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switching from vicodin to tramadol & Lyrica; pain doctors issues
switching from vicodin to tramadol & Lyrica; pain doctors issues
Hi there. I went to a pain management doctor yesterday, who I was referred to by my OBGYN. I did NOT like her, that's a whole other post that I don't have time to get in to, but she did give me samples of Lyrica, since I've been told that I have fibromyalgia symptoms and also a prescription for ultram(tramadol). I've been taking vicodin, basically for the past 2 years now, first my family physician would give me refills and then I was getting them from my OBgyn, who then referred me to the pain specialist. When she asked me about the vicodin(I did not even bring up the pills, she's the one who brought it up!) she went off on how she can't prescribe any narcotics for long term pain, at least not until she gets an MRI, but didn't tell me that she was going to order it........ long story, I ended up complaining about her to the office manager. I don't know what good that did but I sure felt better.
Anyway, I'm thinking of getting a second opinion since I did not click with this dr and did not like her attitude and felt like I couldn't talk to her about anything, she wouldn't listen. but in the mean time I'm thinking of taking the lyrica and see how that goes and getting the ultram filled since I need something for at least that breakthrough pain, BUT one other concern I have is that I take Cymbalta, and my other doctors have told me I can't take ultram with cymbalta because of the risk of seizures. When I mentioned this to this new dr. she blew that off saying something about oh, it just depends on the dosage and you won't be taking that much of it. But still, I'm thinking do I really want to risk it?
I need some advice here. I'm so confused and don't know what to do. I'm at my wit's end actually, this is the 3rd pain specialist I've gone to this past year, just trying to find a way to manage my chronic pain, mainly neck and shoulder pain, but also like I said possibly fibromyalgia too, although NO ONE will diagnose me!!! The other two doctors were like this one, I felt they did not take my pain seriously, and didn't offer any treatment options. With the money I've spent I could've been getting a year's worth of massages or chiropractic treatments that would probably actually help me out better then these quacks! I'm so frustrated right now. I don't have insurance so I'm on a limited budget, all this stress is making the pain worse. What do you think I should do??
Your best bet is to ask your pharmacist about the interactions of the two drugs.Also taking vicodin for more than a couple weeks is not helping you other then getting you dependent.Try and do what the pain specialist advises.....Dave
Antidepressants and Ultram can cause siezures. In fact just Ultram itself can do that(believe me I know) I would be careful. Sounds like your current pain Dr blew you off a bit. That sucks. Maybe you can call your OBGYN and be referred to someone else. I hope you get better...krissy
The head doctor called me....
He agrees with the doctor I saw who prescribed Ultram and said it was okay to take with cymbalta. He explained that not to disregard my other physician but they may not be as aware of certain drugs for pain than the pain specialists are, and that the studies done on rats had seizures(poor rats! ) only when they were given the ultram and cymbalta in over 10 times the regular dose, or something like that. You know how doctors can be, he was nice but was talking real fast and thinking he was doing me a favor by explaining the whole study thing and told me not to be anxious at all about taking the ultram and the cymbalta because he's been prescribing Ultram for 10 years and hasnt had any problems and also has prescribed it with cymbalta and it's been fine.
So I don't know. I'm going to my regular doctor next week, actually a new one I was referred to who appears to be more educated on fibromyalgia. I think I will tell him about this experience and see what he thinks I should do. So far the Lyrica seems to be helping...Yay! But I took the Ultram today and it makes me a little nauseous. Vicodin never did that. I know the vicodin helps me and it just works better for me. but I'll keep trying the ultram until I can get to the regular doctor. I just need something for that horrible breakthrough pain until I feel for sure that the lyrica is really working. I can only take it once at night right now, it makes me too sleepy and out of it. Hopefully I can get used to it, because it did help alot with the pain.
Well Jenidarlin I guess if you have taken it before together you should be ok. Just don't take anymore than the recommended amount. You can get hooked on it just like vicodin. When you see your Dr I would try and get something other than ultram. Good Luck
Be sure to read up on Serotonin Syndrome. If you are taking Ultram with an anti-depressant like Cymbalta you may have a reaction - which can lead to difficulty breathing, panic attack, blood pressure issues, seizure and even death.
