Pharmacology Questions about transmitter depletion and the pharmacology of combining reuptake inhibitors and releasers

[rentedbythehour]

Wow, fibromyalgia sounds awful! I gather you have it under control?
Interesting point that if my pain is limited to my knees then perhaps it's less likely opioid/Kratom related. I don't know, I guess I figured one thing could happen was that the perception of pain would be amplified. So an injury, arthritis, whatever would be perceived as more painful because of the OIH effect. I mean, I'm sure I have physical problems, but maybe they just seem worse? But that could also tie into depression, which I have.
My only experience with antidepressants was taking Prozac and Wellbutrin many years ago. I did seem to get less depressed, and at the same time, my back pain seemed to get better. But I also made changes in my life that helped with my mood, and I have never been sure how effective the drugs really were.
You like Cymbalta, I gather, for both pain and depression. I have been wondering if I should give meds a try again, because I'm suffering here, mood and pain both. As it is I sporadically take small amounts of opioids and it isn't really doing the job.

I like it because it works for me. I have been on many many different psych meds, mainly because they are also used as migraine preventatives. This started when I was young. Prozac made me suicidal so I wouldn't take anything from that family of meds. When I first started on duloxetine, I felt like for the first time, something was working. Not just on the fibro but also my depression. I can adjust the dose if I feel like I'm getting depressed or struggling. But my fibro pain is pretty much gone. I have flare ups occasionally, which are awful. The one negative to this is that, in the beginning, when I would forget to take it for a few days I would get that feeling in the pit of my stomach that the world was ending. Skipped doses brought on extreme anxiety. It was fine once I remembered to take them. I have tried to ween myself off of them before. I couldn't do it. Coming off of duloxetine is, according to the people who have actually done it, worse than hell. It's described as worse than opiate withdrawal. Brain zaps started for me over the summer because I was not taking my meds regularly (which if you've never have had them, it's like little electric shocks in your brain out of nowhere) Reddit has a lot of info from people who have gone thru it. Unfortunately for me, I think it's going to be a lifelong medication.
I really do think if your pain is just your knees, it's just your knees. I have experience in the medical field. I was a surgical tech for 6 years before I had to go on disability. I scrubbed mainly orthopedics, but every other specialty too. General, trauma, neuro, urology, obstetrics, vascular, gyn, bariatric, Ortho. Never scrubbed hearts but did go assist in a couple of occasions. There's nothing quite like holding a beating heart while the surgeon sews in a graft using needles smaller than eyelashes. But this is way off topic now. I'm just letting you know that I have some experience other than my own.

 

[chippermonk]

I like it because it works for me. I have been on many many different psych meds, mainly because they are also used as migraine preventatives. This started when I was young. Prozac made me suicidal so I wouldn't take anything from that family of meds. When I first started on duloxetine, I felt like for the first time, something was working. Not just on the fibro but also my depression. I can adjust the dose if I feel like I'm getting depressed or struggling. But my fibro pain is pretty much gone. I have flare ups occasionally, which are awful. The one negative to this is that, in the beginning, when I would forget to take it for a few days I would get that feeling in the pit of my stomach that the world was ending. Skipped doses brought on extreme anxiety. It was fine once I remembered to take them. I have tried to ween myself off of them before. I couldn't do it. Coming off of duloxetine is, according to the people who have actually done it, worse than hell. It's described as worse than opiate withdrawal. Brain zaps started for me over the summer because I was not taking my meds regularly (which if you've never have had them, it's like little electric shocks in your brain out of nowhere) Reddit has a lot of info from people who have gone thru it. Unfortunately for me, I think it's going to be a lifelong medication.
I really do think if your pain is just your knees, it's just your knees. I have experience in the medical field. I was a surgical tech for 6 years before I had to go on disability. I scrubbed mainly orthopedics, but every other specialty too. General, trauma, neuro, urology, obstetrics, vascular, gyn, bariatric, Ortho. Never scrubbed hearts but did go assist in a couple of occasions. There's nothing quite like holding a beating heart while the surgeon sews in a graft using needles smaller than eyelashes. But this is way off topic now. I'm just letting you know that I have some experience other than my own.

The withdrawals from the SSRIs I took were pretty unpleasant. I can't say how they compare to any other drugs but I don't want to go through that again, for sure.
Yeah, hard to say. Maybe the knee pain has nothing to do with anything but the knees. I am sure pain makes me more depressed, and feeling depressed makes my pain seem worse, though. And for me, there is nothing like going for a good hard hike or backpack to make me feel happy, so being limited makes unhappy.
It's great that it's working for you

 

[rentedbythehour]

Trust me, I understand. I've been dealing with that exact thing for most of my life. Migraines started at 11, so 37 years of dealing with them at this point. And they've gotten worse the older I get.
Have you seen a DR by any chance about your knees? I have no clue about you at all, age, location, what you did to injure your knees in the first place. I can the you there are so many things you can do to your knees that will last a long time. Usually for any kind of stability injury, strengthening your thigh muscles will help. If you cracked your knee cap, they usually have to wire it back together. But like I said, I don't know what your injury is. Maybe you can look up some physical therapy ideas if the pain doesn't go away soon. Good luck.

 

[chippermonk]

Thanks. I've been going to PT but not helping. Actually, I may have aggravated worse , I think. I need to get an ortho appointment or maybe an MRI, if they'll agree to it. They did an X-ray of one knee and didn't show much arthritis but I don't think that's necessarily definitive. I've heavily used and abused my knees for many years, had a number of injuries that I always came back from. This may just be the price to pay.

 

[rentedbythehour]

The problem with X-rays is that they don't show the soft tissue. You could have a torn meniscus or a stretched ligament or tendon. You don't really know until you get an MRI done. Other than that, it's just guessing. I hope you get relief soon.