[angel04]

Hi I've joined this forum as I feel lost and don't know who to talk to, my GP knows very little about this condition and I have loads of questions. I have found so many positive messages on this forum and am glad I joined. I had a mastectomy in August last year and had a lot of problems with haemotas and infections following that, until 6 weeks ago I had no idea I had PN. I live alone and have two budgies to talk to, a week ago I travelled home to Ireland to see my Mum and was delighted that the whole experience was enjoyable, even the flight which I was terrified of. I am on duloxetine, gabapentin and amitrylene, however I want to stop the duloxetine as I want to start on tramadol, but each time I try to stop and take tramadol my scalp starts to sweat and becomes dry and flaky I end up with a rash in my hair and on my forehead, its some type of fungai which, it seems, duloxetine controls. Does this sound mad ? or does anyone have something similar? If so I would love to hear from you and if someone can help with the scalp problem I would be so so happy to hear from you. I feel positive right now and hope I can be like all of you and stay positive:

[mrsD]

Welcome to our PN forum:

If you suspect a fungus type infection, I think shampooing with
Nizoral may help. The sweating may be making the problem worse. If it is severe a visit to a dermatologist may help, as there are liquids for scalp fungus problems. The OTC form of Nizoral is weaker than the RX version.

When you discontinue Cymbalta, you have to taper off. Sweating is one sign of withdrawal.

[malawigirl08]

Welcome to our community, I have found everyone so welcoming here and I am sure you will find this too. It is important to find people who understand what you are going through. I have added Tramadol to my mix of painkillers for breakthrough pain and have found it very effective. Might your GP give you something else instead of Tramadol ?

[angel04]

Originally Posted by mrsD

Welcome to our PN forum:

If you suspect a fungus type infection, I think shampooing with
Nizoral may help. The sweating may be making the problem worse. If it is severe a visit to a dermatologist may help, as there are liquids for scalp fungus problems. The OTC form of Nizoral is weaker than the RX version.

When you discontinue Cymbalta, you have to taper off. Sweating is one sign of withdrawal.

I am using OTC nizoral and it helps as I use it instead of my normal shampoo. I did not know that sweating is a sign of withdrawal, however I experience it only on my scalp so I am not sure if this is a withdrawal sign or not. I am seeing my Dr next week and he can reduce my dose of Cymbalta and I can get started on Tramadol.

[duarte1985]

Originally Posted by angel04

I am using OTC nizoral and it helps as I use it instead of my normal shampoo. I did not know that sweating is a sign of withdrawal, however I experience it only on my scalp so I am not sure if this is a withdrawal sign or not. I am seeing my Dr next week and he can reduce my dose of Cymbalta and I can get started on Tramadol.

Rember tramadol isn't a 24/7 medication like cymbalta, it depends how much pain your in,Is chronic pain or does it come and go. Im on. fentanyl. 50mcg , gabapentin. 1800 and hydrocodone. I also take 400mg topamax but for a different reason. Im jealous. As far as sweating that is witdrawl. Overtime I run out of fentanyl I sweat like crazy I asked a Pharm-D if if this was the kidney she said no your most likely fentanyl .

[angel04]

Originally Posted by duarte1985

Rember tramadol isn't a 24/7 medication like cymbalta, it depends how much pain your in,Is chronic pain or does it come and go. Im on. fentanyl. 50mcg , gabapentin. 1800 and hydrocodone. I also take 400mg topamax but for a different reason. Im jealous. As far as sweating that is witdrawl. Overtime I run out of fentanyl I sweat like crazy I asked a Pharm-D if if this was the kidney she said no your most likely fentanyl .

