Paxil vrs Serzone suggestions..meeting w PDOC | Zoloft Wellbutrin

Question:

Same thing for those getting meds from the Gummint, regardless of how. Instead of insisting that the prices be kept low as in Mexico,

I doubt it’s an option to lower the costs to as low as they are in Mexico. If such a regulation were to be passed they’d just raise the price in Mexico to what’s being charged here and folks in Mexico would just have to do without. If you cut down the ability of a drug company to get return on investment too much you just won’t see any more investment and hence no more new drugs. Many drugs costs millions to develop and either never see the market or get pulled from the market within months due to newly discovered problems. If drug companies had it so easy everyone would own one. Don’t push too hard for the government to step in unless you want similar controls & interference with your industry too. — Don Elton Columbia, SC http://www.midcarolina.org

Response:

I assume all the "alternative" treatment proponents on USenet will be totally against this petition since they mostly claim that they would be happy to operate under the same regulations as pharmaceutical companies

Well, I’d be against it. Over the years I’ve found some companies that make a point of standardising their products. Last thing I want is another layer or six of bureaucrats leeching off of these companies and justifying their expensive lifestyles by promulgating more regulations that will end by jacking up the prices of these products. There are also a few independant companies that review alternative products and report on their findings publicly. Of course, there are also those that are set up by fraudulent companies, but these are also reviewed by the public, and vituperated in the various newsgroups. Much like it’s done here. I trust the posters here a lot farther than some bureaucrat whose boss accepts money from pharmaceutical companies. Over all I like the current set up. It’s inexpensive, and unconnected with the horrendously expensive medical-industrial combine–so far. Is anybody really happy with the HMO situation? I’m sure that the business people in the pharm industry are drooling over the thought of similarly dividing up the alternative health industry.

Response:

I’m sure that the business people in the pharm industry are drooling over the thought of similarly dividing up the alternative health industry.

I have a co-pay for my meds…$15.00 for brand and $10.00 for generic. I went to GNC to look at Chitosan for the heck of it and I believe the small bottle was $29.00 or $39.00. I don’t see what is so cheap about that…alternative stuff is plenty expensive. In fact, I watched a documentary about death and dying. Several people had turned to alternative products and were spending several hundred dollars *per month* on herbs and vitamins. What a rip off… and by the way no one survived. Just because it’s touted as "safe and natural" sure doesn’t mean it’s inexpensive! Patrice

Response:

Well, I’d be against it. Over the years I’ve found some companies that make a point of standardising their products. Last thing I want is another layer or six of bureaucrats leeching off of these companies and justifying their expensive lifestyles by promulgating more regulations that will end by jacking up the prices of these products.

Look for one that responds positively to you, is healthy, and that you get "a feeling" about. It’s all magic really. ;-) I am thinking about getting a African Grey Parrot. What should I be looking for when I go and purchase them other than a healty looking bird? * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

– Kellie Final Portrait * A Novel by Kellie Sisson Snider Kass Arts Publicity <http://kassarts.bizland.com

Response:

Hi. I am trying to find the name of a (high-performance?) European car (1960s ?) that was powered by Ford and, most importantly, had an aluminum I won’t be able to check back here for a while. Thank you.

rid of my dogs, but I don’t have anywhere to go just yet.. I need to

know if there is anyone in Las Vegas or the near surroundings who would

be able to take in 2 Rotts for a month at the very most… I don’t

have a ton of money or I would put them in a kennel (it cost so much!), but I am willing to make monthly payments. I would buy the food and any other neccesities.. I would also come by to walk,

play, and/or groom too. PLease if there’s anyone who can help me contact me at:

702.341.0864 and ask for Brian. – Hide quoted text — Show quoted text – -Heather

Response:

Hi I live in Las Vegas, Nv. I have to rotties that I love and adore, however my Landlord has given my husband and I an eviction notice unless we get rid of the dogs… -Heather

I really wish I could help out, but I’m not even in the States. Is there a reason why the landlord wants the dogs gone? Maybe you could work out some arrangement with him to let you keep the dogs while you look for a new place. Best of luck to you. Ann

Response:

I am thinking about getting a African Grey Parrot. What should I be looking for when I go and purchase them other than a healty looking bird? * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

Look for one that responds positively to you, is healthy, and that you get "a feeling" about. It’s all magic really. ;-) I am thinking about getting a African Grey Parrot. What should I be looking for when I go and purchase them other than a healty looking bird? * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

rid of my dogs, but I don’t have anywhere to go just yet.. I need to

know if there is anyone in Las Vegas or the near surroundings who would

be able to take in 2 Rotts for a month at the very most… I don’t

have a ton of money or I would put them in a kennel (it cost so much!), but I am willing to make monthly payments. I would buy the food and any other neccesities.. I would also come by to walk,

play, and/or groom too. PLease if there’s anyone who can help me contact me at:

702.341.0864 and ask for Brian. – Hide quoted text — Show quoted text – -Heather

Response:

URGENT ALERT- EU VITAMIN DIRECTIVE VOTE TUESDAY- ACTION NEEDED NOW- MORE SIGNATURES NEEDED – forward widely & ACT NOW!

and ignore this attempt by Mr John Hammell (this "organisation" turns out to be one guy in Florida with a part time assistant) to persuade you that he has the interests of European consumers at heart it’s a pretty transparent attempt by sellers of dodgy treatments to avoid getting brought under regulations to prevent false advertising and poor quality control I assume all the "alternative" treatment proponents on USenet will be totally against this petition since they mostly claim that they would be happy to operate under the same regulations as pharmaceutical companies — eric "live fast, die only if strictly necessary"

Response:

