Brief Answer:
Side effect possible but how does the cramping relate to.......

Detailed Answer:
Good evening. Thank for your concerns regarding the cramping in your hands.

I'm not pleased at hearing that you are on such a high dose of trazodone for sleep purposes in addition to 100mg Lyrica for paresthesias (numbness/tingling).

I'm not absolutely clear on whether you are referring to the cramping or numbness/tingling symptoms as being the ones resulting from medication side effects but let's just generalize to the following statement.

Side effects of either cramping OR paresthesias would be most plausible if the symptoms that are the SUSPECTED side effect ones appeared within 1-4 weeks of starting any new medication or any new combination of medications. On the other hand if we simply look at the general side effect profile of trazodone it really has no significant side effects that look like either muscle cramping or paresthesias...though it can do many other things. I am not a particular fan of the medication when used OFF LABEL for sleep because it is potentially habit forming and people trying to get off the drug have a roller coaster ride with insomnia. If I were you I would ask for a referral to a sleep specialist or a neurologist well versed in looking for some better approach (i.e. find the CAUSE of your insomnia) that would include getting you off trazodone with the rather sharp withdrawal effects that can happen by trying to stop it...even if weaning down.....the sleep/wake centers of the hypothalamus need to be resynchronized since trazodone has really played around with those controls.

In the case of LYRICA....now, there are clear and present side effects that could be very consistent with either CRAMPING or PARESTHESIAS as you seem to have but again, if those symptoms are at least some of those symptoms have come on as a result of the medication having been started within the past 4 weeks. If any longer than that then, I believe it would be less likely due to medication side effect.

There are no clinically relevant drug to drug interactions between trazodone and Lyrica....which is somewhat surprising....but it turns out to be true so your symptoms are not due to the INTERACTION between the 2 drugs.

If the discs you mention are only slightly compromised as you describe then, I have very little suspicion that that is going to be the problem. However, you did not mention anything about blood work or chemistries that I would've checked right off the bat such as serum Vit. B12, Vit. D, D2, D3, folate, Thyroid hormones to include BOTH TSH and FT4. I would also throw the inflammatory markers in of ESR and C-reactive protein and possibly a Rheumatoid Factor depending on what the cramping is really like and how your hands look.

I would also question how your CARPAL TUNNEL SYNDROME was diagnosed. If not by a neurologist who did an EMG/NCV study then, I would ask that the PRIMARY doctor please refer me over to either a neurologist to verify that diagnosis and to consider doing an EMG/NCV type of test and if that were negative for anything directly in the hands or wrists to go looking in the neck for something such as a cervical radiculopathy, presence of osteophytes, presence of cervical canal STENOSIS (narrowing), and of course evidence of degenerative arthritic disease in general which if at multiple levels of the cervical spinal cord will be very hard to treat with any type of surgery and a conservative approach would be ultimately preferred.

In conclusion, there is still some work I bet still needs to be done in your case to get to the bottom of what's going on and I hope these ideas have going you some things to think about and potentially discuss with your primary doctor or specialist if you are already followed by one.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 26 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 32 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Spasms or Tremors/Twitches?

Detailed Answer:
Thank you for the response.

I do not believe I saw or understood that your hands were tremoring or shaking/twitching from the first note you wrote since you used the words "muscle spasms in my hands." The word SPASM refers to the sudden and usually PAINFUL contraction of a muscle such as a Charley Horse in the calf. That's an example of a muscle spasm.

If your hands or fingers have "twitching" then, that's a different symptom. As far as the side effects of Lyrica are concerned once it again, the way to ascertain its effects in terms of THIS particular symptom of twitching what I wrote before still holds true. There should be some sort of temporal relationship between the onset of those activities in your hands and fingers and the start of the medication of no more than a few weeks or perhaps a few months if the dose was at all escalated. The way to test for sure if the medication were the cause would be to stop it and see if the twitching would go away.

However, I do not recommend doing that without discussing things with the doctor who first prescribed it since other things could happen such as increase in the symptoms of numbness/tingling or pain if there's any of that for which the medication were being prescribed.

In the blood I would also check for things such as Vit. B12, folate, Vit. D, D2, and D3 as well as thyroid hormones of BOTH TSH and Free T4 (FT4). These are commonly obtained in routine bloodwork. Unfortunately, withdrawing from methadone is a very tricky and difficult process. I hear you when you say that you didn't sleep. Actually, the brain changes that occur long term from taking opiates such as methadone can take a very long time to reverse themselves....sometimes over a year and during that time people can still have residual or hold over side effects that are strange having to do with altered pain and sensory feelings, problems with sleep which could be addressed by getting a sleep study and/or consultation with a specialist.

I would AVOID going back to anything of an opiate nature and look for ways to get your pain under control with something alternate to Percocet even if it were to mean doing surgery for the carpal tunnel to try and do away with that medication.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 45 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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