Your pharmacist and doctor may not be too concerned with it since your Ultram dosage may be so low it shouldn't be a problem. But still read up on Serotonin Syndrome and make sure you can recognize the symptoms.
My with took Ultram (before upgrading to Percocet). One day - while she was also taking an SSRI - she took a couple extra Ultrams (she was prescribed about 400 mg a day) on top of her normal script. Well she went to the ER with difficulty breathing and other symptoms of Serotonin Syndrome. Luckily she had an EMT treating her that was aware of Ultrams and their reaction with SSRI's. When we mentioned the story to our newest pharmacist he said the doctors and the old pharmacist should of warned her of the possible problem.
So be careful and make sure you stick to the prescription! Do not take more of the medicine than you are supposed to in a given day.
As far as Ultram and it's usefulness for nerve pain, I would have to say it worked the best for me and my wife. She has Fibro and I have Occipital Neuralgia. Out of all the medicines I have been on Ultrams work the best. However I was allowed (from a past doctor) to take it daily and developed a tolerance to it (over a 5 year period). I wish I had something like Ultram to take for my nerve pain. Two 50mg tablets would give me relief for almost 8-10 hours. So it might be a good solution for your pain needs.
BTW: Many people get nauseas because of various pain medicines. Sometimes it gets better, sometimes it never gets better and people stop taking their pain medicines because of it. Chat with your doctor if you feel it's getting worse or if the symptom doesn't improve and they may want you to take some otc anti-nausea medicine.
Also Lyrica has shown a lot of promise for people with various types of nerve damage. One of the only problems is that it hasn't been approved for non-diabetic nerve pain. When they tried me on it I had to pay out of pocket (it was worth a shot, but an expensive chance to take). Hopefully your insurance will help you with covering it, that or your doctor gives you a good supply of samples to use.
Lyrica for Fibromyaliga
I heard lyrica was recently approved for fibromyalgia. But I can't seem to find anything about that. Have you heard of this?
According to Pfilzer.com - Lyrica is only approved (according to the FDA rules) for the following:
"LYRICA is medicine approved by the U.S. Food and Drug Administration (FDA). It is useful in treating 3 conditions. LYRICA is used to treat Diabetic Nerve Pain and Pain after Shingles. LYRICA also helps to relieve partial onset seizures in adults with epilepsy who take 1 or more drugs for seizures."
Many drugs have off-label uses and many doctors prescribe drugs for off-label conditions. These uses have not been FDA approved for. Drug companies have various reasons for not submitting their drugs for FDA approval for more than one usage. For one it usually costs a ton of money for the pharmacies to submit drugs for all their potential uses – which would in turn gain a wider FDA approved usage. But if a drug company did this for every drug and for every possible use for their drugs it would just jack up the cost of the medicine for the end consumer and increase the potential for negative publicity if the drug has bad reactions in a certain sample of patients.
For instance only one drug is currently approved for indoor allergies. Currently Clarinex is the only prescription nonsedating, 24-hour antihistamine approved for the treatment of indoor and outdoor allergies and hives of unknown cause. This doesn't mean that it is the only drug that treats indoor allergies. It is however the only prescription drug allowed by law to say they treat this condition - which means they have paid the FDA to have their drug tested and approved for that condition. Many doctors will prescribe Allegra for indoor allergies, even though it isn’t approved officially. Although it hasn't been approved for indoor allergies by the FDA it has shown to be effective.
What this means in the longer run is when a drug is the only one of it's kind to be approved for a certain condition, the drug company has paid to have the FDA test and approve it for such use – then the drug company makes a ton of money because it gets to advertise it’s drug as being the ONLY DRUG APPROVED FOR such and such condition. Many insurances will not pay for new drugs that have just passed approval from the FDA because of price and safety concerns (if a drug is too new an insurance company may hold off for a given amount of time to determine if it is safe for their customers use – basically saving them from costly lawsuits). If they do pay for a new wonder drug they make sure a patient has the condition the drug is labeled for.
