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Suggest Treatment For Chronic Pain And Severe Migraines
Question: My daughter has been currently diagnosed with MS. She is currently taking Gabapentin (600 mg), Amitriptyline (50 mg), Ambien (10 mg) Lorazepam, Rebif, and Morphine. She is constantly in chronic pain and now experiencing severe migraines. My question to you is, by her taking these medications together, making her symptoms worst? She is 44 years young and has experience MS symptoms for over a year. Recently she was given a MRI and her prognosis suggest that she has MS. Because she is in so much pain and losing the feelings of her upper and lower extremities, I wonder if she has another type of illness.
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.
I do not think the pain is related to the medication, none of those drugs (or their combinations) cause pain, some of them are used precisely to treat chronic pain. I do think that Ambien and Lorazepam are perhaps too much since with time they start to lose their effect and she is already under drugs which cause sleep.
MS is often associated with pain. It may be in the form of abnormal sensations such as burning, prickling etc. In that case Gabapentin and Amitriptylin are among the best options.
One other cause of pain is increased spasticity in the limbs. If that is the case (should be confirmed by doctor on physical exam) then medication like Baclofen is more suitable.
Whether another diagnosis may be considered....MS if fulfilling the criteria on MRI is hard to confuse with another condition, so if the MRI result is clear on that I think the diagnosis is pretty certain. Even if there is some accompanying condition like fibromyalgia contributing to the symptoms medication is pretty similar to what she is already under, wouldn't change treatment much I am afraid.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
I do not think the pain is related to the medication, none of those drugs (or their combinations) cause pain, some of them are used precisely to treat chronic pain. I do think that Ambien and Lorazepam are perhaps too much since with time they start to lose their effect and she is already under drugs which cause sleep.
MS is often associated with pain. It may be in the form of abnormal sensations such as burning, prickling etc. In that case Gabapentin and Amitriptylin are among the best options.
One other cause of pain is increased spasticity in the limbs. If that is the case (should be confirmed by doctor on physical exam) then medication like Baclofen is more suitable.
Whether another diagnosis may be considered....MS if fulfilling the criteria on MRI is hard to confuse with another condition, so if the MRI result is clear on that I think the diagnosis is pretty certain. Even if there is some accompanying condition like fibromyalgia contributing to the symptoms medication is pretty similar to what she is already under, wouldn't change treatment much I am afraid.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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