Chronic pain, fatigue, and psych meds

So, anyway, Let’s start a thread on using psychotropic drugs as a way to get ahead of chronic pain. Is anyone else using them as a preventative measure? Chronic fatigue, migraines, constant headaches, aching bones, muscle pain... you name it. It’s that endless cycle of physical misery that only seems to get managed once you start on psych meds.

Please, let’s not derail this thread by dragging psychopharmacology into the mix. We are here specifically to talk about using medication to manage pain—nothing else. Let's keep the focus where it belongs.

I've been dealing with migraines with aura for about 20 years now. Honestly, they used to be pretty manageable since they didn't happen that often. I could usually just knock them back with some standard painkillers or stuff like Relpax and Maxalt.

But then, about two years ago, life just sort of happened, and I ended up on Effexor.
Lately, my migraines have been hitting me way more often.

My migraines have been hitting me so hard lately that I ended up back at the neurologist's office. They’re looking to bump my Effexor up to 150mg a day since it's being used as a preventative for the migraine pain.

I’ve been on this dose of Effexor for about six months now, and honestly? It’s made me completely useless. Instead of things getting better, the pain just kept ramping up. On top of that, I started feeling this intense anxiety that I never even dealt with on the lower doses. Now, I’m stuck taking beta-blockers just to deal with the constant headaches. What am I even doing?
It’s pretty obvious that I can't handle large doses of Effexor very well.
To be honest, ever since I started taking Effexor about two years ago, my migraines have just been getting worse and worse. Is it just me, or does it feel like they've actually ramped up over time? 🤔

My neurologist told me they typically prescribe three different types of psychotropic drugs as a preventative measure against migraines:
Effexor
Cymbalta
And here’s another one who didn't even bother to mention it. Seriously?

So, I said I’m ready to make the switch to Cymbalta at 60mg. 🤔 Are you kidding me? What on earth just happened?

Anyone else out there taking all this stuff just to try and kill some kind of pain?

Preventative migraine medications are usually recommended if you're dealing with frequent attacks—typically five or six times a month or even more often. Over here in the States, we don't really use specific substances like pisotifen or methysergide anymore. Most migraines can actually be managed quite effectively using beta-blockers. Tricyclic antidepressants (like amitriptyline) also tend to work well. You could also look into calcium channel blockers or valproates.
https://www.mayoclinic.org/diseases-conditions/migraine/symptoms-causes/syc-2036020

To prevent migraine attacks, doctors often prescribe beta-blockers such as propranolol, the antidepressant amitriptyline, or valproates.
https://www.webmd.com/migraine/migraine-prevention

http://www.neurologyfoundation.org/patient-resources/migraine-info.pdf

Effective preventative options include: β-antagonists (propranolol, timolol), tricyclic antidepressants (amitriptyline, nortriptyline), antiepileptics (valproates, gabapentin, Topamax), 5-HT receptor antagonists (methysergide, cyproheptadine), and MAO inhibitors (fenelzine). These drugs likely work by modifying how sensitive the brain structures involved in migraine pathogenesis actually are.

http://www.mayoclinic.org/diseases-conditions/migraine/diagnosis-treatment/drc-20363611

https://s13.postimg.org/u37jf9s13/profilaksa.jpg
Clinical recommendation
fluoxetine (Prozac)

Here—maybe you'll find something useful in there.😉

Thanks, I caught up on this a few days ago.

I’ve been managing my neuropathic pain by taking as much Neurontin as I can handle; I tried Amitriptyline before, but it just didn't provide any relief

I have also heard that doctors sometimes prescribe Topamax alongside antidepressants to help with migraines

mistydrifter55, I dealt with glossopharyngeal neuralgia—just constant, excruciating chronic pain that dragged on for months. At first, they tried putting me on corticosteroids, which were absolutely useless. Total waste of time. But after scouring some international medical forums, I saw people talking about how Lyric and Tegretol actually worked for this. My doctors wouldn't touch those prescriptions; instead, they just kept shuffling me off to pain management clinics, and eventually, I ended up with a physical therapist who spent weeks basically blasting the painful area with a laser. It turns out two nerves were inflamed—one exiting the brain and one heading toward the spinal cord. It took me a solid six or seven months before that agony finally subsided. Honestly, there were moments I thought I wasn't going to make it. I wouldn't wish that kind of suffering on my worst enemy...

