Tramadol/Topomax
 

Could someone explain to me the difference in these drugs for neuropathy and Gabapentin/Lyrica?

Tramadol is a pain reliever. It has very weak serotonin actions too, making it useful for chronic pain. It is used for this reason in Fibro patients.

Tramadol seems more effective for some with chronic pain, of nerve origin, than opiates. Some neuropathic pain does not respond to opiates in some patients. Tramadol's effects on serotonin help with CNS pain perception too.

I use tramadol infrequently only for bad times. I only use it at night here and there, so I have no tolerance issues with it.

Topamax is an anti-seizure drug, like others used for nerve pain.
Migraine, trigeminal neuralgia, RSD, neuropathies, respond to anti-seizure medications which change the conductivity of nerves. Gabapentin (Neurontin) and Lyrica are in this family of drugs. Topamax has serious side effects involving the eyes (glaucoma), metabolic acidosis, kidney stones which the others do not. So it is used less frequently if others in this group are tolerated by the patient.

Tramadol is also a type of milder synthetic opiate, and is used in conjunction with
the anti-seizure and anti-depressant meds that are Rxd for PN.

Thank you.........
 

For the in depth explanation. I really appreciate it.

There are some subtle differences between
 

Tramadol, Topamax and Ultracet - It's here in the fine print...read it closely... some of it is ALMOST the same but, not quite the same? Knowing how each works, then what works for you, it can help? BUT! ONLY IF USED SPARINGLY!

Ultram: http://www.ortho-mcneil.com/ortho-mc...r.pdf#zoom=100

Tramadol: http://www.ortho-mcneil.com/ortho-mc.../pi/ultram.pdf

Topamax: http://www.topamax.com/topamax/asset...x.pdf#zoom=100

Ultracet: http://www.medilexicon.com/drugs/ultracet.php
Quirky thing about this last is that it includes tylenol which 'seems' to give it an extra kick for less of the real% of drug...

They all have different %'s of similar ingredients? BUT keep in mind all the side effects? READ them and memorize them, and respect that some meds change blood test results... It's all one of those try what works things, [being very careful, of course], and finding out if one works for you better than another. I find, honestly? Sometimes they help? Other times, they do not DO ONE SINGLE THING to help! Each of us is different in soo many ways? How meds affect/effect us is in that corner. IF SHOULD you find something that's not totally narcotic and works? Count your blessings! Keep faith and hope that you WILL manage to get by soon! :hug::hug:'s - j

Thanks so much Dahlek.........
 

You're a sweetie!

Most people believe that Ultracet was just a gimmick to put on the market a "new" form of tramadol by the parent company to extend the patent life and thereby keep making lots of $$ on it.
People with chronic pain really should not be taking all that Tylenol as it is bad for the liver. The plain one, tramadol, is much safer for your body. Short term use of Ultracet was mostly to target dental and postsurgical pain of short duration, and acute headache.

Other drugs have done this too. Darvon was the most obvious.
It went from Darvon to Darvon compound to Darvocet over a 30 yr period!

I think that if you find something that works for you, you should take it--regardless of what other people say or what their experiences were with a medicine. Obviously you should talk to your doctor and look carefully at the risks associated with each medicine.. but at the end of the day, why take something that won't help you--and why -not- take something that would?

I am on the fentanyl patch, and have been on oxycodone for months. It hasn't helped me at all. Friday I talked to my doctor and switched back from oxycodone to Tylenol #4. I am getting relief from that--not just for my pain, but for headaches as well. Tylenol can be hard on the body... but so can other things.

I only have one good kidney, and tylenol is all that my doctors will let me take (for pain relief--I cannot take ibuprofen, aleve, aspirin, etc)...

I could stay with the oxycodone and not get any relief, or go to Tylenol #4 which is more mild anyway and get relief. I am definitely going to go with that option.

I have been on Tramadol, Darvocet, Ultacet, Topamax, Gabapentin, Lyrica.. all of those. Some worked, others didn't. In the end, I chose to take what worked best for me.

Sara I agree to a degree tho... because long term use..
 

of some of these meds was not their original intent.
I do agree that IF something WORKS? Don't go around playing games w/other meds unless the ONE stops working.
I can only encourage each and every one of US to take on our RESPONSIBILITY To look up all used medications' prescribing informations [the LONG versions, not the short ones] And then be aware/alert to possible unusual side effects from any one med or a combo of meds.
Don't blame this one on the docs! WE as the consumers of these meds must become MORE than fully aware of all the pro's, con's and consequences of any and all we 'consume'.
Use/take any and all with caution? That's all I'm suggesting.
:hug::hug:'s! - j

Indeed. I fully realize that medicines (especially when you get into things like narcotic pain medicines) can be really harsh on our bodies and we need to do the research. I look up every single medicine that I take and watch carefully for symptoms. I also have blood work done to make sure it isn't damaging my kidneys.

But I cannot tell you the number of posts I have read throughout NT (and on other websites--it isn't just here) where people say things like "You should NEVER take [medicineA] because I had a very serious reaction to it... you should only take [medicineB] because it doesn't have as many side effects." Then there are people who are totally against any pharmaceutical 'drug' and tell people they should only take supplements and OTC pain relievers. Well that's all fine and dandy if that works for them... but that isn't going to cut it for everyone.