Ditto! Yeah, wouldn’t it be awful if they had regulations making sure that my gingko pill isn’t actually rat poop? Honestly, I am afraid to buy supplements of any sort, because I have no idea what is in those pills. The only exception is vitamins–i think those are relatively safe, but I still feel that I am playng russian roulette with those. Thanks, Mike — To reply via email remove the (SPAM_BLOCKER) from my email address: – Hide quoted text — Show quoted text – URGENT ALERT- EU VITAMIN DIRECTIVE VOTE TUESDAY- ACTION NEEDED NOW- MORE SIGNATURES NEEDED – forward widely & ACT NOW! and ignore this attempt by Mr John Hammell (this "organisation" turns out to be one guy in Florida with a part time assistant) to persuade you that he has the interests of European consumers at heart it’s a pretty transparent attempt by sellers of dodgy treatments to avoid getting brought under regulations to prevent false advertising and poor quality control I assume all the "alternative" treatment proponents on USenet will be totally against this petition since they mostly claim that they would be happy to operate under the same regulations as pharmaceutical companies — eric "live fast, die only if strictly necessary"

Response:

URGENT ALERT- EU VITAMIN DIRECTIVE VOTE TUESDAY- ACTION NEEDED NOW- MORE SIGNATURES NEEDED – forward widely & ACT NOW!

We are having a private wedding ceremony, but will be having an "open house" type reception for 2 hours afterwards. Now this is a conbination of we got mearried and good bye we are moving 1000 miles away. I am needing suggestions on invitations, and how do you tell those wishing to give gifts that cash or gift certificates are needed due to the move. (Moving van will already be gone and we are flying). Help is really needed for we do not want to hurt or angre any one, it may be a long time until we see them again. Kimbra Hill

Sorry, there’s no nice way to tell people you want a gift at all, let alone that you want cash or a gift certificate. You’re supposed to act surprised and delighted when you get a gift of any kind! If you just can’t live with this, the only thing you might be able to do is whisper to a talkative friend that you’ll be needing lots of money for the move and hope she or he will spread the word. –Nancy Reynolds

Response:

We are having a private wedding ceremony, but will be having an "open house" type reception for 2 hours afterwards. Now this is a conbination of we got mearried and good bye we are moving 1000 miles away. I am needing suggestions on invitations, and how do you tell those wishing to give gifts that cash or gift certificates are needed due to the move. (Moving van will already be gone and we are flying). Help is really needed for we do not want to hurt or angre any one, it may be a long time until we see them again. Kimbra Hill

Response:

We are having a private wedding ceremony, but will be having an "open house" type reception for 2 hours afterwards. Now this is a conbination of we got married and good bye we are moving 1000 miles away. I am needing suggestions on invitations, and how do you tell those wishing to give gifts that cash or gift certificates are needed due to the move. (Moving van will already be gone and we are flying).

I don’t think you can. We’re moving four days after our wedding to Boston (3,000 miles), and we’re just going to ship stuff we get. All of the furniture we have is very bad, so we’re either selling it or giving it to Goodwill (if they’ll take them ). We expect to get some cash gifts, though, but to offset shipping costs, we registered at Macy’s and Crate and Barrel, which are national, and just so happen to be wherever our guests are located (they are scattered all over the US). One option for them is to buy the gift, wait until we have found our new apartment, and send it to us there. It’s not *proper* to ask for cash instead of gifts. It looks as if you are greedy. Hopefully, your friends will make that logical decision to give you cash instead of gifts, but if they don’t, please don’t worry about it. You’ve got more things to worry about than how heavy your gifts will be. Laurel and Jack, 5/25/96

Response:

Why don’t you get At Home cards to put in with the invitations? They say Mr. and Mrs. XYZ At Home after March 20, 1996 1234 Main Street, Apartment 1A Big City, ST ZIPCD They can be printed on cardstock and included with shower invitations as well, or just mailed to people as "change of address" cards – they can also go in the announcements which you send after the wedding. Attendants for you & your spouse-to-be, as well as your parents & other relatives, can tell people that because you are living so far away from where the wedding is, it’s better if girts are sent to your home. People will understand that you can’t recieve gifts at the wedding with ease, and will probably be very willing to "lighten your load." Heidi (& Aaron – October 19, 1996)

Response:

We are having a private wedding ceremony, but will be having an "open house" type reception for 2 hours afterwards. Now this is a conbination of we got mearried and good bye we are moving 1000 miles away. I am needing suggestions on invitations, and how do you tell those wishing to give gifts that cash or gift certificates are needed due to the move. (Moving van will already be gone and we are flying). Help is really needed for we do not want to hurt or angre any one, it may be a long time until we see them again. Kimbra Hill

Sorry, there’s no nice way to tell people you want a gift at all, let alone that you want cash or a gift certificate. You’re supposed to act surprised and delighted when you get a gift of any kind! If you just can’t live with this, the only thing you might be able to do is whisper to a talkative friend that you’ll be needing lots of money for the move and hope she or he will spread the word. –Nancy Reynolds

Response:

Question:

Prozac May Soon Have a Generic Brand (washingtonpost.com) By Katrina Hull Associated Press Writer Monday, July 30, 2001; 5:48 PM INDIANAPOLIS

Question:

I must say that I did not find Simple Green very good as a degreaser. I sprayed it full strength on the chain rings and several areas of the frame with no luck at cutting the grease even after vigorous rubbing. I even let it sit for a while. I went back to the citrus degreaser which works great. Mark

Response:

grapefruit ?

Response:

I bruise more when taking Imuran or prednisone. Sometimes all it takes is just pressing my skin up against a surface too hard (such as leaning it on a box, etc). Be well- Tracy CD class of ‘98 my homepage: http://home.talkcity.com/ParadiseDr/goodboie/index.html : ) smile – it makes people wonder what you’re up to!

