We got lucky. That's exactly the kind of doctor we (are fortunate to) have.

The art of medicine consists in amusing the patient while nature cures the disease. —Voltaire

Doc

SO TRUE Dr. Smith! I never thought of it that way. Instead of switching doctors continously, I am learning to be my own advocate. My binder of medical records is the size of The Odyssey these days! Now if I could figure out what is causing my neuropathy, it would really help..

Spoke to my doctor and she wants me to try Lexapro so here we go again...hoping this one works? I really want to be off all meds but hearing what you and others are on Susanne C. makes me change my tune. It sounds like meds are going to be a part of my life now and that they can help improve my quality of life.

Yesterday I tried to stop taking the Tramadol and ended up in worse shape. Sometimes I think in the back of my mind the meds are contributing to my inability to get better. It does not sound like this way of thinking is going to help from what you all are telling me.

I am on Synthroid 50mg 1x day, Linzess 290mg 1x day (for constipation but I usually end up with diarrhea from it), and Tramadol 50-100mg a day depending on the day. Plus I am taking all the vitamin supplements Mrs. D has on the sticky thread.

Thanks again Kitts, Susanne and Dr.Smith. If any of you have any experience with Lexapro love to hear your story!

there is a major interaction between Tramadol and SSRI antidepressants.

This link is for Tramadol + Cymbalta:
http://www.drugs.com/interactions-ch...221-0,949-2273

Considered MAJOR...

Taking SSRIs with OTC medications with Dextromethorphan in them also is not recommended. This may result in too much serotonin actions too.

Tramadol has some antidepressant actions in it, but they are mild.
But combined with other drugs that increase serotonin, this may be contributory to serotonin syndrome.

I saw that too but my doctor and pharmacist both said it is extremely rare and if I start having any of those symptoms then be worried. It seems like many people are on SSRIs and pain killers? Everything is so confusing.

May I ask what meds you are on Mrs.D? And the cause of your neuropathy? You seem to be the foremost expert on this forum and I am wondering what works for you

My PN was the worst over 30 yrs ago....none of these drugs were available then... except for Elavil and opiates.

My PN improved considerably with treatment for my low thyroid.

I do have arthritis too, and use 1/2 to 1 tramadol 50mg very seldom at night, if things are too overwhelming for me.

But I prefer topical products over oral today. Salonpas patches (arthritis), Lidoderm RX patches severe nerve issues, Biofreeze for burning (not frequent anymore--- avoidance of potatoes fixed that), and magnets for nighttime pain.

I never used the new SSRI drugs, or gabapentin/Lyrica, or opiates. (I had opiates in the hospital for my C-section, and that was the only time).

I have pre-diabetes now, so sometimes my feet flare up, but not terribly. I've learned to live it all, for the most part.

I am currently on a new gluten free attempt...since my GI issues have been more active than usual. I also have congenital malrotation of the GI tract, and hereditary angioedema. So my GI problems are far and away the worst now than ever!

Other pain killers do not have this interaction.... only Tramadol.

Just because some professionals think this is rare... is not a good reason not to pay attention to it. I had a rare event from a common blood pressure pill... it was almost fatal.... and my doctor thought it was "rare" and that didn't help me one bit.

Here are links for tramadol and Cymbalta.... listing the
% of reported side effects to the FDA. It is thought that only a very small % are ever reported however...so the
numbers on this site only reflect the reported ones:

http://www.drugcite.com/?q=tramadol

http://www.drugcite.com/?q=Cymbalta&a=&s=

I currently take Cymbalta and tramadol. I also discussed the interactions with my doctor and pharmacist. I was told by both it was ok to use together. I did choose to stay with it.
I was thinking just the other night that I have spent so much time trying to avoid any opiates. I have refused them due to fear of addiction.

Then I thought to myself, I am pumping all this poison into my body. Such meds as Enbrel and IVIG and my next try rituxan. I avoid the drugs that don't cause other diseases and take the ones that can cause lymphoma etc.

I don't know which train of thought is right?

We are always being bombarded with conflicting information so it is hard to tell Kitt!

