Experiences - Lofepramine - (Tricyclic Antidepressants)

[Tanner Mirabel]

Hi

Recently SWIM was prescribed by his doctor Amytriptilline for anxiety and chest pains (probably caused by gastritis but could also be neuropathic) which kept him awake all night long. SWIM didn't like Amytriptilline due to increased noise sensitivity (any little noise would really startle him) and a constant feeling of something swimming in his brain (really unpleasant). So his doc put him on Lofepramine - but it doesn't seem to do anything except make SWIM sweat (a lot) and gives him headaches.

SWIM wants to know whether he can get something with less side effects and that would help him sleep. SWIM has been on Zopiclone until Tricyclics but it didn't help with his pain. SWIM's doctor is rather old fashioned and seems to prefer using "old" meds.

Any advice will be appreciated
Cheers

[wespawloski]

Wow dude, really, SWIM cant fathom a doc who would do that for pain. SWIM is currently seeing a psichiatrist who takes something like 1/4mg of a benzodiazepine for chronic back pain... And in SWIY's situation, coupled with anxiety, SWIM cant see why SWIY's doc would not instantly jump to a benzo.

Those Amytriptilline side effects and Lofepramine side effects both look to SWIM like dopamine excess... Unless SWIY is are seeking an antidepressant effect, swim would recommend telling his doctor he does not respond well to monoamine modulation and quickly working something else out...

Any exp with opiates on that chest pain? SWIM is horrified a doc would prescribe an antidepressant; The sensitivity to noise is a clear sign of you not needing any stimulation there!

Zopiclone (From this Swimmer's experience with ambien, a like drug) is a very poor choice for insomnia from pain, very bad choice. Zopiclone is a gaba inducer, if SWIM has experienced success with alcohol as remedy then SWIM would suggest looking into benzos, otherwise they are not at all what you need.

Good luck sir.

[Jatelka]

Amitryptiline is often used for neuropathic pain, although there's little evidence for it. It is often also used in low doses for anxiety (because of it's sedative effects), but again, there is little evidence. Something like carbamazepine or Gabapentin would seem like a more logical choice

Why on earth would anyone prescribe a benzo for pain? Unless there was acute muscle spasm contributing it's going to do sweet FA.

Insomnia due to pain isn't treated by prescribing hypnotics, you need to deal with the pain (and I accept that sometimes that isn't easy).

[Sloop]

Milnacipran or Ixel
Seems to work like a TCA with very few side-effects and very few contraindications on drug combinations (except MAOI's as usual). Ixel seems to combine well with gabapentin for swim. An as pointed out above Gabapentin is often useful for pain sleep and anxiety.

Cymbalta is supposedly similar in action to Ixel and TCA's but there seems to be a bit more reporting of side-effects than Ixel (dont know if this is due to Cymbalta being more widely used than Ixel in English speaking countries?) though Cymbalta too seems to be associated with a lot less side-effects than TCA's.

[Rainbowzz]

Originally Posted by Jatelka

Amitryptiline is often used for neuropathic pain, although there's little evidence for it. It is often also used in low doses for anxiety (because of it's sedative effects), but again, there is little evidence. Something like carbamazepine or Gabapentin would seem like a more logical choice

Why on earth would anyone prescribe a benzo for pain? Unless there was acute muscle spasm contributing it's going to do sweet FA.

Insomnia due to pain isn't treated by prescribing hypnotics, you need to deal with the pain (and I accept that sometimes that isn't easy).

SWIM had a thought... SWIM has a twist in her spine as well as degenerative discs.. but have often found that a single .5mg clonazepam will calm the pain down. Dont know if its something to do with muscle spasms or not, but it does seem to help a small amount. Maybe just as swim is often tense and anxious, so relaxing the muscles?