Response:

Another strange side-effect I had while on Imuran was bleeding. The tiniest scratch would cause awful bleeding and would take up to a half- hour to stop. I work alot outside in my gardens and last summer, while on pred and Imuran, I had to carry a couple papertowels in my pocket as every time I turned around, I’d be bleeding from somewhere. Hugs, Linda – Hide quoted text — Show quoted text – I bruise more when taking Imuran or prednisone. Sometimes all it takes is just pressing my skin up against a surface too hard (such as leaning it on a box, etc). Be well- Tracy CD class of ‘98 my homepage: http://home.talkcity.com/ParadiseDr/goodboie/index.html : ) smile – it makes people wonder what you’re up to!

Response:

Bruising, without the slightest trauma, usually reflects thinning of the dermis. What ever you are taking for nutritional supplements…they are not working. It is remedied quite easily by consuming a diet rich in flavanoids. Along with a basic supplement regimen of Vitamin E, Vitamin C and Essential Fatty Acids. Ken.W 7 Years Med Free

– Hide quoted text — Show quoted text – All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

Hi Amy, I have UC to and take prednisolone and mesalazine (same as mesasal). I find that everyfew months I will get tons of brusies coveing my arms and legs for a few weeks and then they just go. They are usually just little bruises but sometimes I find that they can be quite big too. Hope this helps Sarah

– Hide quoted text — Show quoted text – All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

LOL! Hugs, Linda – Hide quoted text — Show quoted text – Not if the horse was a good dancer! Debs Thanks Linda, so it might be the Imuran and it has finally kicked in! Being kicked in the thigh by a horse sounds PAINFUL. I had one step on my foot once, got a lovely looking bruise but that is to be expected! Amy. Hi Amy, I don’t bruise easily – no bruise even after being kicked in the thigh by a horse that didn’t want to go into the horsetrailer but while I was taking Imuran, I’d find bruises when I didn’t remember hitting anything. I seemed to get alot on the backs of my hands and on my arms. Since being off Imuran, I haven’t bruised at all. Hugs, Linda All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

YW Amy About two summers ago, a friend’s horse stepped on my pinky toe and I’m sure she broke it. Nothing I did for it made it feel better except to wear my cowboy boots. I sure looked kinda funny that summer with my shorts and cowboy boots everywhere I went, LOL! Hugs, Linda – Hide quoted text — Show quoted text – Thanks Linda, so it might be the Imuran and it has finally kicked in! Being kicked in the thigh by a horse sounds PAINFUL. I had one step on my foot once, got a lovely looking bruise but that is to be expected! Amy. Hi Amy, I don’t bruise easily – no bruise even after being kicked in the thigh by a horse that didn’t want to go into the horsetrailer but while I was taking Imuran, I’d find bruises when I didn’t remember hitting anything. I seemed to get alot on the backs of my hands and on my arms. Since being off Imuran, I haven’t bruised at all. Hugs, Linda All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

Not if the horse was a good dancer! Debs – Hide quoted text — Show quoted text – Thanks Linda, so it might be the Imuran and it has finally kicked in! Being kicked in the thigh by a horse sounds PAINFUL. I had one step on my foot once, got a lovely looking bruise but that is to be expected! Amy. Hi Amy, I don’t bruise easily – no bruise even after being kicked in the thigh by a horse that didn’t want to go into the horsetrailer but while I was taking Imuran, I’d find bruises when I didn’t remember hitting anything. I seemed to get alot on the backs of my hands and on my arms. Since being off Imuran, I haven’t bruised at all. Hugs, Linda All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

Thanks Linda, so it might be the Imuran and it has finally kicked in! Being kicked in the thigh by a horse sounds PAINFUL. I had one step on my foot once, got a lovely looking bruise but that is to be expected! Amy. – Hide quoted text — Show quoted text – Hi Amy, I don’t bruise easily – no bruise even after being kicked in the thigh by a horse that didn’t want to go into the horsetrailer but while I was taking Imuran, I’d find bruises when I didn’t remember hitting anything. I seemed to get alot on the backs of my hands and on my arms. Since being off Imuran, I haven’t bruised at all. Hugs, Linda All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

Hi Amy, I don’t bruise easily – no bruise even after being kicked in the thigh by a horse that didn’t want to go into the horsetrailer but while I was taking Imuran, I’d find bruises when I didn’t remember hitting anything. I seemed to get alot on the backs of my hands and on my arms. Since being off Imuran, I haven’t bruised at all. Hugs, Linda – Hide quoted text — Show quoted text – All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

It seems, at least for me, that bruises just appear. I have gotten them from just little bumps against furniture to anemia (a simple blood test can tell you if you are really low). I find the skin reacts for some reason I really don’t understand myself and I have CD. If you are real tired and the bruises are a lot contact your dr to be sure it’s ok. UM MOM Susan

– Hide quoted text — Show quoted text – All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

All of a sudden my arms, legs, and stomach are covered in bruises for no apparent reason. I have been moving house, but I didn’t do any of the heavy lifting or anything! So this seems really unusual for me. Has this happened to anyone else before? I have UC, have been taking Mesasal for 18months, Imuran for 13 months (the last 6 at the proper weight-based dose of 100mg/day), recently used Salofalk enemas (4g) in addition to the 12 Mesasal for one month, and have used Colifoam for about 6 or 7 months. I have always had low iron but am not taking any supplements, and I recently found out I already had osteopaenia 18months ago before I was diagnosed with UC and took steroids. Pretty scary for a 25 year old but apparently it is not uncommon in IBD patients. So I haven’t really started on any new medications that would explain these bruises, although perhaps by coincidence just as the bruises started appearing, I also experienced significant improvement in my UC, giving me hope that I am going into remission for the first time since diagnosed. Only 2 toilet trips a day for the last week or so! That is the first time I have been that "healthy" since I was on 50mg of pred. Anyone have any suggestions for me about what might be causing those bruises? Thanks, Amy Melbourne, Australia

Response:

Question:

I am using Azmacort and Serevent regularly and Maxair occasionally. I have recently developed twitches in my eyelids that are quite annoying. I have also been having headaches. Does anyone know whether these are side effects of any of these prescriptions? The pharmacist and physician both say "no." I don’t care if your name IS Erle Stanley, get your rake out of my petunias!

