Chronic pelvic pain and antidepressants

[dlwaller]

I have been having chronic pelvic pain since April of 2015. My doctor initially thought that since I am prone to ovarian cysts that I probably had one rupture. He put me on naproxen and progesterone thinking that would solve the problem. I still had a bit of dull cramping over the summer and fall. The in November, I began to get severe pain in my left pelvic area. I went back to my Gyno and he said that my left ovary would have to come out. When I went to my "surgery consultation" my doctor suggested that I first try to go on an antidepressant because studies have shown that they sometimes help with chronic pain such as I am having. I went on Zoloft that same day, and after the second dose I was having a lot of trouble thinking straight, so my doc put me on a lower dose for a two week trial. After that I upped the dose back to the original 50 mg dose. Within a week I realized that this is not working, so I called and scheduled a consultation to have the surgery that we had originally talked about before he decided to put me on this medication.

My question is, has anyone had any success with using antidepressants for relief of chronic pelvic pain? I was hoping that this med was going to help so I could avoid surgery, but now I am going to have to bite the bullet and have the surgery done, and just hope that it works.

[Hidden]

Doesn't sound like you have had a psychotherapist or other mental health provider really explore anti-depressant options. If your situation is medically stable, you might want to see what a full trial of meds and cog/beh therapy might do prior to surgery. It involves more than just trying two levels of Zoloft doses. Good luck!

[Cheryl37]

Wrong antidepressant for pain. It sounds like your doctor hasn't done his research on what causes the pain relief. You need one that affects both serotonin and Norepinephrine. They are in a class called SNRI's. The one typically used is called Effexor, although there are a few others. I was told by my doctor that it is the norepinephrine reuptake inhibitor that causes the pain relief. I believe Zoloft only affects serotonin. It is also usually prescribed in conjunction with Neurontin (gabapentin) as they work synergistically together. Hope that helps.

[Rocky68]

Is ovary diseased or something wrong with it? Have you tried laparoscopy to see if you have endometriosis? Seems rather severe to remove ovary if nothing is wrong with it.

I take Clonazepam for anxiety but don't know if it is used for depression. I have heard of using Amitriptylene is small dose to relieve pelvic issues. Be careful on antidepressants as some people actually become more depressed when taking them. Rocky68

[dlwaller in reply to Rocky68]

I have had female issues since I first began having cycles and I have had many cysts on my ovaries over the years. I had an ovarian cyst rupture back in April and have been having a lot of pain ever since then. I go in for my surgery consultation tomorrow. I had a hysterectomy 10 1/2 years ago but because I was only 30 my dr left my ovaries. The Dr that did the hysterectomy said that eventually my ovaries would have to be removed but I had my doubts. Now it seems that my Dr was right. I think my current Dr thought that the Zoloft would help with my pain but all it did was make me feel like a zombie.

[Desperateforrelief]

I had problems with ovarian cysts since I was young. I had a hysterectomy and 6 years following had the right ovary removed and the left 2 years after that. I have read that it is common for ovaries to have problems after a hysterectomy. I don't think I had enough estrogen from my ovaries after the hysterectomy and became much better after they were removed and I was supplemented. Not related to this issue I've had pelvic pain from a mesh product and the medications they used in the antidepressant class did not help at all, and some made my pain worse. I've had cysts get to the size of grapefruits. One cyst that ruptured, perforated my appendix and I ended up with appendectomy. If they are causing a lot of pain on a regular basis it is better to get them out. I felt much better. We are all different, so medicines are not one size fits all. Second opinions are also highly recommended before making decisions. Hope this helps!

[dlwaller in reply to Desperateforrelief]

Thank you for your post. It sounds like you went through a similar situation as I am now. I'm glad that you are feeling better since ovarian removal. My Dr says he is going to take both ovaries because more often than not he has to go back within 5 years to remove the second one as well.

[Cardinal]

I agree with Cheryl's comment - Zoloft isn't the right antidepressant for pain, and you should go to a more experienced pain med doctor or even psychiatrist. When you hear of antidepressants helping pain, they are talking about Cymbalta and similar meds to that. Like Cheryl said, it needs to be a SNRI, not SSRI.

Here is a link to reviews for Cymbalta for chronic pain: drugs.com/comments/duloxeti...

Personally, though, I take a small dose of methadone (5mg every 8 hours) and it erases about half of the pain and doesn't give me any side effects like you experienced with Zoloft.

[dlwaller in reply to Cardinal]

My dr did want to put me on Cymbalta but I had an adverse reaction to it a few years ago so I asked what else he could suggest which is why he did the Zoloft. Since it didn't work I'm going ahead with the surgery to remove my ovaries and fallopian tubes. I believe that this is what is going to help alleviate my pain.

I have had female issues since I started having periods at 12 years old. I had a grapefruit sized cyst removed from my left ovary at 18, a hysterectomy when I was 30, a cyst ruptured on my left ovary back in April and now at 41 I'm having my ovaries taken out. I think that once this is done my pain will subside.