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On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Posted by alan k on 1/24/00 at 00:00 (015048)

I certainly believe emotional attitude can be a contributing factor in both causing and healing various ills. Anti-depressant drugs could help with that, but there are also SIDE EFFECTS of some drugs which can be beneficial for nerve pain. That is, there could be a physiological effect of these drugs in addition to or instead of the improved outlook effect which helps nerve pain in the feet.

Peripheral neuropathy patients are often prescribed epilepsy and anti-depressent medications because they help with the nerve pain, even though they were developed for something else.

They even rub anti-depressents meds on their feet with transdermal gel. Amitryptaline is one they use.

What med were you on AndreaB? Unfortunately I have no idea about the classifications of anti-depressant drugs so I wouldn't know whether the answer would be relevant to what they use for pn treatment.

Others with experience with anti-depressnat drugs, especially if they have 'atypical pf' might post if possible and see if there are any patterns in the kind of drugs used and how used.

I would greatly appreciate posts by anyone with experience with anti-depressant drugs.

Thanks, alan k


Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

john h on 1/24/00 at 00:00 (015049)

amitripiline is a frequent prescribed anti depressant for fibro neuralgia. it appears to help in controlling the pain. i would immagine anyone in constant pain is depressed to some extent. i sure am.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Janet on 1/24/00 at 00:00 (015052)

FYI Elavil is another psychotropic that is known to be effective in some instances in controlling pain with a neurological basis. A friend on mine was on it at 10mg./day after a botched operation resulted in damage to a nerve branch in her neck. She said it helped a lot. The recommended dose for pain control is far less than that used for depression. My neurologist said he would be happy to prescribe it for me but I'm holding off for now.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Nancy S. on 1/24/00 at 00:00 (015053)

Alan, I'm posting from your last category, 'anyone with experience with antidepressant drugs.' My own experience with them is unrelated to PF, except that they didn't prevent me from getting depressed over PF -- but this would be natural. Antidepressants for clinical depression (and panic disorder) remove the black cloud and deep hole, but of course a person continues to experience life's ups and downs as other people do, which is how it should be. (I'm speaking as one who has been on antidepressants for a long time -- it is a chronic problem throughout my family and relatives -- ah, those Scottish and Norwegian genes!)
The tricyclics are rarely used for depression anymore -- too many side effects. But I know they are used for other ailments -- one that I know of is for migraine. A friend of mine has had a lot of help for her migraine by using a very low dose of a tricyclic, I forget which one.
Newer developed antidepressants are much better choices for dealing with depression --ones such as Zoloft, Prozac, Paxil, Celexa (I am on a maintenance dose of the latter). These have almost no side effects, and I consider them a life saver, literally, in modern medicine.
I have no idea how an antidepressant might physiologically benefit PN, but I wouldn't be at all surprised if it would, given that research is finding new uses for them almost daily.
Don't know if this helps you much, but wanted to respond since I do have a lot of experience. -- Nancy

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Trish on 1/24/00 at 00:00 (015061)

I had PF surgery in '95 on one foot. It didn't work, and some nerves were damaged in the process. That has eventually improved quite a lot over the last couple of years. For the first couple of years after the surgery, the pain from the nerve damage was really bad. My GP prescribed Elavil (a tricyclic anti-depressant, I believe). It definitely helped, but I had to reduce the dosage almost immediately because it made me so sleepy. Even at the lowest dose, it was very helpful for the nerve pain, but did nothing for the heel pain. After several months I discontinued it because even at the lowest dosage it made me very tired. Here I am 5 yrs. later, and for the last couple of years have been taking Zoloft for depression, not for the nerve pain....as I said the nerve pain seems to be a lot better. Not sure if the Zoloft is contributing to that or not. Tried to get off the Zoloft a few months ago, became extremely depressed and am back on it again. The heel pain may have been a little worse when I was off of it, but my outlook on everything was worse. So not sure if it affects the pain, or the perception of the pain. In any case, PF has contributed greatly to my depression.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

wendyn on 1/24/00 at 00:00 (015069)

When my pain was at it's peak last summer, my one sports med doctor prescribed Elavil. He explained that it was originally developed as an anti-deppresent but that it was rarely used for that anymore. He prescribed a low dosage and said I could take up to five pills at bed time for pain (which is evidently still not much of the drug because of the low dose).

It was not long after this that I was able to get my pain under control on my own, so I never did try the meds.

My PT agreed that this drug can be very effective for pain relief in people with nerve-related pain. Like anything, you have to weigh the risks and benefits because there are potential side effects...but if it comes down to drugs or sawing your foot off with a butter knife.....best to give the drugs a try.


Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

john h on 1/25/00 at 00:00 (015082)

my experience has been more 'anxiety' than depression about this disease. the anxiety of thinking you could have it forever or the anxiety of facing surgery. anxiety is no walk in the park.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Nicole V.R. on 1/25/00 at 00:00 (015089)

Two weeks ago, I started taking Zoloft for depression, mostly related to my heel pain. About the same time, I went off Voltaren, since I had been having less pain and didn't want to be taking the anti-inflammatory long term. Almost immediately, the heel pain came back with a vengeance, but the anti-depressant is helping me feel less discouraged and more hopeful about the future. Although my heel hurts (when I'm walking in this snow from my home to the car, for example), I'm feeling less likely to feel sorry for myself, or spend a lot of time wondering if I'll ever get better. The Zoloft has made all the difference in the world to me, and I'll take it over the pain med any day! As for side effects, I've only noticed I'm yawning much more (although I don't feel more tired), and I had some headaches in the beginning. It certainly doesn't do much for pain!

