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Strange symptoms... looking for cause.

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Chronic Pain
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Posted 8/15/2011 1:23 AM (GMT 0)
In May, my PM had me try Wellbutrin. I used it for about a month, but it had no effect. So we tried Savella. It caused a very unpleasant pressure in my head, mental cloudiness, and severe constipation. So, I stopped it after about a week.
That was early July.

Since then, I've had many days with light-headedness, vertigo & mild headaches. It doesn't feel the same as when I was on Savella, but it seems to have started around then.

During June and July, I was also taking about 50% more medication than typical. Instead of BT meds 3-4x week (for a few years), I was taking them 5-6x week. Usually, I would take 10mg of hydrocodone in the late morning or early afternoon. If needed, either 5mg more in the late afternoon or 5mg of oxycodone.

Relative to most with CP, I assume those amounts aren't too substantial.

I first thought that the problem was a bad batch of Ultram ER because the day I switched to a new bottle, I felt much better. But I also had not taken any BT meds for a few days.

I am currently, evaluating another hypothesis -- and haven't taken any BT meds for 4 days. Over these days, my mental symptoms seem to have lessened, but are still present. Today has been the first day in a while I've been able to focus on work -- so could the Savella have altered how my brain responds to opioids? or could this simply be a result of too many BT meds?

Another possibility is stress, which I have a lot of right now, but I have had enough bouts of stress and anxiety in my past without these symptoms.

So, any ideas? Has anyone else had such lingering effects from a brief trial of an SSRI or SNRI? Or from changes in frequency to BT meds?

Thanks.
Posted 8/15/2011 8:22 AM (GMT 0)
Hey Cogito....

I'm as confused as you smilewinkgrin Meaning - I get what you are saying, but it could be any one of the ideas you've had.

I don't know too much about Savella.... other than what I've read here.... but I would say the timing is *probably* coincidental... and probably not a long-lasting effect of the med. Again, though, just my thought.

It *could* definitely be the BT meds. Especially since reducing the meds, you see some better focus and such. Are you able - with your pain issues - to stay off your BT meds for another week or so to see if things further improve?

That being said, as you said - you are on a relatively low amount of meds.... and you've been on them for such a period of time - that I would think you wouldn't have these side effects.

Re: the stress theory - trust me, I can tell you firsthand that stress can bring on symptoms that you never even dreamed of.... but, like you said, you've been through stress w/out these symptoms - so who knows.

Another thought - all together different - is something totally different and unrelated is going on and it's just again coinciding w/ these different meds and all.

Re: the SSRI thought.... having had to get off of Zoloft and Effexor at different times - SSRI withdrawal can be terrible. However, you were on things so short of a time... and it's been enough time now - that I wouldn't think that it would still be going on....

So, was I a help? Let me answer.....NO :) Honestly, though, if you can - I'd try to stay off the BT for a while longer and see if your symptoms improve. From there, I'd probably say a visit to your doctor might be a good thing.

Sorry.... just trying to help.... but not really sure.... Hopefully others will have some thoughts... or, actually, hopefully your symptoms will just go away!!

--Tina
Posted 8/15/2011 11:45 AM (GMT 0)
When you are feeling lightheaded, what is the position that you are in? Sitting, standing, laying down, etc..

Feeling lightheaded could be a sign of low blood pressure. I suffer from that daily and it can get very low at times where I pass out without much warning or no warning at all.

When you are light headed - try laying down and see if that helps the feeling to go away. Get up from a lying position gradually, if sitting - stand up slowly, etc..

Just a few ideas that may help - I hope so anyway!

Trudy
Posted 8/15/2011 2:58 PM (GMT 0)
I have what might seem like a totally random thought on this that has nothing to do with your pain meds. Do you have sinus/allergy problems? I have environmental allergies and thought I had it under control until last summer when I started having vertigo and light-headedness. It got bad enough while I was on vacation that I went to the ER. They didn't discover anything "wrong" but my doctor suggested that it might have been my sinuses putting pressure on the inner ear, etc. I didn't really think that my allergies were that bad at the moment but I switched up my medication at his suggestion and the problem resolved. At times I do cut back on the meds because of the cost factor but when the problem reoccurs like it did this summer at just about the exact same time I up the doses again with dr's OK and things are under control again.

I just looked through your signature and saw that you have heart issues. Could they be the cause or are those issues well under control?

Good luck in finding a solution, Lee
Posted 8/15/2011 4:29 PM (GMT 0)
Thanks for the ideas.

I've considered my BP, which is a bit on the low side (110/70), but the mental symptoms are present whether sitting, walking, etc. & they don't increase as I am getting up. Lying down, though, does help. My dose of Verapamil could lead to these symptoms, but I went up to 240mg nearly a year ago.

I also wondered if this might be an inner ear or sinus problem, but I have no fever, no allergy problems, and my breathing is clear.

I've gone a few days where the pain was quite bad and I didn't take any BT meds. Today is turning out to be a bad pain day and I'll see if I can make it through without them.

If anxiety related, then I may be stuck since I've never tolerated anti-d's and benzo's will prevent me from working.

If I go to my doctor, what will he do? I suppose various diagnostic tests and/or a neuro referral. I suppose I'll have to contact him if the symptoms don't go away in another week or so.
Posted 8/16/2011 7:23 PM (GMT 0)
you need a fixed dosing time for meds your taking and you should not shock your system by going on and off. until things are stabilized it would be tough to make any Dx.
Posted 8/17/2011 1:00 AM (GMT 0)
Hi Spinal Soldier,

I agree that fixed dosing is optimal for my base-level pain and I do take Ultram ER at the same time every morning.

But my BT pain needs vary considerably, depending upon the weather, what stage of work I'm in (research, writing, revising), and whether I have had to do much in the way of household chores.

Sometimes, I can go most of the week without needing any BT meds (pain stays 1-3, with only brief periods higher); other times, I'm in significant pain through most of the day and day after day for weeks.

I wish there were something slightly stronger than Ultram, or that my PM would prescribe it at 400mg, but unless I move to Oxycontin, etc., I'm stuck with the 300mg Ultram.

I ended up going 5 days before taking any BT medication (10mg Hydrocodone). Today, the symptoms were not any better or worse than 2 days ago, except no headache.

So, I still don't know the cause but I'm keeping a journal of symptoms, medications, supplements, etc. to help me track it down.

I also today started back on some supplements -- I stopped all of them about a week ago just in case they were playing a role. I've restarted my Co-Q10, Vitamin D, Omega 3, Multi-Vitamin, and D-Ribose.
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