Starting New Meds (No wonder!!) - Pain Management Message Board

Leo123 · 07-16-2009, 12:16 PM

From writing on one of my other threads yesterday and from some feedback given to me by various people here.

How is it possible to try a new med for example like say you were taking MS contin and it's not working so well for you lately, so the Doctor say lets try switching you to Opana ER or even IR.

When you first start to take the Opana you are going to be feeling the withdrawl effects from not taking to MS contin anymore and you won't really know if it working or not. Actually you feel like it's not working and that Opana is worthless.

When instead you need to someway Titrate downward your MS Contin dosage while trying the Opana, so you can stop any withdrawl symptoms from the MS Contin and see if the Opana really works.

It's so funny I hear it all the time when anyone switches medication they usually are not to happy and also complain of withdrawl type feeling, unless they are switching to some mega high dosage of some Fetanyl with dilaudid B/T etc..

My history is that I took Oxycontin for a couple of years (went through bad withdrawl's), then stopped all LT pain meds execpt for Norco/Vicodin.Then about a couple of years later had to go back on Pain management (My foor pain started becoming more than I could handle)
When i went back to PM, I asked the Dr. to put me back on Oxy he insisted on trying MS contin first, when i told him I know the Oxy it works for me because of my past history with it. Anyways So I took the MS contin and actually it seemed to work ok for me, definitley not anywhere near as good as I remember the Oxycontin working for me.
After a couple of years on MS Contin my foot condition became beyond bad and I needed more and more MS contin and we were having troubles finding a dosing that worked good for me, so he tried me back on the Oxy 80mg 4X a day. When I first got the script I was thrilled and sure I was going to get the pain releif I needed. Well to my surprise I was taking the Oxy and it actually felt like I was in withdrawl and very little pain releif. I ended taking up to 8 of 80mg a day and after a couple of week I had to go back to the dock and tell him the Oxy just does not seem to be working that well for me and I was getting much more pain releif from the MS Contin.

Needless to say I was shocked and I just couldn't beleive that the Oxy did not work and MS contin was actually better. I took it before it really worked then. Also ask ten people if they prefer Oxy or MS and 9 out of ten will say Oxy.

Now because of a post yesterday I realized that the reason it did not work and I actually felt bad was because I was in withdrawl from the MS Contin. No matter how much Oxy I was going to take it wasn't going to help, which is exactly what happened. (I may have even taken 10 of 80mg on one of days and still no releif and again I felt not right, like I was withdrawling but not)

Which again is big shock to me and it also means that no wonder PM docs have so much difficulty in switching someone medication. It's just obvious by this board that most people who switch to something else after they have been taking a particular drug for a while seem to be unhappy with the new drug.

So sorry for the long>>>>>>>>>story and post. But what do you guys think about this?

Leo123 · 07-16-2009, 04:13 PM

Nobody thinks there is anything to this. It has me blown away, especially reading all the stories about how people who switch other meds find the change so negative when in fact they may be getting something better, if only the doc would treat the withdrawl of the old drug that you are stoping.

So if you are going from MS contin to Opana, And you were taking high doses of the MS contin, then doc would for examplt still give a few 15mg ms contin along with the opana and then you could see better how the Opana works, since it would be getting masked by the withdrawl of the MS contin.

Does anyone think I;m crazy

, cause I think I'm on to something big

Weezi · 07-16-2009, 04:45 PM

From what I understand, anytime a doctor is going to start a patient on something new it's going to be at a lower dose because they don't know how the patient will react. I believe that Shoreline or Brian had pointed out on another thread that you will have to go through a rough patch when you start a new med. After all, most of us had to cope with no pain relief in the beginning so if we could cope with that than we should be able to deal with a little discomfort in changing to a new med. It's worth it if the end result is better pain control. Also, the doctors have to be careful with what they prescribe their patients since everything is monitored. Hope this helps;0)
weezi

Jema X · 07-16-2009, 09:55 PM

I have to say that unfortunately I don't subscribe to your theory - simply because if you're swapped to an equivalent dosing of the new med, you shouldn't get withdrawal symptoms.

I can't take morphine and oxy works really well for me. However when I've been given equivalent doses of other meds, I haven't had a problem - except that they didn't work for me as well as OC. When I've swapped back to OC, I've been fine.

That said, in hospital they use my regular doses of OC along with Fentanyl added in, so no chance of wd there.

If you were taking 4 OC 80mg tablets a day then that's equivalent to 160mg of Morphine. Perhaps morphine just works better for you. There is certainly an adjustment period that you have to go through but WDs shouldn't be a part of it if you've been given an equivalent dose of morphine or OC. OC is a metabolite of morphine also so there shouldn't be withdrawals between the two, again, provided that the doses correspond (you need approximately 50% - 100% more morphine to equal OC).

Sorry to disagree, just my experience.

Jema X · 07-16-2009, 10:00 PM

Just a quick question, have you ever discussed with your PM whether or not you may be one of the rare people that suffer hyperalgesia. It's just that if you took 10 80mg OC (800mgs in one day) and still experienced pain, that's pretty amazing. You may not suffer 'hyperalgesia' as such but trials are finding that really high doses of meds in some people actually cause pain - this is because the receptors are so suppressed by the huge amount of pain relief that that the pain response in your body actually starts to fire like crazy - in case you hurt yourself and don't realise because you're taking so much pain med. It's kind of like a safety mechanism. It's pretty contraversial but has seen to be pretty common in patients taking more than 400mgs OC in a day. The theory is that your body 'needs' to be able to tell you that you're experiencing pain and if the pain meds supress this too much, your brain starts to fire off pain signals. It's just a thought. Might be something to think about.

I feel for you because you must have suffered terrible wds after coming off that much OC and it sucks that it didn't work for you. All that wd for nothing.