My insurance wouldn't pay for Lyrica because I'm not diabetic and I don't have shingles (the two official FDA approved uses when I tried it). So I had to pay for this expensive drug out of pocket. If I did have nerve pain caused by diabetes and my insurance company would pay for a drug like Lyrica they usually would make me try a less expensive alternative. So an insurance company might pay for me to try Neurontin first, then Topamax, and then maybe they would offer coverage for Lyrica (this is in regards to nerve pain).
So from Pfizer’s website Lyrica hasn’t been approved for Fibromyalgia. That isn’t to say it won’t work for you or it doesn’t work for Fibromyalgia. Most people I know try Neurontin and Topamax for their nerve pain. Have you tried these? Like I said my wife has Fibro and has been on a bunch of different types of medicines. If you have any questions just email me or PM me through here. My email is: rhodan69NOSPAM@gmail.com - just removed the NOSPAM part.
In my opinion Ultram is a dangerous drug because for one the doctors are saying it's not addictive when it most certainly is.Also people abusing Ultram are at a high risk of siezures.The pain killing quality of Ultram is about the same as tylenol#3 so it's not a very good pain killer to begin with.All in all anyone taking this drug needs to be aware of the side effects and dangers of taking more than prescribed..Have a good day everyone.....Dave
anyone taking this drug needs to be aware of the side effects and dangers of taking more than prescribed
That's true about ALL drugs. You should know and research as much as possible the side effects of ALL the drugs you are on.
it's not a very good pain killer to begin with
Pain is not a simple generalized issue that can be treated the same across the board. Some people get loopy on 800mg ibuprofen tablets, when others can function perfectly on high doses of morphine. What works for some does not work for all. Many people I have talked with say Ultram didn't offer them the relief they wanted or expected. Other's swear by them.
Ultram reacts/functions so uniquely in regards to what they do to the body/brain that comparing them to pain relievers like Percocet, Viccodine or T3 is hard to do. Yet you are correct on a technical basis. During double blind studies Ultram was equivalent to Tylenol with Codeine 3. But I find it hard to compare the way Ultram functions in the body against normal opioids.
Ultram is a dangerous drug because for one the doctors are saying it's not addictive when it most certainly is
In my experience people who take it 2-4 times a week have no trouble with dropping them when they are no longer needed. So if they are prescribed for you to only use a couple times a week and you follow your prescription as indicated, you shouldn't have addiction, withdrawal or discontinuation problems. This isn't an across the board rule either. Ultram addiction is usually found in people who have the mental/emotional reasons for abusing ANY narcotics. Difficulty withdrawing from Ultrams is increased by the length of time you are prescribed the drug, how many tablets you take and daily usage.
Addiction and dependency are two different things. Most often people dependent on pain medication or narcotics are looked at as addicts. This whole addiction vs dependency issue is what gives people in pain such a stigma from doctors, pharmacists, and many other outsiders looking in.
Oxycontin is a very strong medication that has given many people in chronic pain relief. But this is often overshadowed by the drugs abuse. Just because a drug will give you seizures if you break open and crush up your pills in order to snort them doesn't make the drug evil or bad. The act of crushing your pills, taking them when you just want to get high, snorting or shooting them up is what is wrong or bad. It sure of heck doesn't mean the drug needs to be taken from the hands of the good people in need of the real pain relief in order to make it more difficult for people to abuse.
Anything that makes you feel better when you are in pain has the potential for abuse. It's the double edged sword of pain and pain relief. Luckily new types of morphine-like drugs are being put on the market that self-destruct when you try to crush them for snorting and getting high. Sending blocking agents to the brain and central nervous system to stop the euphoric signals people look to exploit in narcotic and opiate pain relievers.
