Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 06-30-2011, 03:35 PM #11
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There is a reference (out of print right now) on this.

But there are links to abbreviated data from that reference.
There is even a smart phone app for this subject now;

Here are the links:

http://www.chiro.org/nutrition/ABSTR...orticosteroids

http://itunes.apple.com/us/app/nutri...432547190?mt=8

Neither one of these is 100% inclusive, but the Drugs.com link has improved significantly in the past year... so it has food interactions too.

Depletions lead to drug interactions or failures. That is a bit different in thrust, but still very important.

Magnesium is thought to be low in at least 70% of people in the US.... it is significant even when no drugs are at fault.
And for any diabetic ...magnesium is ALWAYS significant.

Magnesium depletion was the major reason Propulsid was recalled...and Propulsid remains the best treatment to date for gastroparesis... a very sad situation for many many patients, that the doctors refused to follow FDA warning letters in its use! IMO.

I have a magnesium thread here:
http://neurotalk.psychcentral.com/showthread.php?t=1138

And I'll share some new info... CVS Epsom lotion is a nice product, very affordable and applies to skin providing some magnesium for muscles and cramping. I am using it now instead of some of my oral supplements. You might want to check it out: (unfortunately they don't provide dosing or quantity, but it seems to do the job when used on legs or arms for me.)

http://www.cvs.com/CVSApp/catalog/sh...new_crumb=true

I get it locally, and this link, has price changes every week it seems for "sales" stimulus etc.
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Old 06-30-2011, 04:30 PM #12
ballerina ballerina is offline
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Quote:
Originally Posted by mrsD View Post
There is a reference (out of print right now) on this.

But there are links to abbreviated data from that reference.
There is even a smart phone app for this subject now;

Here are the links:

http://www.chiro.org/nutrition/ABSTR...orticosteroids

http://itunes.apple.com/us/app/nutri...432547190?mt=8

Neither one of these is 100% inclusive, but the Drugs.com link has improved significantly in the past year... so it has food interactions too.

Depletions lead to drug interactions or failures. That is a bit different in thrust, but still very important.

Magnesium is thought to be low in at least 70% of people in the US.... it is significant even when no drugs are at fault.
And for any diabetic ...magnesium is ALWAYS significant.

Magnesium depletion was the major reason Propulsid was recalled...and Propulsid remains the best treatment to date for gastroparesis... a very sad situation for many many patients, that the doctors refused to follow FDA warning letters in its use! IMO.

I have a magnesium thread here:
http://neurotalk.psychcentral.com/showthread.php?t=1138

And I'll share some new info... CVS Epsom lotion is a nice product, very affordable and applies to skin providing some magnesium for muscles and cramping. I am using it now instead of some of my oral supplements. You might want to check it out: (unfortunately they don't provide dosing or quantity, but it seems to do the job when used on legs or arms for me.)

http://www.cvs.com/CVSApp/catalog/sh...new_crumb=true

I get it locally, and this link, has price changes every week it seems for "sales" stimulus etc.
Thanks Mrs. D and Mike,

I have a very young neurologist but fortunately he is very detailed. I got all the info regarding grapefruit, magnesium, EKG, etc. Also I spent considerable time going through the lengthy package insert. I am a little concerned about the effects of dehydration which occasionally happens to me but feel confident that I can increase hydration while taking it.

I am concerned because, although the package insert did not list it, I found a website that cautioned against taking Namenda, which I take, with Nuedexta. My neuro indicated that the nuedexta would increase the effectiveness of the namenda. I also found a caution for Adderall, which I am also taking. I believe the website listed Adderall as having potentially serious drug interactions.

I am confused. I am putting a hold on taking it until I can track down more information.

I am still interested in feedback from others who are taking nuedexta.

Teri
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Old 06-30-2011, 06:24 PM #13
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Question

Can you give me the link where Adderall and Neudexta showed an interaction?