Andrew Doyle said:mistydrifter55, I dealt with glossopharyngeal neuralgia—just constant, excruciating chronic pain that dragged on for months. At first, they tried putting me on corticosteroids, which were absolutely useless. Total waste of time. But after scouring some international medical forums, I saw people talking about how Lyric and Tegretol actually worked for this. My doctors wouldn't touch those prescriptions; instead, they just kept shuffling me off to pain management clinics, and eventually, I ended up with a physical therapist who spent weeks basically blasting the painful area with a laser. It turns out two nerves were inflamed—one exiting the brain and one heading toward the spinal cord. It took me a solid six or seven months before that agony finally subsided. Honestly, there were moments I thought I wasn't going to make it. I wouldn't wish that kind of suffering on my worst enemy...

Poor 😢
I deal with a specific type of neuralgia myself, and it is chronic.
Only Neurontin provides any relief; Lyric, Clonazepam, and opioids have been completely ineffective. Nothing works except for heavy narcotics.
But the fact that they wouldn't prescribe those medications to you... what exactly do they intend to use to treat such pain if not anti-epileptics or certain antidepressants?
And what on earth were they doing "burning" you with a laser? That sounds horrific!
I suppose I am fortunate to have the care I receive at my local pain clinic.

restlesstrucker15 said:Poor 😢
I deal with a specific type of neuralgia myself, and it is chronic.
Only Neurontin provides any relief; Lyric, Clonazepam, and opioids have been completely ineffective. Nothing works except for heavy narcotics.
But the fact that they wouldn't prescribe those medications to you... what exactly do they intend to use to treat such pain if not anti-epileptics or certain antidepressants?
And what on earth were they doing "burning" you with a laser? That sounds horrific!
I suppose I am fortunate to have the care I receive at my local pain clinic.

restlesstrucker15 said:Poor 😢
I deal with a specific type of neuralgia myself, and it is chronic.
Only Neurontin provides any relief; Lyric, Clonazepam, and opioids have been completely ineffective. Nothing works except for heavy narcotics.
But the fact that they wouldn't prescribe those medications to you... what exactly do they intend to use to treat such pain if not anti-epileptics or certain antidepressants?
And what on earth were they doing "burning" you with a laser? That sounds horrific!
I suppose I am fortunate to have the care I receive at my local pain clinic.

restlesstrucker15 said:
Nothing works, not even Lyric, Clonazepam, or opioids.

If you add all that up, it sounds like you have actual physical nerve damage somewhere. In that case, Neurontin and narcotics might actually help.

Lyric and Clonazepam mostly target the psychological side of things. If your pain is strictly physical, it makes sense why they aren't doing much for you.

Andrew Doyle said:mistydrifter55, I dealt with glossopharyngeal neuralgia—just constant, excruciating chronic pain that dragged on for months. At first, they tried putting me on corticosteroids, which were absolutely useless. Total waste of time. But after scouring some international medical forums, I saw people talking about how Lyric and Tegretol actually worked for this. My doctors wouldn't touch those prescriptions; instead, they just kept shuffling me off to pain management clinics, and eventually, I ended up with a physical therapist who spent weeks basically blasting the painful area with a laser. It turns out two nerves were inflamed—one exiting the brain and one heading toward the spinal cord. It took me a solid six or seven months before that agony finally subsided. Honestly, there were moments I thought I wasn't going to make it. I wouldn't wish that kind of suffering on my worst enemy...

It’s hard to say for sure since you described how miserable it was, but maybe it was a blessing in disguise that they didn't put you on psych meds. Why poison yourself with unnecessary drugs if you could fix it physically? 🤷

Especially since you mentioned there was actual inflammation involved. Psychotropic drugs aren't going to do squat for inflammation. Those are usually reserved for idiopathic pain—you know, when there isn't a clear cause or the doctors are basically guessing what's wrong.

mistydrifter55 said:If you add all that up, it sounds like you have actual physical nerve damage somewhere. In that case, Neurontin and narcotics might actually help.

Lyric and Clonazepam mostly target the psychological side of things. If your pain is strictly physical, it makes sense why they aren't doing much for you.

That is correct; it is chronic damage to the spinal nerve. It provides a solid clinical insight and a clear diagnosis. 🙂
If things get truly unbearable, I find that taking Neurontin can help alleviate some of the intensity of the Targin.
One must remain on Neurontin continuously; that is simply how it has to be done.

A good friend of mine went through a really rough patch dealing with constant exhaustion, tension headaches, and bouts of insomnia... they went through every single test you can imagine, from routine blood work and thyroid panels to full brain MRIs. Eventually, everything led them to a psychiatrist, where they were prescribed antidepressants and some sleep medication. They’ve been on that regimen for about a year now, and they are finally starting the slow process of tapering off everything.