As for the seizures - people do need to read the information packets the pharmacies give them. I advice ANYONE who uses more than three prescription pills daily or have a chronic illness/condition to get one of the various Pill Books available on the market. If they have internet access then sites like these are an extremely valuable tool for knowing your medicines and finding out the latest studies results that are available.
Here is the insert that comes with the bottle of Ultrams from Ortho-McNeil (the original makers of Ultram): http://www.ortho-mcneil.com/active/j.../pi/ultram.pdf . Usually you don't get this pamphlet when you fill your prescription at your pharmacy. They opt to give away their version.
Jenidarlin - As for Fibromyalgia my wife and I have been reading a great and rather large book about it. It's called: Fibromyalgia & Chronic Myofascial Pain by Devin Starlanyl & Mary Ellen Copeland. It is in it's 2nd printing so if you get a copy make sure it is the GREEN cover and not the BLUE cover - but if you find the BLUE cover for a cheap price grab it. Try to order a copy from Borders through their used program. We have places called Half Priced books near us. All of their books are half of the retail price. If you got something like that near you be sure to check them out for a copy. It retails for: $19.95, but for most people with Fibro they consider it worth $50 or more. It's THAT useful and informative. Good luck!!!
Pfizer's Lyrica Cleared for Fibromyalgia
Associated Press 06.21.07, 4:23 PM ET
Drug developer Pfizer Inc. said Thursday the Food and Drug Administration approved its drug Lyrica as a treatment for fibromyalgia, a widespread and chronic pain condition.
The drug is already approved as a diabetic nerve pain treatment.
I just started taking it and it sure helped but I took it during the day, which is not a good idea, due to the side effects of feeling dizzy and totally, OUT OF IT.
I am so sorry for what you are going through. I am very experienced with this so called rare and mysterious fibromyalgia. You know this is really just a name for a group of symptoms right? because they don't really know what to call it , and most Drs. don't even have a clue of what they are dealing with too.
We have it rampant on both sides of the family , as well as the disorders that cause it's symptoms , or it, fibro.
This is something that if you are having this type of trouble already with , I would try to do some searching either through friends , family etc., and or however you can. Internet it doesn't matter.
The majority of fibro cases we have heard of (through a group we were once in that had about 3000 people with it's symptoms in it) ended up having to be diagnosed through a neurosurgeon , wityh MRIs. A few neurologists were good enough to DX it but remember a NSG is the one who will have the final say on any MRI DX , and possible future MRIs that could actually nail down the cause of your problem.
You may even need a CINE MRI ( one which can show if you have a restriction that is causing any restriction in the flow of CSF (cerebral spinal fluid). This is the idea behind the initoial MRIs , except most pain specialists who order one are looking for something that is going to stick out like a sore thumb. ie tumors, etc., etc. There are neurogists galore out there who can't really read certain things on an MRI and don't know to order a CINE MRI. It's not that they are stupid, it's just they have not seen certain things before, and my point is here , that a pain specialist most likely isn't going to be able to read an MRI on the level of a very experienced NSG, or probably even a so so neurologist.
I know this really sounds critical and alot of people will absolutely not believe this and say we just have had bad experiences etc., and this is our opinion.
I swear it is not that at all.
My wife and son both have chiari. A condition that ends up putting pressure on among other things, more critical, the spinal cord , which is what creates the fibro symptoms.
I and my side of the family have spinal stenosis. Which is a narrow spinal canal basically and leads to pressure on the spinal cord causing fibromyalgia symptoms etc.
Some of us have spent 30 years going from DR. to Dr. with no answer and basically had to do the detective work ourselves by locating others with the same symptoms and go from there.
What is really shocking is how many people that have chiari have , or were DXed with fibro originally , and some of their Drs. still say they just have fibro, until they see a report from a NSG about the chiari that caused it.
We've seen neurologist get really angry over a NSG "we saw behind their back" and their DX of the chiari that the neurologist could not DX for years. The NSGs get to go in and see these things right inside of the skull, and do the repairs too. We have been told by a NSG that some neurologists actually are jealous of this, and just hate that the NSGs always get to have all of the fun more or less; )
I would maybe take the pain management Drs. MRi suggestion. Jsut call the office and say you want to schedule for it if you can and see what they say. There are only so many pain magmt Drs. in each area and we have burnt way too many bridges with Drs. over the years with this chiari thing and what was an obvious lack of experience and compassion, by many Drs.
