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Neurology (Expert Forum)
Counteracting "drugged" effect of pain meds
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Counteracting "drugged" effect of pain meds
by Sarah__0__0, Dec 29, 1998 12:00AM
Dear Doctors:
Our family is wondering if there is anything that might help our sister, whose life has virtually become destroyed by what has been diagnosed as "ideopathic small fiber neuropathy," after extensive tests at a major center for peripheral nerurolgy.
Medications that seem to help at lest some with the pain leave her too "groggy" and "drugged" to work (she is a Ph D-researcher, and relies heaviliy on her mind to work). We have tried all kinds of combinations of different drugs, in virtually every class of drugs, at different dossages, and can get some pain relief--but nothing that works on the pain, leaves her mentally OK to work. She has tried doing nothing for the pain, in order to try to be mentally alert enough to work, but then the pain itself is overwhelmingly "distracting."
I am wondering if neurologists have tried a combination of stimulants with any of the drugs that work on PN pain? This combination made the life of a friend of mine with cancer quite "workable."
We could find nothing of use on the topic of stimulants-with-analgesics in peripheral neuropathy searching Medline, but wondered if you might have had some practical experience.
Thank you for your wonderful forum--I wish we could come to Cleveland (and we are saving our money to do so; may next year)
=========
Hi Sarah,
thank you for your question. It is a good and an important one.
You are correct in that many of the drugs we use to treat pain/neuropathy have sedating side effects. I have not however run into problem using these medications. The key is to start low and to increase slow.
Can you tell me what meds she is on and how much ?
This will give me an idea of how sensitive your sister is to these meds.
i.e. if she is on a highdose of an extremely sedating drug then it'll need to be adjusted, vs if she were on a low dose and not too sedating meds.
I have used a combo of an activating and sedating drug in the past but have had more problems than success. In addition, these activating drugs have high potential for abuse. There are conventional drugs (for pain and neuropathy) that have some activating effects such as Vivactil (a class of TCA), and Effexor (an antidepressant).
Good luck and Ihope this helps. We look forward to your visit to our clinic.
Our family is wondering if there is anything that might help our sister, whose life has virtually become destroyed by what has been diagnosed as "ideopathic small fiber neuropathy," after extensive tests at a major center for peripheral nerurolgy.
Medications that seem to help at lest some with the pain leave her too "groggy" and "drugged" to work (she is a Ph D-researcher, and relies heaviliy on her mind to work). We have tried all kinds of combinations of different drugs, in virtually every class of drugs, at different dossages, and can get some pain relief--but nothing that works on the pain, leaves her mentally OK to work. She has tried doing nothing for the pain, in order to try to be mentally alert enough to work, but then the pain itself is overwhelmingly "distracting."
I am wondering if neurologists have tried a combination of stimulants with any of the drugs that work on PN pain? This combination made the life of a friend of mine with cancer quite "workable."
We could find nothing of use on the topic of stimulants-with-analgesics in peripheral neuropathy searching Medline, but wondered if you might have had some practical experience.
Thank you for your wonderful forum--I wish we could come to Cleveland (and we are saving our money to do so; may next year)
=========
Hi Sarah,
thank you for your question. It is a good and an important one.
You are correct in that many of the drugs we use to treat pain/neuropathy have sedating side effects. I have not however run into problem using these medications. The key is to start low and to increase slow.
Can you tell me what meds she is on and how much ?
This will give me an idea of how sensitive your sister is to these meds.
i.e. if she is on a highdose of an extremely sedating drug then it'll need to be adjusted, vs if she were on a low dose and not too sedating meds.
I have used a combo of an activating and sedating drug in the past but have had more problems than success. In addition, these activating drugs have high potential for abuse. There are conventional drugs (for pain and neuropathy) that have some activating effects such as Vivactil (a class of TCA), and Effexor (an antidepressant).
Good luck and Ihope this helps. We look forward to your visit to our clinic.