I did not find one at drugs.com

This is the interaction reported for Namenda + quinidine:
http://www.drugs.com/interactions-ch...981-0,1551-936
Has to do with the kidney.--and is listed as a minor interaction/potential.
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Old 06-30-2011, 07:23 PM #14
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Quote:
Originally Posted by ballerina View Post
Thanks Mrs. D and Mike,

I have a very young neurologist but fortunately he is very detailed. I got all the info regarding grapefruit, magnesium, EKG, etc. Also I spent considerable time going through the lengthy package insert. I am a little concerned about the effects of dehydration which occasionally happens to me but feel confident that I can increase hydration while taking it.

I am concerned because, although the package insert did not list it, I found . My neuro indicated that the nuedexta would increase the effectiveness of the namenda. I also found a caution for Adderall, which I am also taking. I believe the website listed Adderall as having potentially serious drug interactions.

I am confused. I am putting a hold on taking it until I can track down more information.

I am still interested in feedback from others who are taking nuedexta.

Teri
Teri -

Your neurologist was quite correct, Neudexta would increase the effectiveness of Namenda. In fact, the potentiation of Namenda by Nuedexta is one of Nuedexta's best properties, if personal experience counts for anything.

Mike


ps Sorry I can't help you on the Adderall, which I would have loved to have been on years ago, but my then treating physicians passed on it because of my glaucoma. Instead they gave me Prozac, which landed me overnight in a monitored cardiac bed with SVT. Whereupon the UCLA Adult ADHD Clinic discharged me as "too hard." (Not that they ever checked my BP or pulse during any of my office visits.) So instead I joined the gym and signed up with a personal trainer in an effort to be more efficient at work. And here I am today, as a direct result of that last ill-fated call.
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Old 06-30-2011, 08:34 PM #15
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Quote:
Originally Posted by mrsD View Post
Can you give me the link where Adderall and Neudexta showed an interaction?

I did not find one at drugs.com

This is the interaction reported for Namenda + quinidine:
http://www.drugs.com/interactions-ch...981-0,1551-936
Has to do with the kidney.--and is listed as a minor interaction/potential.

I found the adderall interraction on drugs.com. I found it by going to ask.com and posing the question, "Can adderall be taken with nuedexta?"

Thanks again for your help!
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Old 07-01-2011, 03:21 AM #16
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I get this page for Adderall and Nuedexta:

http://www.drugs.com/drug-interactio...281-14874.html

I also searched Nuedexta separately by both drugs in the combo.
No interactions.

Of course drug interaction databases are not 100% reliable 100% of the time. And there are exceptions.

This one lists amphetamines with Nuedexta:
http://nervous-system.emedtv.com/nue...eractions.html
But offers no details.
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Old 07-01-2011, 05:53 AM #17
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Quote:
Originally Posted by mrsD View Post
I get this page for Adderall and Nuedexta:

http://www.drugs.com/drug-interactio...281-14874.html

I also searched Nuedexta separately by both drugs in the combo.
No interactions.

Of course drug interaction databases are not 100% reliable 100% of the time. And there are exceptions.

This one lists amphetamines with Nuedexta:
http://nervous-system.emedtv.com/nue...eractions.html
But offers no details.
Adderall is listed on Drugs.com as interacting with Nuedexta, under the category "Nuedexta." Then go to the section, "What other drugs will affect Nuedexta?" Adderall is the fifth drug listed.
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Old 07-01-2011, 06:11 AM #18
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Lightbulb

Okay, I see the reference to ADHD medication....
Strattera is the first one listed, followed by the amphetamines.

I can see strattera, since it is related to SSRIs... and has QT risk.
But as far as the amphetamines go?
There are no metabolic connections (like with Strattera) but perhaps it is the stimulant properties themselves, that might complicate the action of the DM in the brain?
This quote from side effects of Nuedexta:
Quote:
agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting;
from http://www.drugs.com/nuedexta.html

The bolded words would be additive with any stimulant. Amphetamines do increase heart rate.

Interactions between drugs usually refer to metabolic interference, meaning raising or lowering levels in the blood, so that a drug may become inactive or toxic because of that metabolism.