I get similar symptoms when I have a sinus infection Patricia

Response:

Drugs such as serevent and maxair (beta agonists) can cause muscle twitching. I have had several patients that had to stop the use of serevent due to severe tremors. Do not stop your medication with out talking to your physician.

Response:

– Hide quoted text — Show quoted text -I am using Azmacort and Serevent regularly and Maxair occasionally. I have recently developed twitches in my eyelids that are quite annoying. I have also been having headaches. Does anyone know whether these are side effects of any of these prescriptions? The pharmacist and physician both say "no." I don’t care if your name IS Erle Stanley, get your rake out of my petunias! I get similar symptoms when I have a sinus infection Patricia

I just started getting eyelid twitches and am on the same meds. and here my husband thought I was winking at him!!!! Seriously, does anyone else have the same problems??? Peace, Tish are the thoughts,you have hidden in your heart…….

Response:

I am using Azmacort and Serevent regularly and Maxair occasionally. I have recently developed twitches in my eyelids that are quite annoying. I have also been having headaches. Does anyone know whether these are side effects of any of these prescriptions? The pharmacist and physician both say "no."

Sounds like the BuSpar was augmenting the anti-panic effects of the Zoloft. Chip

– Hide quoted text — Show quoted text – ok, so here is my story went to my psych three weeks ago he told me to lower my dose of buspar from 40 mgs/day to 20mgs/day, then after 2 weeks go off it all together am still taking the zoloft, 100 mgs/day and the lorazepam, .5 mgs/day, sometimes 1 mg/day neways, did that wrong thing to do yesterday aft, had about 5-6 panic attacks in a matter of 2 hours shitty shitty shitty thought 4 sure i was going to die tried everything possible, but the damn things kept coming back finally got ahold of my family doc, after trying numerous times to get ahold of my psych he told me to go back on the buspar and start with 10 mgs/day, but hell with that am going to take 20 mgs/day after yesterday, don’t want that to happen again hopefully today will b alot better scared the shit outta my 6 yr old and my fiance will let you all know tomorrow how i did today later…..

Response:

Response:

I was wondering for a minute there how "wind" could cause stomach aches. but now I understand you didn’t mean the weather kind — -Beth, Pseudo usenet cop BikeE FX, AT and rans gliss Anchorage, Alaska http://home.gci.net/~dawg/

– Hide quoted text — Show quoted text – My daughter suffered with stomach aches caused by wind. On the second day of induction she wasnt a nice person to be around but she has got rid of her stomach ache and hopefully the wind that was causing it. I used to have chronic bloating and stomach pain every evening after meals. Yet, when I tried LC, my bloating disappeared. I am thinking I might be allergic to wheat or something like that. Has anyone else experienced positive side effects (besides weight loss), as a result of eliminating or cutting back on carbs? Tina

Response:

My daughter suffered with stomach aches caused by wind. On the second day of induction she wasnt a nice person to be around but she has got rid of her stomach ache and hopefully the wind that was causing it.

– Hide quoted text — Show quoted text – I used to have chronic bloating and stomach pain every evening after meals. Yet, when I tried LC, my bloating disappeared. I am thinking I might be allergic to wheat or something like that. Has anyone else experienced positive side effects (besides weight loss), as a result of eliminating or cutting back on carbs? Tina

Response:

I used to have chronic bloating and stomach pain every evening after meals. Yet, when I tried LC, my bloating disappeared. I am thinking I might be allergic to wheat or something like that. Has anyone else experienced positive side effects (besides weight loss), as a result of eliminating or cutting back on carbs? Tina

Response:

Absolutely! – PMS virtually disappeared. Now I have to pay excrutiating attention to the calendar instead of relying on breast tenderness, bloating, moodiness, rages, etc to indicate that my period was about to start. – Digestive problems greatly diminished. – Depression has disappeared. I’m now on an even keel emotionally for the first time in my life. – I’m awake and alert all day, where before I used to take a nosedive onto my desk at about 2 in the afternoon. – I sleep better and can wake up easier in the morning. – Food no longer has control over me. – I can stop eating when I’m satisfied instead of being compelled to eat more, even if I was gorged. Oh, and I’ve lost 61 pounds. — Cheers! Nicole K. 263/202/150 ~~ Yes, its tough to do, but the results that last a lifetime are worth more then a bowl of ice cream that lasts only 5 mins. –Tinakaye

– Hide quoted text — Show quoted text – I used to have chronic bloating and stomach pain every evening after meals. Yet, when I tried LC, my bloating disappeared. I am thinking I might be allergic to wheat or something like that. Has anyone else experienced positive side effects (besides weight loss), as a result of eliminating or cutting back on carbs? Tina

Response:

Question:

"Edee Roche" <Roche…@AOL.COM

wrote in message

news:39.80b5c24.26b3c117@aol.com…

I’m on prozac, which costs between $140 and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada?

1) You bet your *ass* prozac is cheaper here, Edee. It would run $90-120CDN ($60-80US) for your scrip. 2) Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here. :-( — (((((((((((((U))))))))))))) Michael <muirh…@island.net

-=[ Livin' on Island Time ]=-

Response:

In a message dated 07/27/2000 11:57:35 PM Central Daylight Time, ta…@TNS.NET writes:

<< I just downloaded a huge list of pharmacies in Mexico and that’s my next step.

