Back trauma medication. Pain relief not an option. Have tried SSRI's. Not much help?

I've been put on methadone, 20mg per day, (5 mg tabs 4x's a day) for chronic pain - it got rid of the majority of the pain, however had to augment the medication with 300mg of Tramadol and 225mg of Lyrica (helps very minimally, but the doctor felt that the risk of going up with the methadone was too risky). Also have been on the Pristiq (100mg) which has been by far and away has been the best medication that I've tried for depression. I also have panic attacks / general and social anxiety, so I've also had to add in the Klonopin - 3mg per day, the only thing that stops the anxiety for me. Recently had a spontanious flashback to early childhood abuse / trauma that left me stunned, and something that I totally forgot (repressed) and left me with more depression, anger, self hatred, and guilt than I've experienced for over 15 years. Now I'm starting to remember all of the years of abuse in segments.

Expand this post...

I guess all of my problems are finally clicking together as to what the inner "demon" is.

Regardless, as far as pain goes, Methadone has worked wonders for me. All of the other narcotics such as Norco (Vicodin) just made me not care, but didn't really relive the pain, just made me stupid - unlike the Methadone, which I get no effect from except for the pain relief.

Due to all of the sedatives that I have to take, I have troubles staying awake during the day, and now have to take 250mg of Nuvigil. I also lost my sex drive, so Cialis has also been added (every med listed above took a long time of trial and error (Lexapro, Cymbalta, Zoloft, Requip, etc.), in addition to over 30 medical tests and several doctors (in the same medical group) to achieve the current mix and to confirm the conditions. A totally ridiculous amount of meds, but they are the only thing that has made me feel somewhat normal. The psychiatrist now wants to check me out for mild Narcolepsy, induced by the meds... so now I have to see a Neurologist! Hopefully my psychologist will be able to help that we now have a grip as to what a large part of the cause is, and isn't just a result of genetics (a long, long family history of problems - and grew up with the motto of "(our family name) don't have problems)". My older brother now is violently psychotic - and I don't want for my kids to ever, ever, ever, go through what I did.

I sincerely apologize for the novel - guess I just needed to vent a bit... and hope that this is also somewhat helpful for you.

Hi it looks like you have had all the fun you can stand. I am confused by your statement that “pain relief is not an option’ If it was me, and it has been, it would be “pain relief is the option and what are we going to get relief”. I assume that you blew out your stomach by quaffing down pain pills loaded with aspirin? My stomach is one of the few body parts I have that actually works pretty good LOL. I have had YEARS where I took 5000 to 6000 mgs of ibuprofen a day. For some reason my little tummy worked like a charm. If that is the reason for your statement your Doc has a big bagful of meds that do not have additives. There was something else you mentioned as a side effect of anti-depressants; I also was not able to perform in some areas that used to bring my wife and me great pleasure. I was told that most chronic pain patients at some point suffer depression. Most anti-depressants can cause trouble in the bedroom.

Expand this post...

My wife was not happy with most of the ones I tried. I was whining to my pain doc one day and he suggested I have my testosterone checked. I was shocked as I was practically on zero!! For some reason opioids also can have an effect on testosterone levels even though there is no nexus as far as I know. I thin k it’s worth having it checked in any event. Most people give up on antidepressant. I think the reason is that most of them don’t work very well. What works for one person doesn’t work for others but there are so many new ones coming out that it is worth sticking to a goal of making it work even though it may take a year or so working with your Doc to find one or a combo that gives you noticeable relief. BTW you are not pill shopping if you are working thru a doctor to find a pain management program that will give you relief. Now if you go into this expecting or hoping to wake up one morning all bright eyed and bushy tailed with a complete cure you need to reset your goals some Once you have had back issues and certainly once anyone has go in to repair you will never again be at 100%. That doesn’t mean you can’t have a life that allows you to do most of the things you could b4 you were injured. Part of any good pain management program will include self hypnosis and guided imagery. Have you had any practice in that area? Your pain management team should be able to help.
I hope I have given you a few things to chew on and to ask your Doc about. I am sorry that I can not speak specifically to the Prestiq. I do know that several of my friends that have chronic pain take either Cymbalta or Lyrica and have had very good results.

One last thing I will say. Your Doc probably sees between 100 and who knows how many patients. You HAVE to be an advocate for YOU and make sure he is thinking of you as he is looking and doing research on other ways to treat your conditions. The old saying “the squeaky wheel gets the grease” is very true in the medical field