Therapeutic effects are different, usually additive or synergistic physiologically meaning the drugs may affect the same systems in action.

What we have been discussing on this thread are metabolic interactions which lead to unexpected results (mostly cardiac).

The effects listed for amphetamines are similar to amphetamines + other stimulants. (caffeine for example).

Today, the drugs that are available are very complex chemically. And it is no surprise that the 4th leading cause of death in US is from prescribed medications or errors with them.

I think we are reaching a ceiling of sorts, where all medications are going to have to go thru a screening data base for patients, to avoid problems. All patients are going to have to be evaluated soon for liver enzyme potentials and genetic variances. There are people taking 10, 15, and even 20 drugs a day. I see them on boards frequently and saw them in real life every day!
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Last edited by mrsD; 07-01-2011 at 08:41 AM. Reason: adding clarification
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Old 05-02-2012, 01:41 PM #19
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Default Ive increased my dose

I have been taking Neudexta for about a year now. I started with the prescribed dosage on once in the morning, and once in the evening. The med was making a noticeable difference in my daily life, but after a few months my neuropathy was beginning to creep back into my life. I met with my very accredited neurologist, and we have increased my dosage to two pills twice a day. To an extent my symptoms are restrained, however I still have a problem with , not so much pain but, discomfort that never subsides.
I have been through nearly every test and exam and remain undiagnosed. I have seen the warning against taking Nuedexta with Elavil, however I have been a long time user of Elavil and have not noticed any adverse side effect. In fact, most of the side effects of the combination are the symptoms that the Nuedexta is suppressing; go figure.

so currently, I am taking

Neudexta 2capsuls PO 2x daily
Elavil 100mg 1x nightly


I guess im just open to anyone's thoughts or ideas on where I could possibly go from here. By "here" i mean being undiagnosed and exhausted.
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Old 05-02-2012, 02:00 PM #20
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Lightbulb

There is a significant interaction between Elavil and Neudexta:
http://www.drugs.com/interactions-ch...-74,3281-14874

This is metabolic and occurs at the liver enzyme level.
If Elavil builds up in system, it can affect the heart.

Seems to me if you needed "more" effects from Neudexta, you could just take a bit more DM... and not increase that quinidine to dangerous levels. It is the DM affording the pain relief.
You can buy DM OTC in liquid form called Delsym.

This drug is highly problematic. And in combination with Elavil VERY problematic. Should you become low in potassium and magnesium (say from a stomach virus), you could have a QT event. IMO you are in a dangerous spot, with that dosage increase.

Here is more information on QT events:
http://www.azcert.org/

It might be to your advantage to have the DNA testing for liver metabolism of drugs...
This is now affordable and would reveal errors in metabolism before you have some serious event:
https://www.23andme.com/?gclid=CJKBk...FQVoKgodHlOsDg
detail:
http://spittoon.23andme.com/2011/10/...zing-medicine/

One of our PN members did this test and discovered she did not have good metabolic enzymes for 3 families of drugs! Pretty soon everyone will be tested so that serious drug events can be avoided.

Quote:
Originally Posted by perplexed View Post
I have been taking Neudexta for about a year now. I started with the prescribed dosage on once in the morning, and once in the evening. The med was making a noticeable difference in my daily life, but after a few months my neuropathy was beginning to creep back into my life. I met with my very accredited neurologist, and we have increased my dosage to two pills twice a day. To an extent my symptoms are restrained, however I still have a problem with , not so much pain but, discomfort that never subsides.
I have been through nearly every test and exam and remain undiagnosed. I have seen the warning against taking Nuedexta with Elavil, however I have been a long time user of Elavil and have not noticed any adverse side effect. In fact, most of the side effects of the combination are the symptoms that the Nuedexta is suppressing; go figure.

so currently, I am taking

Neudexta 2capsuls PO 2x daily
Elavil 100mg 1x nightly


I guess im just open to anyone's thoughts or ideas on where I could possibly go from here. By "here" i mean being undiagnosed and exhausted.
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Last edited by mrsD; 05-02-2012 at 02:17 PM.
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