hydrocodone-one doc suggests longer acting pain med.-help please?

Question:

Today I saw my doctor who prescribes anti-depressants for me (psychiatrist). We were discussing my pain meds and he suggested I take something longer acting than hydrocodone (Norco) which I am now taking, since they tend to make me depressed, etc.  He said possibly the duragesic patch or MS Contin might be better, and to discuss this with my pain doc.  What do you folks think about it?  I’ve been seeing the psychiatrist for about 13 years (for anti-depressant medication only – no therapy, per se). I’d appreciate your input.  Thanks, Editor

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Response:

<snippage> >We were discussing my pain meds and he suggested I take something longer >acting

You didn’t say what is causing your pain. Is it backpain, migraines or what? That would make a difference in the type of med a person would take. > He said possibly the duragesic patch or MS Contin >might be better, and to discuss this with my pain doc.  What do you folks >think about it?  

I have never used the MS Contin, but I do use the duragesic patches and for my type of nerve pain they work great.  They don’t take the pain completely away, nothing will, but it does bring the pain to a level I can tolerate it. Good luck and keep us posted. Sue We survive together or not at all.

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Hi Richard, Interesting, it was the other way round for me. Oxycodone brightened me up, whereas Duragesic patch depressed me. Strange, as Fentanyl IV doesn’t have that effect at all. Morphine and Demerol in more than low dose makes it very hard for me to sleep, however. It just shows us how individual we all are, doesn’t it! Jay

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Sue, it’s for lower back pain (spondylolisthesis).  Thanks for your reply…any more to offer? Editor

– Hide quoted text — Show quoted text – please? > <snippage> >We were discussing my pain meds and he suggested I take something longer >acting > You didn’t say what is causing your pain. Is it backpain, migraines or what? > That would make a difference in the type of med a person would take. > He said possibly the duragesic patch or MS Contin >might be better, and to discuss this with my pain doc.  What do you folks >think about it? > I have never used the MS Contin, but I do use the duragesic patches and for my > type of nerve pain they work great.  They don’t take the pain completely away, > nothing will, but it does bring the pain to a level I can tolerate it. > Good luck and keep us posted. > Sue > We survive together or not at all.

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what does this mean ? http://opioids.com/fentanyl/fentket.html "CONCLUSIONS: Fentanyl activates NMDA pain facilitatory processes, which oppose analgesia and lead to long-lasting enhancement in pain sensitivity." Does this mean that pain sensitivity becomes greater over time by using this ? I wonder if anyone here has developed a pain syndrome from the stress of a bad withdrawal from prescription drugs ? I have it all…chest pains when breathing..soreness in the chest and stomach and 2 years of severe muscle stiffness and tightness and loss of equilibrium. I am trying Elavil now becuase Ocycodone makes me feel ill.  I am new to this and the pain is wearing me down and in Bristish Columbia one cannot just walk into a rheumatologists office..6 months wait..like everything here.  Anyone envious of Canada’s health care system should dosome investigating. R

– Hide quoted text — Show quoted text -> Today I saw my doctor who prescribes anti-depressants for me > (psychiatrist). > We were discussing my pain meds and he suggested I take something longer > acting than hydrocodone (Norco) which I am now taking, since they tend to > make me depressed, etc.  He said possibly the duragesic patch or MS Contin > might be better, and to discuss this with my pain doc.  What do you folks > think about it?  I’ve been seeing the psychiatrist for about 13 years (for > anti-depressant medication only – no therapy, per se). > I’d appreciate your input.  Thanks, > Editor > Editor , >    Individual reactions are so hard to predict . > I have been treated for Major Depression for years > and I have an opposite effect , in that hydrocodone > does not depress me like oxycodone . I only use the > Norco rarely , so I don’t worry about the acet . > The Oxycodone may give you significantly greater > pain relief , which in itself may help your depression . > On another note , fentanyl ( Duragesic ) actually > perks me up a little . If I had to start with Duragesic > or MScontin , I would go for the Duragesic . This > is based only on my own experience and YMMV . > Getting the correct dose of either is as important as > which is best for you , and that may take a little time . > Good Luck ! > Peace , > Richard

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- Hide quoted text — Show quoted text – >please? >what does this mean ? >http://opioids.com/fentanyl/fentket.html >"CONCLUSIONS: Fentanyl activates NMDA pain facilitatory processes, which >oppose analgesia and lead to long-lasting enhancement in pain sensitivity." >Does this mean that pain sensitivity becomes greater over time by using this >? >I wonder if anyone here has developed a pain syndrome from the stress of a >bad withdrawal from prescription drugs ? >I have it all…chest pains when breathing..soreness in the chest and >stomach and 2 years of severe muscle stiffness and tightness and loss of >equilibrium. I am trying Elavil now becuase Ocycodone makes me feel ill.  I >am new to this and the pain is wearing me down and in Bristish Columbia one >cannot just walk into a rheumatologists office..6 months wait..like >everything here.  Anyone envious of Canada’s health care system should >dosome investigating. >R

That site was quite interesting.  Not sure what to make of it.  I have been using the Duragesic patch for 2 years now and the benefit I find is they give me a constant level of pain relief.  In the beginning, my pain specialist started me on the 50mcg patches and that was not sufficient.  He raised it to the 100 mcg and the relief I received was very sufficient.  During this period of time, I was taking oxycodone for break through pain.  Started in March  of this year, we started changing the patch every 48 hours rather than the 72 hours the packaging recomends.  That again made a sufficient difference in the relief I received.  I now use very few oxycodone for break through pain.  In fact I had my doctor reduce my prescription to half of what it was before. Everyone is different in how medication works for them.  This works great for me.  I still do not have the life I had before all of this happened.  But I can now take care of my basic needs, which was nearly impossible before proper control of the pain. I have not had to have my meds increased since changing the patch ever 2 days and from what my pain doctor tells me, a person actually reaches a place where they kind of plateau and seem to stay there.  Perhaps I have reached that place.  He has let me know I will be on these meds the rest of my life which seems rather daunting.  I cannot say enough good about the patches.  They are an extremely strong medication, about 100 times stronger that morphine.  So a patient must be opiate tolerant for their use. The one thing in that site you sent was they were using the patches for post operative pain.  It is my understanding that is not a proper use for the patches. Sue We survive together or not at all.

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