I’m on prozac, which costs between $140 and $156 for 60 caps. I take Miacalcin to rebuild and strengthen my bones @ about $66 a month. These are two of the 10 meds I take, and the most expensive. Tammy mentioned Mexico. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? Edee

Response:

Shell, I can increase my neurontin if I want too (more $$$$) – I don’t want to go back on morphine as I do travel – it is very difficult to go out of this country with morphine – I went to Tel Aviv (Israel trip) – found out after that if my meds were inspected I dould have been arrested even with Neuro’s lettters etc. That scared me. Be well Shell Love Barbxx. "Shell" <smin…@epix.com

wrote in message

news:397B4595.FA1F6D1B@epix.com… – Hide quoted text — Show quoted text -

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never

even

ask for morphine and that is why I put up with the awful neuro I currently

see

because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give

you some

for break thru pain? I never sleep thru the night. I hate this nasty pain

and I

feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their

jobs.

Take Care Shell Barb Edmiston wrote: Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise

I

get into this ‘overdrive’ like tremors and weakness + pain but fast

heart

and nightmares.(Neurontin relief is reduced by eating high protein =

steak

or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering

what

the ****** is going on in my body. Got my first wheelchair last week –

for > > home – but failing badly at everything else. Hey – xx be well on both > > meds!! OK? > > "joannek4" <joann…@email.msn.com

wrote in message

> > news:ePKwXo58$GA.420@cpmsnbbsa08… > > > Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> > > news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > > > Shell – I thought morphine worked really well for me – it changed my > > life! > > > > But the Docs are dead against it now as some folk have discovered ho w to

change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro

sent

me to a Pain Clinic because he tried everything he could and didn’t work.

I

deal with nerve pain which in my opinion only Morphine can help calm

the

pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

On 29 Jul 2000 08:14:03 +0300, Roche…@AOL.COM (Edee Roche) wrote: }and if so, }what iis the procedure to follow to get my meds from Canada?

I just did a search for any outlets that sold prescription drugs on-line. The only one I found was Guardian Drugs, but you must have a prescription from a physician licensed to practice in the Province of Ontario. If you want to search further then I suggest http://www.canada.com — jcarter at superaje dot com The next century and the next millennium begin at midnight on December 31,2000.

Response:

Here are some drug comparisons from an article in the OREGONIAN newspaper. The U.S. insured price is the cost negotiated & paid by the insurance company. Drug U.S. insured Canada Mexico U.S. uninsured Prilosec $58.73 $49.80 $37.50 $117.56 Zoloft 115.70 125.00 133.00 223.61 One of the tv stations did a cost comparison between Portland, OR pharmacies and found some of the best prices at small pharmacies. Carole – Hide quoted text — Show quoted text -Michael Muirhead wrote:

"Edee Roche" <Roche…@AOL.COM wrote in message news:39.80b5c24.26b3c117@aol.com… I’m on prozac, which costs between $140 and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? 1) You bet your *ass* prozac is cheaper here, Edee. It would run $90-120CDN ($60-80US) for your scrip. 2) Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here. :-( — (((((((((((((U))))))))))))) Michael <muirh…@island.net -=[ Livin' on Island Time ]=-

Response:

In a message dated 07/23/2000 3:34:30 PM Central Daylight Time, ms150…@MINDSPRING.COM writes:

<< He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though my actions show otherwise. Isn’t it frustrating? Really tough when we have this pain and can barely function, and to add to it, we have to fight the doctors to get what we need.

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee

Response:

Joanne, You SAID it girl! Power to the patient! Susan E

Response:

John P. Husvar <jhus…@apk.net

wrote in message

news:8lhabj$1rh$1@plonk.apk.net…

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement.

I agree…this has been an ongoing issue for me. With sufficient pain meds, I’m up and around, active, working, eating better, and less tired. Funny how my non-MS friends can take a Vicodin and it wipes them out…for me it’s a few hours of respite on bad days and it gets me up and functioning. My HMO disagrees. MS is officially a "painless" disease. I am hoping the MS Society will come out with some official statement at some point that will allow some of the stricter HMO’s (I have Kaiser) to prescribe adequate pain relief. We’re actually looking into going down to Mexico for meds at this point. I spoke to a therapist about meds – she specializes in illness with chronic pain. The whole addiction question. Her questions were "Have you increased your dosage or frequency?" No. "What do you do when you take a pain reliever?" Laundry, play with my child, cook, work, and sleep restfully. Her response made sense to me….that if we are addicted to anything it’s the relief from pain, and that if monitored carefully, the improvement in quality of life far outweighs the risks. Unfortunately, she can’t write prescriptions Tammy —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM

wrote in message

news:44.5bbe4f0.26ade33a@aol.com… – Hide quoted text — Show quoted text -

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain

and

can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is

the

pain and that was a right I was entitled to. Edee

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I just spoke with my Kaiser pharmacy and my doc (and he IS a specialist) hasn’t gotten around to this month’s refill approval yet (I have to get a new one every month, and it’s about half of what I actually need). It makes me sick. I just downloaded a huge list of pharmacies in Mexico and that’s my next step. This is a huge waste of energy. I though the National MS Society was considering a statement on pain management and MS? Their stance on the ABC drugs is the one and only reason I got approved for Copaxone after a 3-month fight. (I wasn’t "sick enough". For a prophylactic drug.) Tammy <ms150…@mindspring.com

wrote in message

news:8lopl0$r75$1@slb0.atl.mindspring.net… – Hide quoted text — Show quoted text -

I am going through the exact same thing myself! I take hydrocodone and my neuro is afraid of addiction!!! :O I too cut them in half and wait as

long

as I possibly can between pills. My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled. He gave me one more and said ‘no more’! I am switching to a specialist and hoping that he can help with something else that will work as well. No one can imagine this pain that

we

go through. NOT the pain of the occasional spasm! But feels like being

in

labor 24/7! Karlyn Shell wrote in message <397F4EA9.2E732…@epix.com… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making

it

up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when no patient should have to

worry

about living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give

you > to > >> parcel them out over a month’s time to make them last. It’s ridiculous, > and > >> does increase stress – something none of us need. It feels like a > >> never-ending battle. > >> Tammy > >> Edee Roche <Roche…@AOL.COM

wrote in message

> >> news:44.5bbe4f0.26ade33a@aol.com… > >> > I cut mine in half also. I have been taking oxycodone since 1980, about