I take 2 gabapentin 600mg 3 times a day and this is prevention as I am afraid of the pain itself, it stops me doing anything. I've used tramadol before for my back (which I can't feel anymore!) and it worked really well. Do you take fentanyl for the pain ? I've never heard of it before and the same for hydrocodone, do you think I could take either of these instead of duloxetine? When you sweat is it all over, sorry about all the questions but you understand the medication and honestly I don't. What do you think and do you have PN and for how long x

[Dr. Smith]

Originally Posted by angel04

I did not know that sweating is a sign of withdrawal, however I experience it only on my scalp so I am not sure if this is a withdrawal sign or not.

You made the connection/observation yourself that "each time I try to stop and take tramadol my scalp starts to sweat".

Side effect and withdrawal symptoms can be unpredictable.

Any time a symptom develops as a result of stopping a medication, the possibility of withdrawal should be considered. Tapering off any SSRIs is recommended over abrupt discontinuation.

If you actually took the tramadol, it could also be a side effect of that (which may be only temporary as your system adapts to the new chemistry). Depending on how often you'll need the tramadol, you may have to taper off of it as well.

It's important to know that physical dependence is not the same as addiction, and that because you've experienced withdrawal symptoms does not mean that you were, are, or will become addicted to these or any other medications.

I. Addiction
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

II. Physical Dependence
Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

III. Tolerance
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.
http://www.painmed.org/files/definit...t-for-pain.pdf

Doc

[mrsD]

People who use opiates for pain, (and fentanyl is one very potent opiate/narcotic), often have sweating when their dose is wearing off, or they are becoming tolerant of that dose. When in a real withdrawal from opiates, the sweating can be enormous.

Fentanyl is not indicated for the opiate "naive", meaning the patients should have been on a relatively high dose of narcotic for a while, before considering fentanyl.

Sweating can also come from impaired glucose tolerance. This precedes diabetes, and often happens when blood sugars fall suddenly from a high value to a more normal number, or become low from swinging high to low from a sugar intake. This type of sweating can occur when eating a large meal and is called gustatory sweating, and often only involves the head and neck area.

There are many drugs that can cause sweating. Some people who have inflammation in the body will sweat when they use aspirin or another NSAID in high doses.

[Dr. Smith]

Originally Posted by angel04

I take 2 gabapentin 600mg 3 times a day and this is prevention as I am afraid of the pain itself, it stops me doing anything. I've used tramadol before for my back (which I can't feel anymore!) and it worked really well. Do you take fentanyl for the pain ? I've never heard of it before and the same for hydrocodone, do you think I could take either of these instead of duloxetine? When you sweat is it all over, sorry about all the questions but you understand the medication and honestly I don't. What do you think and do you have PN and for how long x

Fentanyl and hydrocodone are opioid analgesics (pain medications). They are not in the same class as duloxetine. If you've had experience with tramadol, and it worked, really well, and your doctor is recommending it again, I wouldn't worry about the others. Selection of which pain medications to prescribe is usually best left to the physician, who is familiar with your medical history & conditions. Then, if there is a problem, side effect, etc., let the doctor know, and allow him/her to make an adjustment.

Doc

[angel04]

Originally Posted by Dr. Smith

Fentanyl and hydrocodone are opioid analgesics (pain medications). They are not in the same class as duloxetine. If you've had experience with tramadol, and it worked, really well, and your doctor is recommending it again, I wouldn't worry about the others. Selection of which pain medications to prescribe is usually best left to the physician, who is familiar with your medical history & conditions. Then, if there is a problem, side effect, etc., let the doctor know, and allow him/her to make an adjustment.

Doc

Thank you Zachary for your reply, I stopped taking the duloxetine for about 3weeks but the pains and sweating I experienced in my scalp and and down my neck and back was too much so I returned to the duloxetine. I have taken the tramadol during this break but got physically sick because of it. Is it my mind that is convincing myself that duloxetine is calming the nerves in my head? I was given them last christmas when I was really bad with depression but my dr said they also numbed the nerves, I guess that why I feel the way I do. I really do want to go back on tramadol and get off these but is there any other medication that numb the nerves in my head? As I said I have so many questions and I don't know if they will be answered or not and thats scary.