and it does correlate with pain I think), I become edgy and irritated, the smallest thing can set me off. I find it difficult to sit still and this yucky energy usually lasts untill about 10pm...which is when I feel quite clear minded even though my pain is bad. I have double the energy at 10pm than at 10am, it drives me bonkers. I just can't quite see how it's oxy related though I can get aggitated at the start or end of dosing schedule - I think I'm quite sensitive to plasma changes.
This must sound like I'm whinging about nothing but it really upsets me that I'm no longer even tempered. I've always leaned toward anxiety but not like this. Hope this helps, Ex, it doesn't sound very 'exact' or concise thanks
I went back to look at your dosing schedule, but it was gone....I understand why you edited it out....I'm trying to piece it all together....I think I remember the majority of it.
What's probably happening is that your plasma levels are building all day...By taking the different meds at the different dosing times. Some of your dosing schedules overlap, so that is why the plasma level is building. By late in the day, you've taken a bunch of meds, so your levels are at their highest and this is probably why you have so much energy.
Conversely, when you sleep, your levels fall, and this is probably why you feel so sluggish, or "tired and lethargic" early part of the next day. Do you take your meds upon waking? Most people do. Again, I can't remember the exact schedule. I wanted to make sure I had all your information before I commented....Describing exactly how you feel when issues are going on is key.
Your late in the day issue (4pm) is normal for many...Not just those on meds. Could be your falling insulin levels. I tend to get a second wind after dinner, for example. Your early after noon dose could be affecting you as well....In terms of a bit of "up and down" and that's why you feel edge late afternoon.
If you feel more comfortable, PM me and we can discuss there.
Thanks Ex, I will. I take oxy @ 6am, 2pm, 10pm. I tend to go back to sleep for a few hours after the 6am dose because the pain dulls again...and otherwise I only get 3 or 4 hours sleep. I'll pm you, thanks very much. You may be right about insulin levels too, now that I think back on it, I used to suffer terribly in the afternoon when I was ballet dancing. Definitely worthexploring.
Not sur about coffee and pain - I do know that if I take my oxy with a cup of coffee, it speeds up the first release - a good and bad thing. I find that coffee is a lifesaver in the mornings when I'm dopey.. It does cause washout toward the end of dosing schedule though, I guess this could be what is meant by increasing pain. I think a lot depends on your own metabolism. What are your experiences?
I take caffeine in the AM, for the exact same reason as you. Honestly, I don't think it has much of an impact on pain or meds. It will "perk" one up a bit for the obvious reasons, but I don't think it's a game changer re: pain meds or our pain overall.
What time do you go to bed? If it's much past 10pm, that may explain why you have trouble sleeping....Not enough BPL to get you through the night....Coupled with the pain. I take my NT dose right when I go to bed. I find it helps me sleep better and, I have less episodes of pain overall.
Also, pain meds supress the pit gland, which regulates hormone production. I would think about going to your GP and getting blood work done to measure your estrogen, testosterone and others. People don't equate T with women...Only men....But the fact is that women make it too...Just not as much as men. Low T can cause all sorts of mood issues, depression, sleep problems and etc. Same with estrogen. This could also be part of your problem. CP people often talk about digestion being slowed (constipation), but the fact is that narcotics slow just about everything, including metabolism and hormone production.
Sufficent bt meds are hard to come by in australia. I usually take 5mgs IR oxy around 6pm or so in order to cook dinner, sometimes earlier in the afternoon if my pain spikes and I have things to do. I take my last dose of oxy at 10pm and that's when I go to bed, it usually wakes a couple of hours before I can get to sleep - considering what you are saying, it would probably be beneficial for me to use bt meds at this time to cover me until the oxy kicks in? Unfortunately I'm only supplied with enough for once a day. I do take neurontin at night which should stabilise things somewhat? Pain management is very complicated!
My hormone levels are all ok, I have had them tested recently. I had a liver tumour removed last year that was caused by the pill - I am clearly very oestrogen sensitive. The resection would have definitely upset hormone balance etc for quite a while but should surely be back to normal now. The observation you made about cp patients and morning lethargy made sense to me and perhaps is just an unfortunate truth that I'll have to deal with. I am hoping that something like cymbalta might help.
May I ask how and when you believe bt meds should be used? Pm in australia greatly limits the use of bt meds but is more reasonable with the use of meds such as oxycontin because of its safety profile. There are CPers on the boards here who are given 60+ bt meds a month - I am lucky to be written 30, 20 is considered th monthly maximum and the most that can be written at one time without an authority. Thanks again. Juliet
well.. when i wake up in the morning, because of my back and knee, i take oxycontin 40 everyday or when pain persists. Now, when it comes to drinking caffiene (coffee) in the morning, it helps me go #2 alot better, without consipating.. if u know what i mean. i never had bad experience with it with taking my pill.. That is why i wanted to ask . thanks for ur response.