It is great to hear what other people have experienced.. and hear about some uncommon side effects that people may not be aware of. But it really bothers me when people tell another person that they should not, under ANY circumstances, take medicine A, B, or C. What works for one person will not always work for another.

(This is not just about this thread... I am just talking in general. I really feel that the patient and his or her doctor should make the ultimate decision on what to try--not some random stranger over the internet. Advice and suggestions are valuable--but they should not be the ultimate authority.)

So.. I am in total agreement with you. :)

:hug:

A good resource for people looking for more information than a drug insert provides is: This site gives the FDA medwatch reports on serious post marketing events for many drugs.

www.patientsville.com

Drug inserts are often incomplete, and sometimes old, and are from when the drug was first marketed. Information about things that come to light AFTER the insert is FDA approved and the drug is approved, do not show up on them often. And many doctors are totally unaware of post-marketing warnings.

Even some studies have been shown to be fraud, as in the case Dr. Reuben from California:
http://lawmedconsultant.com/677/bipo...ud-while-manic

CDC just caught a doctor making fraudulent papers on vaccines and autism.

Merck concealed the toxic potential of Vioxx from doctors in one of the biggest fraud cases ever, with over 100,000 heart attacks blamed on it!

There are drugs with huge side effect profiles... that many people react to. Neurontin and Lyrica are two examples. In fact Pfizer was found guilty of representing Neurontin to doctors for conditions without FDA approval (in effect they experimented on patients, and convinced the doctors to do it!) Pfizer had to pay over 650 MILLION dollars in fines for that one.

The atypical antipsychotics have generated over a billion dollars in fines for over promotion, from Lilly, and other companies for Risperdal, Zyprexa, and Seroquel.
So when drug companies do this ....the internet remains a good resource to shed light on their hanky panky.

So one has to be very careful where one "searches" for answers.
Nowadays, one cannot always believe a drug insert!

A very good book to read about this is Bitter Pills, by Stephen Fried.

Another eye opener is
The Truth about the Drug Companies, by Marcia Angell, MD... who is the previous editor in chief of the New England Journal of Medicine. This book will really shock you!

edit-- this new post from our PD forum reveals some of the nasty things going on with ghostwriting of papers...yes, drug companies steal names of Legit doctors and put them on papers to impress other doctors without permission:

http://neurotalk.psychcentral.com/thread137816.html

If you Google "ghostwritten medical papers" there will be more, much more.

Acetaminophen (Tylenol, Paracetamol, APAP) Toxicity
 

A couple of posts in this thread have mentioned the inherent risks in high dose and/or long term acetaminophen (or medications containing acetaminophen) therapies, and rightly so. It's rough on the liver, and anyone who takes a lot of acetaminophen should probably have a discussion with their doctor(s) about prudent periodic liver function blood tests.

Unfortunately, some folks like smae (and myself) don't have a lot of choice. I don't tolerate NSAIDs (Non-Steroid Anti-Inflammatory Drugs) well.

In my own case, I include NAC (N-Acetyl Cisteine/N-Acetylcysteine/N-acetyl-L-cysteine) in my daily supplement regime. NAC is an OTC supplement which, among other things, is administered intravenously as the first-line antidote for Tylenol overdose.

For more information:
Wiki: Acetylcysteine
Google: NAC tylenol

N.B. There is no proof/study that I'm aware of at this time that suggests that NAC taken prophylactically will prevent/reduce liver damage from acetaminophen. OTOH, taken as directed, and with knowledge/consent of one's doctor, it shouldn't be harmful either - It couldn't hoit! NAC has some other potential benefits as well.

There is an archived Usenet newsgroup discussion (sci.med,sci.med.pharmacy) from 1995 on this subject between two physicians (Steve Harris, M.D. & Jonathan R. Fox, M.D.)
http://yarchive.net/med/tylenol.html

Reviewing the above Google search, there may also be some similar potential prophylactic benefit from the supplement S-Adenosyl methionine (SAM, SAMe, SAM-e) but I'm not personally familiar with that one (yet).

Doc

I used SAMe for about 10 yrs. It was helpful for my arthritis, but really did nothing for my PN.

It was quite energizing too, especially at first.

I settled in at 600mg a day. (some weeks I took 400, but eventually I'd get a pain relapse so 600mg was my normal).

I stopped taking it last year, when I added a new supplement which was expensive. I haven't noticed much relapse since then.

I rebuilt my right knee for those 10 yrs and avoided a knee replacement.

I have severe osteoarthritis in my spine, but it seems to pale in comparison to other pain issues and kept in check with other things in my regimen.

I'll be looking at SAMe more for the acetaminophen-countering effect (I never exceed my prescribed dose, and get periodic blood tests) but any additional benefits won't be dismissed/ignored. If it's too expensive, I'll have to stick with the NAC, which I've been taking for years with no side effects whatsoever, and my liver tests are all well within normal. XX

Doc