SSRI for Chronic Pain (sensitized nervous system)?

[Anonymous]

I have been dealing with chronic pain for the past five years+. Headaches, nerve pain, muscles, skeleton, neck, back, hips, knees, face, etc. Mold (actually found in my house), lyme (yes I was bit by a tick), TMJ, oh my. Fibromyalgia-like pain. Pain is triggered by acute stress (e.g. kid's struggles), weather changes, hormones, exhaustion.

Some days are better than others, but it is a part of daily life that keeps me from exercising, living the life I want to live and it's super depressing. Also, I look "normal and fine" on the outside and don't really talk about the pain with other people that often, which is isolating.

I have tried endless hours of PT (multiple modalities of it), CBT for a few years, functional doctor ($$$), elimination diet, brain retraining, so much money on so many kinds of therapies for the pain. The only "preventative" drug that has helped is gabapentin, but it wrecks my short term memory and effects word retrieval, so not great at all. Otherwise I am juggling tylenol, advil and migraine med, along with many, many types of vitamins (tumeric, magnesium, etc) that help somewhat - trying to feel my best each day.

I am at the point where I want to consider a psychiatric drug. I have certainly had depression and anxiety as part of my soup of issues, but I have been reluctant to try an antidepressant after a failed trial of amitripaline a few years ago.

I am wondering if others who have chronic pain have had things turn around with an SSRI. I don't think my pain is "in my head" but I do think that my nervous system is messed up and might just need to have the volume lowered.

[Anonymous]

Duloxetine (SNRI) has evidence to help with chronic pain in addition to anxiety and depression.

[Anonymous]

I’ve had no luck with SSRI for migraine or for chronic musculoskeletal pain post-Covid. However, I’ve known within a few days to two weeks whether I could tolerate the SSRI. Taking them wasn’t really a particular setback, since doctors don’t have a lot of alternative tools for chronic pain. I’ve also had friends who have had a lot of success with SSRIs for migraine. Anyway, it’s probably worth trying, even if things don’t pan out in the long run.

[Anonymous]

Anonymous wrote:Duloxetine (SNRI) has evidence to help with chronic pain in addition to anxiety and depression.

Came to suggest this as well. It has helped me immensely.

[Anonymous]

No. But I have tried Gabapentin, and it didn't help. And I start Lyrica this week. I'm not hopeful.

[Anonymous]

Yep. My friend that was having chronic back, hip and leg pain tried an antidepressant and it greatly helped her.

[Anonymous]

I took a small dose of Zoloft for about a year over twenty years ago. It didn't seem to help much if at all with the chronic pain and it made it harder for me to sleep.

[Anonymous]

Anonymous wrote:I took a small dose of Zoloft for about a year over twenty years ago. It didn't seem to help much if at all with the chronic pain and it made it harder for me to sleep.

Oh also yes I find Neurontin a little helpful but I only take 100 mg at night and even then it makes me spacier the next day.

[Anonymous]

Anonymous wrote:No. But I have tried Gabapentin, and it didn't help. And I start Lyrica this week. I'm not hopeful.

After trying Gabapentin, my new doctor switched me to a low does of Lyrica and a low dose of Cymbalta. It took a bit to figure out the balance, but it has been a huge game changer. Depends on your pain source, of course. But for me, it was a game changer for neuropathic pain.

[Anonymous]

Anonymous wrote:

Anonymous wrote:No. But I have tried Gabapentin, and it didn't help. And I start Lyrica this week. I'm not hopeful.

After trying Gabapentin, my new doctor switched me to a low does of Lyrica and a low dose of Cymbalta. It took a bit to figure out the balance, but it has been a huge game changer. Depends on your pain source, of course. But for me, it was a game changer for neuropathic pain.

Do you feel like it gives you brain fog? I am really worried about these meds and whether they will lead to higher chance of dementia but I also wonder about living a life of pain (which is also bad for your brain).

[Anonymous]

It did absolutely nothing for my wife with chronic back pain (and frankly, I was offended on her behalf at the implication that the pain is in her head). She also didn’t have negative side effects from it, so I guess it was worth the try.

[Anonymous]

Didn’t help at all but think a lot of it is related to something else but all doctors ignored it for years.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:No. But I have tried Gabapentin, and it didn't help. And I start Lyrica this week. I'm not hopeful.

After trying Gabapentin, my new doctor switched me to a low does of Lyrica and a low dose of Cymbalta. It took a bit to figure out the balance, but it has been a huge game changer. Depends on your pain source, of course. But for me, it was a game changer for neuropathic pain.

Do you feel like it gives you brain fog? I am really worried about these meds and whether they will lead to higher chance of dementia but I also wonder about living a life of pain (which is also bad for your brain).

Once the balance was made, I did not experience brain fog. When the Lyrica was too high, I did experience brain fog. I take a higher dose at night (when my pain is the worst) than in the morning.

The Cymbalta gave me energy back that gabapentin and Lyrica alone took away, which means I eat better, can tolerate more exercise, and do other activities that are typically thought of dementia-fighters (more socializing, brain games, learning, etc.). Alzheimers runs in my family so this is also a concern of mine.

[Anonymous]

NP. How long did people take doses of meds before determining whether they were working or not?

OP and others, I wish you relief from pain.

[Anonymous]

Anonymous wrote:Duloxetine (SNRI) has evidence to help with chronic pain in addition to anxiety and depression.

+1 and it helped me.