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Lori S on 1/25/00 at 00:00 (015104)

I've taken anti-depressants several times in my life. About every couple of years I have a bout with short term memory loss. Was last prescribed Zoloft which was much better than the stuff they prescribed many years ago. I take the Zoloft for about 6 months and then my chemicals in my brain seem to be OK and I go off of it. It's pretty good stuff. Didn't notice any real side-effects except the yawning which wasn't bad. I will take it again if/when the memory loss comes back.
Lori in AZ

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

john h on 1/24/00 at 00:00 (015049)

amitripiline is a frequent prescribed anti depressant for fibro neuralgia. it appears to help in controlling the pain. i would immagine anyone in constant pain is depressed to some extent. i sure am.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Janet on 1/24/00 at 00:00 (015052)

FYI Elavil is another psychotropic that is known to be effective in some instances in controlling pain with a neurological basis. A friend on mine was on it at 10mg./day after a botched operation resulted in damage to a nerve branch in her neck. She said it helped a lot. The recommended dose for pain control is far less than that used for depression. My neurologist said he would be happy to prescribe it for me but I'm holding off for now.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Nancy S. on 1/24/00 at 00:00 (015053)

Alan, I'm posting from your last category, 'anyone with experience with antidepressant drugs.' My own experience with them is unrelated to PF, except that they didn't prevent me from getting depressed over PF -- but this would be natural. Antidepressants for clinical depression (and panic disorder) remove the black cloud and deep hole, but of course a person continues to experience life's ups and downs as other people do, which is how it should be. (I'm speaking as one who has been on antidepressants for a long time -- it is a chronic problem throughout my family and relatives -- ah, those Scottish and Norwegian genes!)
The tricyclics are rarely used for depression anymore -- too many side effects. But I know they are used for other ailments -- one that I know of is for migraine. A friend of mine has had a lot of help for her migraine by using a very low dose of a tricyclic, I forget which one.
Newer developed antidepressants are much better choices for dealing with depression --ones such as Zoloft, Prozac, Paxil, Celexa (I am on a maintenance dose of the latter). These have almost no side effects, and I consider them a life saver, literally, in modern medicine.
I have no idea how an antidepressant might physiologically benefit PN, but I wouldn't be at all surprised if it would, given that research is finding new uses for them almost daily.
Don't know if this helps you much, but wanted to respond since I do have a lot of experience. -- Nancy

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Trish on 1/24/00 at 00:00 (015061)

I had PF surgery in '95 on one foot. It didn't work, and some nerves were damaged in the process. That has eventually improved quite a lot over the last couple of years. For the first couple of years after the surgery, the pain from the nerve damage was really bad. My GP prescribed Elavil (a tricyclic anti-depressant, I believe). It definitely helped, but I had to reduce the dosage almost immediately because it made me so sleepy. Even at the lowest dose, it was very helpful for the nerve pain, but did nothing for the heel pain. After several months I discontinued it because even at the lowest dosage it made me very tired. Here I am 5 yrs. later, and for the last couple of years have been taking Zoloft for depression, not for the nerve pain....as I said the nerve pain seems to be a lot better. Not sure if the Zoloft is contributing to that or not. Tried to get off the Zoloft a few months ago, became extremely depressed and am back on it again. The heel pain may have been a little worse when I was off of it, but my outlook on everything was worse. So not sure if it affects the pain, or the perception of the pain. In any case, PF has contributed greatly to my depression.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

wendyn on 1/24/00 at 00:00 (015069)

When my pain was at it's peak last summer, my one sports med doctor prescribed Elavil. He explained that it was originally developed as an anti-deppresent but that it was rarely used for that anymore. He prescribed a low dosage and said I could take up to five pills at bed time for pain (which is evidently still not much of the drug because of the low dose).

It was not long after this that I was able to get my pain under control on my own, so I never did try the meds.

My PT agreed that this drug can be very effective for pain relief in people with nerve-related pain. Like anything, you have to weigh the risks and benefits because there are potential side effects...but if it comes down to drugs or sawing your foot off with a butter knife.....best to give the drugs a try.


Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

john h on 1/25/00 at 00:00 (015082)

my experience has been more 'anxiety' than depression about this disease. the anxiety of thinking you could have it forever or the anxiety of facing surgery. anxiety is no walk in the park.

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Nicole V.R. on 1/25/00 at 00:00 (015089)

Two weeks ago, I started taking Zoloft for depression, mostly related to my heel pain. About the same time, I went off Voltaren, since I had been having less pain and didn't want to be taking the anti-inflammatory long term. Almost immediately, the heel pain came back with a vengeance, but the anti-depressant is helping me feel less discouraged and more hopeful about the future. Although my heel hurts (when I'm walking in this snow from my home to the car, for example), I'm feeling less likely to feel sorry for myself, or spend a lot of time wondering if I'll ever get better. The Zoloft has made all the difference in the world to me, and I'll take it over the pain med any day! As for side effects, I've only noticed I'm yawning much more (although I don't feel more tired), and I had some headaches in the beginning. It certainly doesn't do much for pain!

Re: On ANTI-DEPRESSANT drugs, and questions about them, and to AndreaB--

Lori S on 1/25/00 at 00:00 (015104)

I've taken anti-depressants several times in my life. About every couple of years I have a bout with short term memory loss. Was last prescribed Zoloft which was much better than the stuff they prescribed many years ago. I take the Zoloft for about 6 months and then my chemicals in my brain seem to be OK and I go off of it. It's pretty good stuff. Didn't notice any real side-effects except the yawning which wasn't bad. I will take it again if/when the memory loss comes back.
Lori in AZ