A few years ago, after my lifetime mild chronic depression became no longer mild, I was prescribed Sertraline.
For the first week, I was mildly stoned. For the second week, I was apparently unaffected apart from a tendency to twitch violently at the moment of falling asleep.
Then, overnight, I became sharply manic (roughly equivalent to a moderate recreational dose of methamphetamine) and severely Tourettic. Multiple tics per second, violent enough to smash surrounding objects and cause self-inflicted bruising and scratches.
Despite ceasing the Sertraline immediately, that condition lasted for six months. After that, the mania subsided and the Touretteās reduced from severe to moderate. Socially rather than physically crippling.
Itās two years later now. The Touretteās is apparently permanent.
Ouch! Iām glad I specified āin most casesā in my previous post. Indeed, side effects can be more severe. In France itās common practice to set an appointment ten days into a new treatment, in order to check for extreme issues. These drugsā effects can be rather fickle from one person to another.
It might help if drug companies spent more on R&D and less on marketing, and if there werenāt so many perverse incentives in the current system.
I get that you are an expert in the subject as regards the pharmacology, but I am interested as regards the sociology, and this paints a slightly different picture. It depends, in fact, on how you interpret the statistics.
14000 deaths in one year caused by overdoses of prescription opioids in the US is smaller than but comparable in order of magnitude (in the astronomical sense) to both gun deaths and road deaths. If you add in deaths from non-prescription opioids itās about the same as total gun deaths. The report also says:
āIn 2014, almost 2 million Americans abused or were dependent on prescription opioids.ā
It then goes on to suggest that about a quarter of the people prescribed opioids go on to have dependency problems, which is quite a high rate of iatrogenic illness, wouldnāt you agree?
Now we could follow your logic and say, well, 14000 deaths among 2 million drug abusers/dependents is less than 1% per annum which is pretty good, though if those people are long term dependent the chance of dying becomes a lot worse over period. Or we could ask whether there is an opioid prescription problem. The CDC seems to think so. See the front page of that report:
Iāll say.
My wife is extraordinarily sensitive to most drugs and experiences quite crippling side effects, which makes management of hip joint pain difficult to say the least. I have a condition which is controlled by a quarter of the normal dose of a drug and my GP jokes that it must be homoeopathic - though my own careful experiments have shown this not to be the case; the normal dose causes severe side effects and we guess that for some reason I metabolise this drug very slowly.
I guess with anything oral the effect is going to be mediated not only by personal genetics but also by gut flora in a lot of cases, which is why Iām so interested in current research into gut flora.
Yes, it was. I had gone in for something routine, and the doctor asked me if I was sleeping well, because sheād given me Ambien before. I said no, Iām currently working 70 hour weeks and not sleeping much at all really. She asked if I was being social and I said well, no, Iām just working, really, to meet my deadline. She diagnosed social anxiety and handed me a two-week supply of Zoloft. I started taking it, and after five days, I didnāt want to leave the house. I was profoundly depressed. I stopped going to work and was actively fantasizing about suicide. When I realized how bad I was, I called the doctor, and told them I was borderline suicidal, and she said, āoh, thatās actually not surprising. One known side effect of Zoloft is to cause suicidal ideation in some people. You should stop taking it.ā
Years ago when I completed my course on psychopharmacology, our lecturer said to us āCongratulations, you now know far more about this subject than the average general practitioner, and you also know enough to know that you would need years of training before you were qualified to prescribe.ā
I was given gabepentin for chronic pain and it did nothing for the pain and made me sicker. My doctor keeps trying to put me on antidepressants and I keep telling her I am not depressed, I am in pain and canāt sleep more then 2 hours at a time so I am always tired. I donāt want a pill, I want the underlying problem fixed, not masked. Physio and counseling helped me more than any drug.
Perhaps if more money was spent on researching pain (<500 million)https://report.nih.gov/categorical_spending.aspx and less on cancer (>5 billion) there will be better alternatives to āhere is magic pill, you may become addicted/dependent to itā¦ next patient pleaseā.
You have experienced the world of the migraneur. Although hopefully without the mental incapacitation that usually goes along with an attack.
Many of us will not take painkillers prescribed after surgery or dentistry, weāll hoard them instead.
Walking barefoot on cold floors is a good one. Hot wet compresses on the forehead is good too. Before sumatriptan, I occasionally did some embarrassingly stupid things that seemed, at the time, like they might help.
They make some people terribly sick. But they work for most humans; compared to most drugs, their effect is remarkably predictable and consistent.
Naproxen, which is an over-the-counter NSAID, makes my throat swell shut which is pretty terrifying to experience. I really thought I was going to die for a remarkably long time! But most people can use it like aspirin.
Our cat was on gabapentin for his amputationā¦ He would not tolerate the liquid stuff, so I got the dog sized capsules from the vet and split them. The prescribed dose, 50 mg, was too much ā turned him into a zombie (as you mentioned). ~30 mg seemed just right ā I still give him a lower dose, since it is supposed to help a bit with phantom limb issues.
Hello fellow mutantā¦ My sister and I both seem to have an immunity to opioids. My wife is quite the opposite ā she would probably be knocked out by licking the dust off of the inside of the prescription cap.
Well, we decided to stop the drug because he already had a impacted bowel issues and we felt as if he was struggling even more with the drug. He actually had to have an enema.
This is the reason why I avoid pain medication, and Iāve been fortunate in this regard. Once, I broke my leg (fibula) and I took one vicodin immediately and then one after when I had the surgery a week later. I still got constipated. Grrr.
My momās like that. Be sure to warn the anesthesiologist if she has to have surgery. It takes a week or so for my mother to recover from a bare minimum dose of general anesthesia.
At one time Ponstel was effective against my migraines, but I became immune to it eventually.
I figured out after being on tramadol for YEARS that I canāt sleep with it in my system. The best I can do is sleep limbo. So like an idiot I would take it at night, sleep limbo for 6-8 hrs, and maybe get 2 or 3 hours of real sleep.
I also find them rather unpleasant and canāt imagine ever wanting them without severe pain. I took vicodin once for a really bad toothache since I couldnāt get to a dentist until the next day, and while it worked for the pain I found the experience very annoying and I actually found it harder to sleep. Canāt believe people actually enjoy that.
