Pain control with PLMD

[wantokporo]

I take 100 mg Lyrica for PLMD, the lowest possible dosage as I never have been able to shake the daytime sedation. Now I have some kind of pinched nerve that has been causing chronic pain. Tylenol is not sufficient (I am going to try a lidocaine patch today for the first time and hope that will help). I have been on almost every opioid and had trouble with them. Most recently I retried Tramadol and Oxycondone, both caused PLMD rebound. A couple of questions: I am going to try CBD and I know "everyone is different" but I am wondering if anyone has advice on the minimum CBD/THC portions, and how to figure out what is working; i.e., I start with a dropper of tincture under my tongue and then if that isn't working, add another 1/2 dropper, or what? Also, I know Remeron is on the bad list, but I did take it in the past without initial problems and wonder if they just kick in after a while normally? Thanks in advance.

[ChrisColumbus]

I'm afraid I can't help on the pain front, but on the last paragraph: Mirtazapine (Remeron) can exacerbate RLS symptoms, but some consider it less bad than most other antidepressants.

Dr Mark Buchfuhrer's RLS Support Group website says "Remeron may have less side effects than the serotonin uptake inhibitors and the tricyclics, and it even seems to promote sleep. There are 2 case reports of Remeron causing worsening of RLS, so it should be used with caution in RLS patients."

Your previous experience may indicate that you can tolerate Mirtazapine: we're all different.

(Wellbutrin and Trazodone are generally regarded as safe for RLS: Wellbutrin has been shown to actually help RLS, Trazodone not to make it worse).

Both Mirtazapine and Pregabalin (Lyrica) can have CNS depressant effects, taken together these *may* affect the ability to perform skilled tasks. (From British National Formulary)