20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for

its

intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I am going through the exact same thing myself! I take hydrocodone and my neuro is afraid of addiction!!! :O I too cut them in half and wait as long as I possibly can between pills. My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled. He gave me one more and said ‘no more’! I am switching to a specialist and hoping that he can help with something else that will work as well. No one can imagine this pain that we go through. NOT the pain of the occasional spasm! But feels like being in labor 24/7! Karlyn – Hide quoted text — Show quoted text -Shell wrote in message <397F4EA9.2E732…@epix.com

… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do

as I

cannot take aspirin or ibuprofen and of course the docs think I’m making it

up

like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go

through

their little phase and end up at Betty Ford. I’m sorry just having a bad

pain

day and so tired of playing the game when no patient should have to worry

about

living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible

feeling

of no refills and no help in sight. Or counting out what they do give you

to

parcel them out over a month’s time to make them last. It’s ridiculous,

and

does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about

20

years. I use less now than ever and have had now problems with it at

all.

Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found

that

stress increases pain, including stress caused by knowing you are in

pain

and can’t do anything about it or are running low on pain medication with

no

refills. I told my GP and my neuro both that the only part of MS I can control

is

the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making it up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when no patient should have to worry about living with this awful pain. Take Care Shell – Hide quoted text — Show quoted text -Tammy wrote:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

Here in NY- this is a problem as well. Drs. here are paranoid about any pain meds. Their fear is addiction. This is insanity-I know so many are suffering with tremendous pain on a daily basis, but Drs. here refuse to Rx. I guess they are more concerned with how they appear to the HMOs than with the welfare of their patients. Its called CYA.!! Dianne-NY – Hide quoted text — Show quoted text -

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com wrote in message news:ea5v0lT9$GA.64@cpmsnbbsa07… Hi Michael, I have to agree with you on getting addicted to whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Hi Michael, I have to agree with you on getting addicted to whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com

wrote in message

news:ea5v0lT9$GA.64@cpmsnbbsa07… – Hide quoted text — Show quoted text -

Hi Michael, I have to agree with you on getting addicted to whatever a person

takes for

pain and it works. We are talking about MS and the severe pain that

comes

with it. What is more important stopping the pain enough to deal with

it or

becoming addicted. It is ridiculous for a Doctor to even bring this up

to a

patient but if it’s a must,well I feel it’s our choice to continue to

take

it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never even ask for morphine and that is why I put up with the awful neuro I currently see because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give you some for break thru pain? I never sleep thru the night. I hate this nasty pain and I feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their jobs. Take Care Shell – Hide quoted text — Show quoted text -Barb Edmiston wrote:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else. Hey – xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com wrote in message news:ePKwXo58$GA.420@cpmsnbbsa08… Barb Edmiston <barbedmis…@dingoblue.net.au wrote in message news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

I have this pain and my neuro prescribed Hydrocodone and it works! Doesn’t take the pain away completely, but leaves you with a feeling of pressure instead of PAIN. But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top of not taking away the pain. I have some of the hydrocodone left and as this exacerbation has started subsiding, I have been cutting my 10mg tablets in half and that seems to be doing the job…at least now. I have an appointment with a new neurologist Aug. 1st who specializes in MS and we will see what he has to say. Only problem is that I have pain meds to last only until the 28th and my current neuro, will not prescribe any more. He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though my actions show otherwise. Isn’t it frustrating? Really tough when we have this pain and can barely function, and to add to it, we have to fight the doctors to get what we need. Karlyn "Laura K." wrote in message <8e.7f85b88.26a64…@aol.com

… Hello Group: For all interested, another prospective on MS pain. use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

Response:

Karlyn wrote…

I have this pain and my neuro prescribed Hydrocodone and it works!

Doesn’t

take the pain away completely, but leaves you with a feeling of pressure instead of PAIN. But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top

of

not taking away the pain.

Gimme a break. Your doctor is an idiot. Don’t fault him too harshly for that, most of them are in this regard. Of *course* you’ll become addicted ("tolerant" and "dependant", to name it properly) if you take any opiate for long enough… so WHAT? It’s not that hard to become UN-addicted when the time comes to stop taking the stuff. What he’s *really* afraid of is that you’ll become the stereotypical poster-campaign drug fiend that the world has come to know and fear. Doctors aren’t granted some special immunity to social pressure, you know.

He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though

my

actions show otherwise. Isn’t it frustrating?

Yup. You’ve given him ample evidence that even if you *did* become addicted, you’re prepared to end your addiction as soon as it’s appropriate. Model behaviour, I’d say. Tell your new neuro about all this, will you? It might be a good litmus test of how commited he/she is to helping you, rahter than merely *treating* you. — (((((((((((((U))))))))))))) Michael <muirh…@island.net

-=[ Livin' on Island Time ]=-

Response:

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing that works for me are narcotics. This is one whacky disease, what works for one of us doesn’t work for another. I’m glad you have found relief with the Neurontin but I never ever want to see it again. Take Care Shell – Hide quoted text — Show quoted text -Barb wrote:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price) thank you for your info! Barb. In respite I think - I hope………. xxx

Response:

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. :0( So glad it works for you – keep eating the tinned pears beats prunes….(good for the bowel!!) Barb..(on Neurontin now)…. Be Well x. "Shell" <smin…@epix.com

wrote in message

news:3975F006.9B920A51@epix.com… – Hide quoted text — Show quoted text -

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing

that

works for me are narcotics. This is one whacky disease, what works for one

of us

doesn’t work for another. I’m glad you have found relief with the

Neurontin but

I never ever want to see it again. Take Care Shell

Response:

Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au…

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it.

Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else. Hey – xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com

wrote in message

news:ePKwXo58$GA.420@cpmsnbbsa08… – Hide quoted text — Show quoted text -> Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > Shell – I thought morphine worked really well for me – it changed my life!

But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent

me

to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price) thank you for your info! Barb. In respite I think - I hope………. xxx "Laura K."" <Nygab…@AOL.COM

wrote in message

news:8e.7f85b88.26a6439f@aol.com… – Hide quoted text — Show quoted text -

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute

of=20

Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of

neurolog=

y=20 at Thomas Jefferson University. Dr. Knobler has basic science and

clinical=20

research expertise in multiple sclerosis, viral immunology and the

managemen=

t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with

multiple=20

sclerosis and chronic pain disorders. About half of the patients I see

with=20

multiple sclerosis are also affected by chronic neuropathic pain.

Therefore,=

=20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and

interrupt=

s=20 the patients’ activities of daily living. The pain may be a result of

trauma=

=20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a

bur=

ning=20 dysesthetic sensation. Many of the newer anticonvulsants work

particularly=20

well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an

effort=20

directed at pushing this class of medication to its limit before

considering=

=20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400

milligrams=20

total). The patient is still experiencing sensory dysesthesia as well

as=20

having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by

starting=

=20 at a lower dose of 100 milligrams to start, and then titrating upward to

a=20

higher dose. I start the patient on the medication at bedtime initially,

to=20

be certain that the patient gets to sleep, and then add additional

doses=20

during the daytime, as needed, to get maximal relief. Recognizing that

this=20

is an educational process for the patient, I explain that it will take

time=20

to get the maximum benefit from the medicine, and encourage the patient

to=20

work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to

start,=20

and have the patient titrate up to as much as 40 milligrams at bedtime,

if=20

that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact

on=20

improving mood, slowing the urgent bladder, reducing burning pain and

helpin=

g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for

this=

=20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It

is=20

far more difficult to get a patient to continue a medication that they

have=20

had an adverse reaction to caused from taking too much of the drug, than

to=20

have the patient gradually increase the dose and tolerate the side effects

a=

=20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose

i=

n=20 100-milligram increments, generally until reaching three tablets at

bedtime.=

=20 I may then begin to spread the medication throughout the day as needed.

For=20

tiagabine, I start patients with 4 milligrams and escalate at

4-milligram=20

increments to reach a dosing schedule of two 4-milligram tablets four

times=20

per day. This can be reduced to twice daily dosing if needed for

convenience=

.=20 For topiramate, I start patients with 25 milligrams at bedtime and

escalate=20

to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at

the=20

same time. I have observed that I can continue to use lower doses of

each=20

type of medication effectively and keep the side effects low while

improving=

=20 efficacy since their mechanisms of action are different (which is beyond

the=

=20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also

be=

=20 addressed to provide effective care and management. These symptoms

include=20

aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory

problem=

s. I have noted that medication and lack of sleep can contribute to the

combine=

d=20 symptoms of sleep disruption, confusion, muscle spasms and memory

problems.=20

To address these issues effectively, I have found that a certain degree

of=20

pain relief is needed for quality sleep to take place. Pain is an

alerting=20

response that will effectively prevent sleep, and lack of sleep can lead

to=20

confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with

th=

e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

s=20 of possible side effects such as nausea, vomiting, delayed swallowing

or=20

delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in

patients=20

treated with opioids. However, some patients indicate higher pain levels

at=20

their follow-up appointments for several reasons: (1) they have not

taken=20

their medication in order to drive to their appointment; (2) they

over-repor=

t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in

or=

der to=20 look as if they need more pain medication, or to ensure continuation of

thei=

r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement

as=20

well. I caution them about the use of magnesium citrate if they are at

risk=20

of developing fecal impaction because of the potential danger of

perforation=

.=20 Patients usually don=E2=80=99t like to hear that, but they have to know.

If=20=

they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an

antidepressant.=

=20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note

that=20

they have been of some use in both relief of depression and treatment

of=20

migraine. This is helpful since there is an element of migraine-like

headach=

e=20 in many of the patients that develop upper extremity pain problems.

Migraine=

=20 may be the response that any of several stimuli yields when triggered,

but=20

whatever the explanation the depression must be treated. Fluoxetine

(Prozac)=

,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records

of=20

effectiveness. When an SSRI cannot be used because of a potential

conflict=20

due to simultaneous use with an anti-migraine triptan (Serotonin

Syndrome),=20

bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5

t=

o=20 10 milligrams per day, with some improvement. Confusion should subside

as=20

sleep improves and the dose of anticonvulsant adjuvant is reduced.

Improved=20

pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control

is=20

that associated with the control of movement-related muscle spasms.

Muscle=20

spasms are made worse by physical activity of even the mildest variety,

a=20

dependent posture and cold ambient temperature. This is important

because=20

treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of

the=20

pain, before it has had a chance to become "centralized" pain due to

changes=

=20 secondary to the release of excitatory neurotransmitters within the

dorsal=20

root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of

1mg=20

at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so

needed=

,=20 with a maximum of eight full 4-milligram tablets per day (32

milligrams).=20

Tizanidine reduces the spasm of movement and the pain associated with

that=20

spasm,

… read more »

Response:

I hated Neurontin. It exacerbated all my symptoms and I will never take it again. I know it has helped a lot of patients but not me….yuk. As for Zoloft……To each their own. Take Care Shell – Hide quoted text — Show quoted text -"Laura K." wrote:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as

… read more »

Response:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as needed basis during the day or night. Taken together, the use of medications for the burning pain/allodynia=20 (anticonvulsants); aching pain (analgesic/narcotics); bowel regimen (stool=20 softener/fiber); reactive depression (antidepressants); disturbed memory=20 (memory enhancer); muscle spasm (antispasticity agents) provides the basis=20 for a plan of rational polypharmacy in the clinical management of the patien= t=20 with chronic neuropathic pain. Nygabnet

