Medication?

[Marieg1270]

Hi, can people please let me know their experience of medication. Currently I'm taking amitriptyline each night dose keeps being increased but I remain in pain. Is it better to now try something different?

Thanks

[Blearyeyed]

Many people are helped by Amitriptyline, but many are not. I personally could not sleep on it , it made me on edge because of how it effected my other conditions and actually made the pain worse because of it.

If you were prescribed it to help your pain and not , as many people receive it , just to help you to sleep and you have not felt any significant improvement from it despite increases in dose it is definitely worth asking your GP to trial you on other options , especially if you have been on it for more than 12weeks. You could always remain on Amitriptyline at night as well but taper back down to a lower dose to help you relax and sleep.

There are many options out there and they can either be taken alone or in combination together depending on the individual patient and how well they respond to them.

What is a cure for one can be a curse to another so you will hear both positive and negative experiences about any drug you are offered. What you are looking for is testing what works for you at the lowest dose.

Medications , whether they are prescribed , supplements or over the counter remedies can't control the pain alone , they are only one side of the triangle of Self Care no matter which illness you have.

The other two sides are Physical Care , including diet, physical therapy and pacing your daily activities to reduce the triggers of pain and keep your body strong enough to cope with it.

And Mental Care , involving pacing of mental activity , reducing stress and home and complementary therapies that help you to relax like creating a sleep routine, relaxation techniques, breathing and CBT.

The aim isn't to be 100% pain free but pain managed and you are generally being successful if you are 85% pain free with a reduction in flare days while maintaining a more well balanced but good quality of life.

Options for medications include Pregabalin, Duloxetine, Garbapentin various antidepressants and anti epileptics (which are prescribed for managing nerve pain rather than for the reason they were originally created). Including paracetamol in combination with these medications , vitamin and mineral supplements , and increased water intake can also improve the pain , other Fibro symptoms that increase your pain, and help your body cope with dealing with Fibro in general.

Both myself and my daughter take a combination of lower doses of Pregabalin, Duloxetine and Paracetamol.

These work as well as they can in combination with the other medications we need to manage our other health problems which would flare up the Fibro.

We use Pregabalin rather than Garbapentin because, although these drugs are virtually the same , it can have the same effect on lower doses and it is gentler on the stomach causing less constipation than Garbapentin. That's important if you also suffer from IBS.

My daughter also takes Mebeverine to reduce her IBS and menstrual pain , and this can be helpful to people who get quite a bit of abdominal pain and spasms.

Whichever medication you try if you get serious side effects within hours or days like breathlessness. rashes , allergy reactions, swelling , chest pain you need to call the GP immediately and come off it as you may just be intolerant or allergic to it.

It took quite a bit of trial and error on my part to find the right combination. I ruled out various first options because they made no great difference and gave me more side effects.

Rather than increasing the dose constantly if there was no significant difference after 8 weeks I would go back to the GP ask to try the next option on the lists recommended by Fibro websites while tapering off the one that wasn't working.

You can get mild side effects on any of them so it's better to start at the lower doses while you get used to the new drug in your body to reduce the side effects then increase to a dose that works if it feels that it is making a difference. The initial common side effects can reduce over a month as your body adjusts.

I found I couldn't take more than 100mg of Pregabalin because higher doses made me feel spaced out and drowsy in the day, but I only take 50mg 3x a day now in combo with an equally low 25mg 3x a day of Duloxetine and paracetamol, but this combination only keeps things under control if I listen to my body , avoid my triggers and balance my activity sensibly with rest.

Hope you find your right choice soon , Bee

[Marieg1270 in reply to Blearyeyed]

Thank you that is helpful it has been more than12 weeks and I have an appointment Monday with the doctor. Also good know about side effects as I do suffer IBS as well as being coeliac. I'm constantly trying to stick to a routine and not over exert or stress myself.

[moo196]

The absolute best thing I have ever done wrt pain is to give up diet coke and absolutely everything else with artificial sweeteners in.It tends to be in an awful lot of things since the sugar tax - need to check everything from yoghurts, soups, tonic water, squashes to ketchup. I certainly know it if I accidentally have something with it in.

Worth a try?

[Cat00 in reply to moo196]

I feel like this sugar tax is really backfiring for me. I rarely drink sweet drinks but on the odd occasion you feel like one I would always opt for high fat option as I generally dislike the taste of artificial sweetners and I felt I knew where I was with sugar at least. I was told when I was a child that aspartame had links with cancer etc But now everything has them in so I'm stuck with coffee, tea and water ☹️

[moo196 in reply to Cat00]

I am using juice with fizzy water at times

[Cat00]

That's a good idea, sometimes you just want something other than water...