I started the Lexapro last night but only at 5mg to start with. I am more along the lines of you Mrs. D to not take these drugs. I feel like it is poisoning my body and could cause even more medical issues down the line. But my poor family has dealt with me long enough and I am willing to try just about anything to have a better quality of life.

It scares me that I am 40 and have so much more time to live with this-especially when it is all of a sudden rapidly getting worse and nobody can pinpoint why.

I checked out your old thread Mrs. D http://neurotalk.psychcentral.com/sh...hlight=Lexapro and do not see that you reviewed Lexapro unless I missed something. Have you researched this SSRI at all? Any thoughts??

Thanks again...

Lexapro is on that list.

It is an SSRI (but does not have mixed neurotransmitter effects like the SNRIs...like Cymbalta or Effexor or Savella.)

It is a metabolite of Celexa --which had 2 racemic forms one of which was the active Lexapro. When Celexa's patent expired the company put Lexapro out. It is much more potent and active than the Celexa-- the latter is often given to serotonin sensitive people because it is much weaker.

The rationale for using antidepessants involves MIXED acting ones primarily. This is because the central (in the brain) pain loop reacts best to mixed types.

If you are overly sensitive to serotonin type drugs...then the obvious choice to me is using a dopamine acting type. That
would be Wellbutrin (Bupropion). Starting with low doses and working up. Some people here have had success with this drug, and for men especially, it interferes with sexual activities the least.

I would bring this up with your doctor and here is a medical paper illustrating its usefulness with pain treatment:
http://www.ncbi.nlm.nih.gov/pubmed/18457535

Good information although a bit above my head to be honest! I made an appointment to go back in this Thursday and see my doctor again. Just took my 5mg Lexapro after dinner and within an hour I already feel dizzy and "off." I feel like that half the time anyway these days so who knows.

I should probably start a new thread about this, but since I have your attention Mrs. D perhaps I should see if you can shed any light on possible neuropathy causes my doctors are overlooking? As most of us, I would just like to know what is causing my pain so I can at least stop the progression! So far, this is what my bloodwork has shown:

Lyme Disease Negative
Total Protein SPEP 6.6
Albumin SPEP 4.5
Alpha-1-Glob SPEP 0.1
Alpha-2-Glob SPeP 0.6
Beta-Glob SPEP 0.5
Gamma-Glob SPEP 1.0
Vitamin B6 23.1
Syphilis Negative
Vitamin B12 938
Folate RBC 452
ESR 4
CRP <029
Anti-Ro Negative
Anti-La Negative
Sjogren's SS-A Antibody 236 (Johns Hopkins lip biopsy came back inconclusive although 3 blood tests show positive for SS-A)
Sjogren's SS-B Antibody 26
SCL-70 Antibody 28
RNP Antibody 18
JO-1 Antibody 32
Histone Antibody 22
Centromere Antibody 15
C3 53
C4 14
IG-G 1160
IG-A 263
IG-M 100
Anti-Thyroglubolin Ab 6
Thyroperoxidase Ab 15
HIV NonReact
Rheumatoid Factor Screen <20
Antinuclear Antibody 1:40
FSH 7.3
T3 Uptake 35.3 (on synthroid)
T3 Total 40
T4 5.0
T7 1.77
TSH 1.1
Estradiol <12
Progesterone <0.2
Testosterone 19
Glucose Serum 48 was most recent but it has been as high as 91 in some tests
Bun 21
Creatinine 0.75
Egr 100
Bun/Creatinine Ratio 28
Sodium 133
Potassium 3.7
Chloride 97
Carbon Dioxide 23
Calcium 8.6
WBC 3.5
RBC 4.34
Hemoglobin 13.9
Hematocrit 42.5
MCV 98
MCH 32.0
MCHC 32.7
RDW 13.4
Platelets 193
Homocysteine 11.5
Methylmalonic Acid 0.13
Arsenic 4.4
Mercury 33.9 (high but toxicologist dismissed it as neuropathy cause?)
Lead 1
Copper 884
Zinc 67
Also tested negative twice for celiac

I know that is a lot of information but if anything stands out to you PLEASE let me know! I wish you were my doctor after reading all your posts!!! I will understand if this is way too much to digest and you can just say hope your doctor helps on Thursday

Thanks again-and to anyone else who might be able to help...