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Posted 8/23/2018 4:03 PM (GMT 0)
It's been already several months that I am having depression, anxiety and OCD mainly caused by chronic knee pain that is affecting my daily life and has forced me to stop the sports and activities I used to enjoy.

After several tries with CBT, psychotherapy etc. failed, I was recommended, by more than one doctor, to go on an antidepressant. I read that Effexor is an antidepressant that may work also for chronic pain, even if its use for that is off-label. My orthopedist wanted to put me on gabapentin for the pain, but I am too scared by the side effects.

What is your experience with Effexor? Did it mess up with the GI system? Often antidepressants can cause nausea, diarrhea or constipation etc. Are these effects temporary while the drug builds up in the body during the first weeks or will they always be there as long as you take it?

Thanks.
Posted 8/23/2018 4:46 PM (GMT 0)
No....it doesnt work for chronic pain at all. I've never had relief from using it....not even in the slightest.
No issues with UC....i did have nausea for a week or so when I started it.

Cymbalta is what's suggested for chronic pain....specifically fibro.
If you haven't started Effexor, start with Cymbalta.

Have you tried Celebrex? Another option for you could be LDN.

q
Posted 8/23/2018 5:15 PM (GMT 0)
Consider sulfasalazine instead of the other oral mesalamines (asacol/lialda/etc)? Sulfasalazine is used to treat both UC and Rheumatoid Arthritis.
Posted 8/23/2018 5:31 PM (GMT 0)
It's not joint pain due to RA or UC, I had that checked both by a rheumatologist and a gastroenterologist. According to the last ortho I saw, it's synovitis, inflammation of the synovial membrane surrounding the knee, and I also had a bone scan that shows increased metabolic activity in the kneecaps, which means that the bones are stressed.

The ortho wanted me to go on a trail of gabapentin, but I am really scared by the side effects and withdrawal later. It's a potent medication, it's used on-label for seizures and diabetic and shingles neuropathy.

So I was looking for an alternative medication that could help both with the pain and with the depression and anxiety associated to it.

I heard about Cymbalta, but again it seems that it has more side effects than other antidepressants and that it's really difficult to come off it because of the withdrawal symptoms.
Posted 8/23/2018 6:22 PM (GMT 0)
I can 99% guarantee you that effexor will not help....but you may be that 1%. Gaba won't help with inflammation. There's lyrica possibly.

Celebrex? I'm on it now...for past 2 months, and my hip pain has gone down by half, but it's still bad at times. It's soft tissue probably, or combo with my back issues as well..... but I'm waiting for MRI of lower back. My knee pain....probably soft tissue, no diagnosis as of yet either.....seeing the specialist doc sept 4.
Celebrex (with breakfast) has helped a lot as well.

I begged for the celebrex because my brain needed a break from it.....diagnosis process is (every expletive possible) slow here unless its obvious.

Im also taking NAC at supper....just because of all the tylenol I take and it seemed to help in the past.

Have you tried compounded topical pain reliever?
My friend has one that seems awesome. Could be worth a try....I'll get the mix if you're interested.

q
Posted 8/23/2018 7:07 PM (GMT 0)
I have actually tried a COX2 inhibitor very similar to Celebrex last year, Exinef. I took the first dose, then started immediately to have abdominal pain, so I stopped it. After 4 days I got my first UC flare since diagnosis. At the same time I had also started to take a curcumin and boswellia supplement for joint pain. I have always wondered if it was the COX2 inhibitor, the curcumin and boswellia supplement or the combination of both that caused the flare. Or if it was coming anyway. No doctors can know that either.
Research about GI side effects of COX2 inhibitor is still inconclusive.

Since then, I have always been very wary about taking again a COX2 inhibitor (let alone regular NSAIDs).

I have tried Voltaren cream (based on diclofenac), but it didn't help. Probably it doesn't reach deep enough into the tissue to have an effect.

Lyrica is in the same class of drugs as gabapentin. They are not for inflammation, but for neuropathic pain. The ortho wanted me to go on gabapentin because he thinks that there is a neuropathic component in the pain I have. The inflammation is more chronic and low level, never had any swelling, tenderness or warmth. I even had a steroid injection that did absolutely nothing.