Response:

Question:

Self-injury with knives and razors. I would cut on myself when I was depressed, before I got on the right medications. I’m ashamed of it, I still have scars, but I have a great therapist that’s helping me understand why I did that. -Emily

I take Effexor for different reasons then you but I’m curious about the side effects you are taking about. I started to take Effexor because of depression due to the M.S.. The one thing I liked about the drug was the lack of side effects. So I’m real curious to find out about the side effects you have. They might be caused by the combo of the meds your currently on. Take care! — Annie

|

| Effexor has helped many people with ADD+anxiety. I found it helpful | until an unusual side effect stopped me from using it. | | <snipped | | I’m curious as to what was the "unusual side effect" that caused you to stop | taking Effexor? | | (I’m curious only because I too get an unusual [and annoying] side effect | from my Effexor [which, btw, has been added to my Dexedrine, with positive | results for my attention deficit]; a side effect that has me wishing there | was something equivalent out there that could provide me with the same | benefits as Effexor, but without this one distractingly uncomfortable side | effect.) | | Sodah | |

Response:

Effexor can cause elevated high blood pressure and possible sedation. These were the reasons I quit taking it two weeks ago, and went back to Prozac – for the additional pep, and also because I stated taking stronger stims which also elevate BP. Could either of these be the unusual side effect? John Got questions? Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Self injure?? Like what, if I may ask? – Hide quoted text — Show quoted text -Hi, I thought that I would post this and see if anyone else has noticed anything like this. In addition to having ADD, I have clinical depression and severe anxiety. I found that Adderall was like a miracle for my anxiety, because it took away so many of the racing thoughts and ruminations in my head. However, my most difficult time has always been at night. I used to have panic attacks so badly that I would hyperventilate and faint. Well, even though Adderall seems to be the best med. for this, I was told that I couldn’t take it at night, as it might interfere with the onset of sleep. So, my psychiatrist added Xanax for nighttime. Well, even though it seemed to help the anxiety, it actually kept me awake instead of putting me to sleep. It also made me severely depressed and apathetic, to the point where I began to self-injure; something that I hadn’t done for a long, long time. Needless to say, I went right off of it. Anyway, several weeks ago, my psychiatrist put me on the anti-depressant Effexor, saying that it would help with my ADD and anxiety, as well as the depression. Because it acts on norepinepherine as well as serotonin, it’s a good adjunct to stimulants in ADD/ADHD people. Anyways, it has been amazing! After only a week of taking Effexor XR 75mg/day(in the morning), my nighttime anxiety was nearly gone! I also noticed that I didn’t get nearly as irritable when my Adderall wore off in the evening. I used to hate the dropoff that I noticed with my stimulant, and now I can hardly detect it. It just feels like the Effexor has smoothed out my day. I don’t have the peaks and valleys that I had while I was just on Adderall. I am feeling a lot more even. I just thought I would see if anyone else has had an experience with Effexor and ADD. Ciao! -Emily

– Colette

Response:

Hi, I thought that I would post this and see if anyone else has noticed anything like this. In addition to having ADD, I have clinical depression and severe anxiety. I found that Adderall was like a miracle for my anxiety, because it took away so many of the racing thoughts and ruminations in my head. However, my most difficult time has always been at night. I used to have panic attacks so badly that I would hyperventilate and faint. Well, even though Adderall seems to be the best med. for this, I was told that I couldn’t take it at night, as it might interfere with the onset of sleep. So, my psychiatrist added Xanax for nighttime. Well, even though it seemed to help the anxiety, it actually kept me awake instead of putting me to sleep. It also made me severely depressed and apathetic, to the point where I began to self-injure; something that I hadn’t done for a long, long time. Needless to say, I went right off of it. Anyway, several weeks ago, my psychiatrist put me on the anti-depressant Effexor, saying that it would help with my ADD and anxiety, as well as the depression. Because it acts on norepinepherine as well as serotonin, it’s a good adjunct to stimulants in ADD/ADHD people. Anyways, it has been amazing! After only a week of taking Effexor XR 75mg/day(in the morning), my nighttime anxiety was nearly gone! I also noticed that I didn’t get nearly as irritable when my Adderall wore off in the evening. I used to hate the dropoff that I noticed with my stimulant, and now I can hardly detect it. It just feels like the Effexor has smoothed out my day. I don’t have the peaks and valleys that I had while I was just on Adderall. I am feeling a lot more even. I just thought I would see if anyone else has had an experience with Effexor and ADD. Ciao! -Emily

Response:

Question:

Hi Sherri. I was here about two years ago and now I’m back. But I don’t feel depressed. Right now, I should add. I take prozac and I am also 28. Depression is pretty much a biweekly battle for me (meaning, every two weeks, it tries to take me down). – Hide quoted text — Show quoted text – I was here about a year ago, looking for some support for this horrible feeling. Now I’m back. I don’t think this will ever go away. Sometimes giving in sounds much better. From some of your post you know what i mean. I was really gone last year at this time, but I’m feeling better now. Who knows about tomorrow. Well anyway I really would like to get to know some of you. But I really don’t know how to start. I was wondering how many woman verses men there are that suffer from depression. And also the age. I’m wondering if you fell the same as I do. Are most of you taking medication? If so what do you take, and are you getting better? I’ve probably taken about 15 different kinds. I feel like I’m riding a roller coaster ride that makes me sick. UP Down UP DOWN Hopefully you can answer some of my questions. Anxiously awaiting you reply. Sherri

Response:

Note: the following sweeping generalizations are based on my opinion and experience, not on anything scientifically reliable, like a Cosmo quiz or Glamour poll Realize that Men Don’t Cry

Prescription Medication Knowledge Base

Discuss the issues around popular medications

Help Needed

Question:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response:

Response: