Quix-Zanaflex vs. Trileptal

[Heather3418]

Quix,

I am really having a struggle with the Pain Management Center over these two drugs.  I have tried Zanaflex several times over the many years, since I have been diagnosed.  It causes nausea, dizziness and helps very little with my spasms.  (Not to mention the protential bad side-effects to the liver)  I tried it again a couple of months ago, at the PMC Center's insistance.  Still the same symptoms.  So again, I stopped taking it.  Now they started me on Trileptal.  Dizziness big time, but I am titrating the dose as prescribed.  

I have done some Internet research on both of these drugs.  Aren't they really the same kind of drug, just with two different names.  I wish I had a PDR at my disposal, but feel that I am probably getting just as much information from my Internet searches.

As a physician, do you know anything about either of these drugs?  I am up to 300 mgs. a day of Trileptal.  No decrease in the spasms, as yet.  Because of that (and a flair-up) they increased my pain medication yesterday.  I am now on Oxycodone, which is a real big pain in the kester.  Because of Federal regulations, I have to physically go into my doctor's office (35 miles round trip) once a month, to pick up and sign for the prescription. Even have to show my driver's license.  Isn't that some ****?  (Wish the feds were doing more to stop the illegal use of these kinds of drugs, so people that REALLY NEED THEM, wouldn't have to go through an act of Congress to get them)  

Would appreciate any advice you may have about these drugs or your personal views on what helps most with spasms.  Baclofen was a good drug for me, years ago, but at only 40 mgs. a day, I had trouble walking.  The only drawback to it was that it actually made my legs weak.  As I told my doctor yesterday, it was only at 40 mgs. that I was able to get any partial relief from the spasms, so lowering the dose to prevent the weakness, would do me no good.

Thanks in advance, Heather.... followed by the ever present, "MS-Pac Man."  (I'd love to include "him" in a 'Neuro Weenie Roast.'  Pulverize him into a BBQ sauce for the Neuro's.)  

[Heather3418]

Thanks and thank you for the info about the neutralizing anibodies to the Interferons.''

[Quixotic1]

This is definitely one of the black hole areas in my knowledge - Meds used in adult neurology.  But, if the two meds are similar in the same class (as opposed to the same med with a different name) then they can act differently.  I know this just from practice.  But the rest, not my field.  We really need a good neuro here, full-time.  I just pretend to know this stuff...

Quix

ps.  Also you asked several days ago about testing for neutralizing antibodies.  This is what my neuro told me.  When someone seems to be failing a med (interferon) as part of the decision to persevere or switch, they then do the antibodies.  These are still fairly elite and expensive tests and not all labs can do them.  Many antibodies have been identified that "bind" to the drug in vitro (in the lab) but, it must also be shown that they destroy or reduce the drugs effectiveness.  Most of the binding antibodies have no effect at all.  There are ways to establish this, but I don't think it is always straight forward.  Q