I am now considering asking him if it makes sense to try a short course of oral steroids rather than NSAIDs.

Post Edited (adamas) : 8/23/2018 1:12:41 PM (GMT-6)

Posted 8/23/2018 7:15 PM (GMT 0)
Are you still on Effexor quincy? How long have you been?

Is it a medication that one can continue lifelong or are there long-term side effects?
Posted 8/24/2018 12:03 AM (GMT 0)

adamas said...
I heard about Cymbalta, but again it seems that it has more side effects than other antidepressants and that it's really difficult to come off it because of the withdrawal symptoms.

I was diagnosed with UC last month, and the last two months have been the most miserable of my life; however, before that, the most two miserable months of my life were probably a decade ago when I stopped taking Effexor. The withdrawals both during the tapering off period and after I was complete off were terrible. I've never been on Cymbalta, but from what I've read, I have no reason to believe it's any better or worse than Effexor withdrawal wise.

I experienced no negative side effects from the Effexor other than a near complete dampening of my emotions (which was somewhat expected) that I didn't even recognize until after I got through the withdrawals, and I did not suffer from any chronic pain at the time, so can make no statements about that.
Posted 8/24/2018 1:47 AM (GMT 0)
Adamas..I've been on it since 2001, low dosage.37.5...went off, back on and to 75mg around 20022 or 2003. Then off 2012, and back on 6 months later. Had no issues withdrawing, but I'm only 75mg. Took 3 weeks - a month to get off and used alternating dosage process as well as taking out some of the spheres from the 37.5 capsules.

Was going to consider cymbalta......I'll discuss it with a doctor to try it. My GP is retiring at the end of sept. So new doctor I get I'll consider 8t then, and after seeing the rheumy sept 25th.

One celebrex type med wouldnt have caused your flare, and probably not the other supplements.


q
Posted 8/24/2018 2:21 AM (GMT 0)
A, Effexor will not help your knee pain at all. Synovitis is inflammation of the synovial fluid. Synovial fluid is what lubricates the knee joints. NSAIDS are the first line of treatment, which is out for UC folks. Next step is to scope the knee & clean it up on the inside. Arthroscopic surgery on knees are not difficult to recover from. In fact they want you walking on the knee the day of surgery. I would suggest finding an orthopedic that does knees only. I have had 5 knee scopes over the years for various problems.

The side effects from Effexor should go away in a week or two at the most. You may not have any issues with it all. Again, Effexor will not work on the pain you are having with your knees.

Take care.
Posted 8/24/2018 5:49 AM (GMT 0)

straydog said...
A, Effexor will not help your knee pain at all. Synovitis is inflammation of the synovial fluid. Synovial fluid is what lubricates the knee joints. NSAIDS are the first line of treatment, which is out for UC folks. Next step is to scope the knee & clean it up on the inside. Arthroscopic surgery on knees are not difficult to recover from. In fact they want you walking on the knee the day of surgery. I would suggest finding an orthopedic that does knees only. I have had 5 knee scopes over the years for various problems.

The side effects from Effexor should go away in a week or two at the most. You may not have any issues with it all. Again, Effexor will not work on the pain you are having with your knees.

Take care.

I have seen already four different knee orthopedic surgeons over the past year. This knee pain has been a nightmare, since I had to abruptly stop every activity I used to enjoy and even in my daily life I feel pain often. The first three OSs just told me that it's patellofemoral syndrome (a syndrome is not a diagnosis...) and there's no indication for surgery, just told me to do PT and knee injections.

Since I didn't improve with these treatments, I did my research and found an OS in San Francisco who extensively studied this condition and has a real diagnosis for it, i.e. synovitis, despite the MRIs not showing it as clearly as the classical synovitis of someone with rheumatoid arthritis. He is very conservative and considers arthroscopic surgery as a last resort. He prescribed me gabapantin because, in his opinion, the pain has both an inflammatory and a neuropathic component. Gabapentin is for this latter, not for the inflammatory one.

I found out that some SNRIs are used for neuropathic pain as well off-label, Cymbalta for sure and there's some limited evidence for Effexor also. Since I got depression from this ongoing problem, I was looking for something that could treat both issues.
Posted 8/24/2018 4:54 PM (GMT 0)
Do cymbalta.....Effexor isnt going to help.

q
Posted 8/24/2018 5:40 PM (GMT 0)

quincy said...
Do cymbalta.....Effexor isnt going to help.

q

Quincy, you said you have been on Celebrex for 2 months continuously, right? What dosage?

Has it ever bothered your UC? Have you had any other GI symptoms like heartburn, cramps etc.?
Do you take it with a PPI?

Thanks.
Posted 8/24/2018 6:28 PM (GMT 0)
Hi.....I take Zantac usually one or sometimes two at bedtime.

The celebrex (celecoxib 200mg) is to be taken with food, so I take it with breakfast. I have the OK from my GI and hepatologist....Uc and PBC is in control and I'm on meds for both. No change since taking the Celebrex re symptoms or blood tests.

I do, however, have a voice change. I did and do have that from reflux....last year my asthma inhaler change to Breo created a hell mess. I stopped it and changed back to Pulmicort and added Oxeze last fall to twice daily. It could be the factor, but it changed more notably after starting the Celebrex. I'm also being checked for Sjogrens....so dont take that as a gospel side effect.

Oh....and maybe more relaxation of my vision....but the other meds like robacacet, dicyclomine and the fact I had vitreous detachment in both eyes (left in Dec, right in Feb) has taken me aback bigtime with the floaters and blurring, etc.

Im also on blood pressure and statin meds. I dropped the Amlodipine because I saw it as an INCREASE in pain all over, and swelling of my right knee and right foot metatarsal area.
Eye issues are associated with it as well.....so who knows. I'm royally ticked and stressed by the changes. Too much at one time, and my temper can be from 0 - 100 in 3 seconds relating to myself. Now its more of a quiet anger....a better change.

The topical my friend uses is in abreviation.....I'll post it. I suggest you ask your doc to create a concoction to be compounded from hers as a suggestion.

q
Posted 8/24/2018 7:23 PM (GMT 0)

quincy said...
Hi.....I take Zantac usually one or sometimes two at bedtime.

The celebrex (celecoxib 200mg) is to be taken with food, so I take it with breakfast. I have the OK from my GI and hepatologist....Uc and PBC is in control and I'm on meds for both. No change since taking the Celebrex re symptoms or blood tests.

I do, however, have a voice change. I did and do have that from reflux....last year my asthma inhaler change to Breo created a hell mess. I stopped it and changed back to Pulmicort and added Oxeze last fall to twice daily. It could be the factor, but it changed more notably after starting the Celebrex. I'm also being checked for Sjogrens....so dont take that as a gospel side effect.

Oh....and maybe more relaxation of my vision....but the other meds like robacacet, dicyclomine and the fact I had vitreous detachment in both eyes (left in Dec, right in Feb) has taken me aback bigtime with the floaters and blurring, etc.

Im also on blood pressure and statin meds. I dropped the Amlodipine because I saw it as an INCREASE in pain all over, and swelling of my right knee and right foot metatarsal area.
Eye issues are associated with it as well.....so who knows. I'm royally ticked and stressed by the changes. Too much at one time, and my temper can be from 0 - 100 in 3 seconds relating to myself. Now its more of a quiet anger....a better change.

The topical my friend uses is in abreviation.....I'll post it. I suggest you ask your doc to create a concoction to be compounded from hers as a suggestion.

q

Maybe I could cautiously try again Celebrex. I am still scared that it was the cause of the falre I had last year, but, on the other hand, seems unlikely that a single dose, immediately interrupted, would cause a flare. It's not even in the same class as ibuprofen, but it's a COX2 and theoretically should have less GI side effects.

I am wondering if it was the curcumin+boswellia, but that seems unlikely too, they are being studied for controlling UC!
Posted 8/25/2018 2:05 PM (GMT 0)
When you flared last time on celebrex and curcumin/boswellia.....what meds were you on?

