Hi Guys,
I have severe chronic pain along with a variety of problems. I have been taking MS Contin 30mg twice a day for almost 5 years. This medication has helped me so much. My entire family noticed a huge improvement in my behavior after having my pain controlled properly. Lately, I have been very depressed and have been diagnosed with major depression from a neuropsychological evaluation. I am wondering if I need an increase in pain meds? I am having more pain but that could be due to depression. I do not do well on anti-depressants but am feeling so bad I am willing to give them another try. I just don't know if increasing the MS Contin would be the answer or adding an anti-depressant. What do you guys think? Anybody had experience in this area?
Thanks,
Brain

Sorry your pain has increased. If I were in your shoes, I would try the anti depressant. If depression and anxiety are less, usually the pain goes down a notch too. I don't like taking them either, but I know they have helped me. I would do that before an up in the narcotic. If you don't get a bit of relief after being on the anti depressant, sure talk to your doctor. I do all I can not to take the narcotic. I know how difficult it is to get off the medications, thats why I limit as much as I can. Sure hope you are OK. ginnie

If you have been on that same dosage for 5 years, you have UNDOUBTEDLY become accommodated to it. There is no question that you'd get used to that after all that time. So it's bound to stop being effective. Your doctor should know that. Tell him that it's just not effective anymore, and your pain is either increasing or the dosage isn't adequate anymore. He WILL need to increase the dosage. Just an increase once a day should do it, and your 2nd dose could stay the same, but he needs to do something. 5 years is a long time to be on the same dosage!

So explain it to him if he doesn't "get it." Some doctors really & truly DON'T. Amazing, isn't it?

Best of luck & let us know how you come out. God bless & take care. Hugs, Lee

Thanks Leesa,
I really feel the same way. I think/know I need an increase in the dosage. I was doing fine and stable until recently. I really think an increase in my MS Contin would help. My doctor is just so against it. I hope I can convince him to give it a try. I mean I am already dependent on this medication. What is it going to hurt? I have seizures and most the anti-depressants are bad for people with seizures. Also, I have already tried like 20 different kinds of anti-depressants before being put on narcotic medication and I had bad, bad reactions to them all. I am going to try counseling too but I am in the major depression category. I need help with medication as well. Any ideas on how to convince my doctor that an increase is needed/necessary? Finding another doctor is not so easy. I feel lucky to have found this one. None of them want to treat pain sufficiently. I am only able to leave my house for 2-3 hours a few times a week with the way my medication is now but when I have tried an extra pill I find I am able to leave my house for 5-6 hours. Isn't the functioning a sign that I would do better with an increase? A lot of the depression is from being so housebound and alone all the time. I appreciate your responses. I have noticed your response to my post in the depression section too. I did not answer your questions about the lawyer and disability because I am too frustrated to talk about that. I have had 3 major seizures recently. Since being put on clonazepam they have stopped, or at least I have not had a major one for a month. I pass out from the hypoglycemia a couple times a year. Last episode was in October. I fell and hit the side of the bathtub and broke my nose. It is a horrible condition and has caused me to have a severe panic disorder. Thanks again for your responses. It is nice to speak with someone who "gets it" . Much love to you my friend.
Brain

Dear "Brain" ~ You're going to have to convince him by using logic. Tell him something like this: Doctor, I've been on this dosage for 5 years. I haven't asked for an increase. I don't abuse my medication. It's been working well until now. After 5 years, I've become accommodated to this dosage, doctor and it's just not working anymore. You must admit that when someone is on the same dosage for 5 years, their body gets USED to it. That is what has happened with me. The medication isn't as effective as it used to be and I'm in ALOT of pain. And like I said, I haven't asked for an increase before. Something HAS to be done, because I just cannot live like this. I'm miserable -- I can't do----(you fill in the blanks about what you can & cannot do) Please doctor, help me. I really cannot live like this.

