antidepressants and physical pain

Post Reply New Topic

I'm having problems with physical pain due to a neck injury that left me with joint damage, plus depression because, in a nutshell, my life's a mess. I'm sure that the pain and depression are linked to a degree and that one may be exacerbating the other.

I have a very strong fear of taking any sort of drug and had some childhood trauma because of family members with addiction problems, though, so I'm the type of person who doesn't even like to take an aspirin. Plus, when I was growing up, my mother put down people who sought therapy or took antidepressants as being weak, so I have that thought in the back of my head, as well. However, she's not a part of my life right now and I'm at a point functionally where I need to admit to myself it's serious enough that I have to at least consider antidepressants and research them. Basically, I want to make an educated decision as to whether or not they're right for me, rather than just basing it on fear and other emotions.

What I'm most interested in is hearing about people's experiences with antidepressants used to treat both chronic pain and depression, like Cymbalta and Effexor. It *seems* like if they are effective, it could be a two-for-one deal for me. Has anyone found them helpful for either physical pain or depression? What kind of side effects did you experience? Did you feel the benefits were worth the side effects? Thanks for any info you can share.

I've never tried them for both. Can't say much on that end.

You're not weak for needing help. You're strong for having the sense to ask for it. And your mom may be stupid.

Only piece of advice I can give is, find someone who knows what they're talking about and is willing to start you out at a low dose and see what happens. It's not true of everyone, but I know that it is true of me and many others on the spectrum, that lower-than-usual doses are often very effective.

^^Reasonable and sensible advice--thanks

The only thing I can tell you is its doubtful that any given psychiatrist will be able to nail the right thing the first time. I don't know anything about Cymbalta, Effexor is a bit more mixed in its function being more multipurpose than a standard SSRI (I believe it has some dopamine increasing properties as well - a bit like, say, St. John's Wart or sam-E).

I don't know exactly what you're dealing with (ie. what's always been there, what may be hereditary, vs. what's current stress), just that if you have more reason to believe that the depression is more circumstantial than anything - my advice would be the cleaner the SSRI the better. I generally had poor reactions to most SSRI's, the closest I came to being able to stay on something and not lose personality was Celexa, which is very mild on side effects compared to the rest (at least as of maybe 2004 or 2005 when I tried it). In the meantime - definitely do whatever you can to help the medication along so that you need as little of it as possible; I say that because the state of the art with this stuff is still isn't particularly great and more often than not the side effects are either close to or even passed the benefit.

Yeah, that's what I'm afraid of. And, since my medical insurance plan is absolutely awful ($5,000 deductible, with a $3,000 HRA), plus various co-pays, I want very much to get things done as easily as possible.

I don't know, maybe I just should go for steroid injections in the joint and assume that when I feel better, I'll get my life back and feel less depressed. I really don't know what to do.

It might be a matter then of asking the doctor for two things - both the mildest SSRI they can try you on and additionally have it be one that has a generic available. At least if you're getting it at over-the-counter prices it won't be so bad. Sometimes as well if a doctor knows that you're strapped for cash or paying out of pocket they will give you a handful of samples, I've had that happen before.

Prescriptions under my insurance plan actually aren't too bad, a generic is, like, $15 a month, I think. It would be much, much less expensive than injections, which would count towards my deductible. (I'm eligible to get reimbursed for some expenses via Victims' Services, but I don't think they'd pay ongoing expenses for the rest of my life or anything.) I'm also not too keen on the idea of someone injecting stuff into my spine, anyhow.

I'm a bit burnt out and all over the place right now, but am leaning towards giving it some time, then maybe trying one of the prescriptions and, if that doesn't work, going for an injection sometime next year. Thanks for your input; I appreciate it.