You just have to play the game until you can get the help you need.
It doesn't matter that they should already know all of these things. (well it does but not to you because you need the help right now, and can fight to change the system later).
We had to learn this the hard way , so hard I can't tell it all here . But we have been begged to write a book over the last 11 years of my wife's treatment.
We ended up having her become brain damaged from ignorance and a DR's refusal to make a simple phone call to our NSG , and had to pull her out of a local hospital and take her by car since it was AMA (here) and we were told another hour or so longer to get her to the university hospital where her NSG was at, and she would have been much worse, with retardation, paralisis, or even death. She had an emergency brain surgery and lamenectomy within 24 hours.
I'd try to find at least a neurologist or NSG if you can, who is experenced in fibromyalgia.
Good luck. God Bless
Hope this was of some help to you.
Oh my gosh, I'm so sorry to hear your story, I hope your wife is doing better. Could you explain what an NSG is, what does that stand for? And what is chiari? Thanks!
Topamax is being widely prescribed and easily accessible but beware of this drug. There is a plethora of side effects associated with it. I've been on it for epilepsy and the only reason I stayed on it as long as I did was because I lost my insurance and this was the only drug my neuro would help me get (she gave me samples, she got me on their patient assistance program). She was such an advocate of this drug. I say Keppra, she say Topamax. I say Depakote, she say Topamax.
Topamax destroyed my memory over the course of two years and my vision. I also lost my job shortly after going on it. The dumbing down effect is very common. I literally begged her to help me and she refused. She did give me Exelon, an Alzheimer's disease drug for my memory.
I ended up moving to Florida to get help from my mother. Now weaning off the drug and charging another AED to my credit card. This drug made me so crazy and I got no help when I sought it out at the free clinic in LA. I was told I need neurologist and as I said, I lost my insurance when I lost my job. I am now seeking help at the epilepsy foundation and i have met others who have experienced the same as me. I've also met some who had okay eperiences on topamax. This drug is HIT OR MISS. Was told, however that the negative outweight the benefit. Something pharmaceutical company doesn't want you to know. They are making bank on Topamax. Research plethora of side effects from blindness, glaucoma, kidney stones, hypothermia, insomnia, joint pain and what was the worse for me the cognitive side effects where i was rendered a drooling idiot in job interviews.
I Have Been On Pretty Much Evry Pain Meds Known To Man......also Every Anti Depression Drug Too......i Think I Have Found The Right Combo.......i Take Tramadol 50 Mg 2 Every 4 Hrs (8per Day Max) And 300mg Of Lyrica Also I Take 225 Mg Of Efexorr The Tramadol Is An Immediate Relief For Depression...dr's Will Prescribe This More Freely Because It Is Not A Narcotic...but Acts As One....the Lyrica..is A Little Different...it Makes U A Little Foggy ....it Makes Me Feel Drunk And I Tend To Fall To The Left.....if U Are One Vicodin U Probally Have Vomitted Alot...give The Ultram A Shot ...this Has Been A Wonder Drug 4 Me I Have Been On It Over A Yr.......it Does Have Withdrawls Symptoms That Are Pretty Bad...2 Days Of Anxiety And Flu Like Symptoms.....thats If U Stop Cold Turkey......i Cannot Say Enough Good Things About Tramadol......get Off The Narcotics Especially Anything Cut W/ Tylenol....the Liver Damage Is Bad And Thing Is U Will Not Notice It That Day It Will Get U In A Day Or 2.......t
Lyrica Is Very Expensive If U Do Not Have Insurance Retail It Is
$6.oo Per Pill....but Phizer Has A Program To Get The Meds At No Cost Just Google : Get Lryica At No Cost It Will Come Up ....hope This Helps Someone