This doesn't have to be word for word, but I'm just giving you something to go by. This is basically what I said to MY doc, while I was bawling my head off. Seems when I am at the end of my rope, I end up crying which makes me MAD. I HATE to cry, but i guess it works cause he DID increase my meds that time. LOL In fact, he changed everything to a combo that worked quite well. I still hurt alot, but nothing like I used to.

Now let me tell you something -- antidepressants are NOT going to help your pain. You may be depressed, but they are NOT a pain reliever. If they're trying to put you on an A/D because you're depressed, that's one thing, but if they're trying to put you on one to help with pain, they're nuts. LOL

Appeal to your doc's MEDICAL side -- he should KNOW that patients get accommodated to medications!!! if he doesn't know that, then he needs to go BACK TO SCHOOL. You can't keep taking a medication for 5 years and expect the same results. It just doesn't work.

Let me know what happens, will you? I'd REALLY like to know, hon. Big hugs, Lee

Thanks Lee,
I will do this. I would not ask him if I really did not need an increase. I have been ok with where I was at for a long time. I think I have done really well to go this long on the same dosage. I won't be seeing him again until the end of next month. I would go sooner but my mom and dad are having to pay for me and I don't want to cost them any more money than I have to so I will suffer it out for another month. I think the same thing as you. That trying to use anti-depressants to control severe pain is ludicrous. I think I am having this major of a depression problem as a symptom of the pain control level no longer being sufficient. I have noticed that I am moaning a lot more again and my personality i very flat. I don't laugh and joke like I used too. I see the difference in my behavior and I feel the difference in my pain and body. I am having a very hard time sleeping despite being on Ambian and clonazepam for seizures. Both of these should put me right to sleep. But I am up at night massaging my leg and trying to make it pop. It feels like it is out of socket. This was the same thing I was doing before being treated with the pain medication. I need to be able to get out of this house more. I am going to appeal to him on those things. If I can function better with a little increase isn't that better? I am only on the 30mg pills. It's not like I am at 120mg a day or something. I don't understand why he is so against any increase. I did ask him for one the last time I went and he was not having it. I hope I can convince him. I am going to have my mom tell him the same thing because she agrees with me. She would not even agree if it were not the case. I think that may help. She goes with me to every appointment and agreed with him the last time when he said no but now she is seeing what I am saying and if she tells him I am hoping it will help. Why do we have to feel like this and fight so hard to have pain control? I am so mad at the people who have abused these much needed meds and made life so hard for us people who are in pain and in need of this medicine. The abusers sure don't seem like they have any problem getting pain meds so why do legitimate pain patients have it so bad? I do not want to get on anti-depressants. I have already tried that route and had bad reactions. In fact Paxil and Neurontin put me in the hospital. Thanks for the support and encouragement.
Hope things are going ok for you.
Love,
Brain

Leesa had a good approach for discussing the pain meds with your doctor. I would do exactly as she said. Logic does work with doctors. If your medication is not working, she is correct, you built up a tolerance to it. I did the same thing. I hope you get more help now, and that you can have a better quality of life without so much pain. I am thinking of you....ginnie

Thanks Ginny and Lee. I appreciate your kind compassion and support. I know that you both know what it is like to live in constant pain. You are both wonderful ladies. I hope you are both doing well and not suffering too much. I am really trying to do more and have to or depression is going to overtake me. I am finding that if I get out of the house more it helps a lot but I need a little better pain control to do this. Right now I am overlapping the meds instead of waiting the entire 12 hours. But I have to get out or I am not going to make it. I think my doctor will understand. He is not heartless.
Thanks for thinking about me.
Love, brain hugs for you both!

hi brain...like you i have had trouble balancing pain and depression. for me [and everyone is different] if i take too many pain meds i get depressed. when i feel the depression hitting i go the other way. i reduce the pain meds for a short period of time [3 to four days]. then when i return to my normal dose i feel less depressed. most of this stuff is trial and error. best of luck brain...pete

In the young, and you must be, if your parents are paying; the sustained release meds often do not work for 12', perhaps 15 mg every six would work better. Maybe 30mg twice daily with 15 mg in between, roughly 8 hours apart. good luck