Remember, I'm not 100% pain free....but at least I can climb the stairs with much less pain. I still take Robaxacet (costco Back relief brand) and a Robaxin when I get up in the morning and usually the back relief in the late afternoon or as needed.

My friend's topical rx for pain is (all abbreviated)...
Cyclo 2%
Gaba 5%
Ketop 5%
Lido 2%
In Versapro base

q
Posted 8/25/2018 3:31 PM (GMT 0)
I have been put on Celebrex several times over the years. It has not ever caused me any issues. I have seen many members be rx'd it over the years here at HW. It may be worth a try, like you said I don't think one pill would cause a flare.

I feel for you that the ortho's have literally blown you off over your knees, unless in their opinion the inflammation is mild. For someone with severe synovitis they do what is called a synovectomy. Part of the procedure is to remove the synovial fluid to be tested by a pathologist to rule out several potential issues.

I hope you can figure out something that will bring you relief.
Posted 8/25/2018 6:02 PM (GMT 0)

quincy said...
When you flared last time on celebrex and curcumin/boswellia.....what meds were you on?

Remember, I'm not 100% pain free....but at least I can climb the stairs with much less pain. I still take Robaxacet (costco Back relief brand) and a Robaxin when I get up in the morning and usually the back relief in the late afternoon or as needed.

My friend's topical rx for pain is (all abbreviated)...
Cyclo 2%
Gaba 5%
Ketop 5%
Lido 2%
In Versapro base

q

I was on 3.6g/day Lialda and 1g mesalamine suppository, and had been on that for a long time. Plus, I was taking probiotics (VSL3).

The flare started out of the blue one day, and I got a bout gastritis and reflux too. I hindsight, my GI said that it was a mild flare because I had no more then 3BMs/day, limited tenesmus and urgency and CRP, ESR, WBC etc. were all within the normal range. But I had loose stools/diarrhea with mucus and every now and then I saw blood mixed with mucus.

I have ordered a curcumin supplement (Meriva brand, curcumin only, no black pepper or anything else) and would like to give it a go. I cannot carry on physically and mentally with this knee pain. Then, if the curcumin does nothing, I could try Celebrex.

If most of the people here didn't have particular issue and since the research is showing that the risk of GI side effects is much lower than conventional NSAIDs, probably the flare I had was on its way regardless...

I have tried a topical cream before, with little or no relief, because it doesn't reach deep enough into the joint.

Quincy, is your pain inflammatory arthritis due to UC or is it unrelated to that and it's more musculoskeletal/mechanical?
Posted 8/26/2018 4:06 PM (GMT 0)
I dont think it's related since I've had issues since I was 10ish in mid 60s. Growing pains is what I had....sigh..... but always back pain and hips/lower groin into thighs, and right knee bad in 1970 - 72 which Xray showed nothing for that.

I was diagnosed with myofascial syndrome in 1987/1988, so definitely musculoskeletal/mechanical. Spray and stretch treatment sent my neck and back into complete hell spiral, and add the first diarrhea episode in early 1987 and a weighloss of 17 pounds which I suspect was some invader that eventually triggered UC.

None of the pain is new, just really more ticked as I age.

q
Posted 8/27/2018 5:48 AM (GMT 0)
Effexor killed one of my best friends. It causes elevated blood pressure, which caused her to pass out in a position that ended up suffocating her. Stay away.
Posted 8/27/2018 4:40 PM (GMT 0)
Travesty.....sad to hear about your friend's death.
There are always other variables involved. It can raise blood pressure....yes. Not everyone on Effexor dies from it.

q
Posted 8/27/2018 6:01 PM (GMT 0)
No, not everyone dies from it. But it is one of a few antidepressants that has the side effect of raising blood pressure such that people who go on it are supposed to be monitored. If there are other options, take them. Effexor is often used as a last resort for people who are otherwise resistant to other antidepressants because of all the side effects (like my friend).
Posted 8/28/2018 6:54 PM (GMT 0)
If you say so.
That must be why there are 11 generic makers of it.
q
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