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Suggest treatment for chronic pain

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Posted on Mon, 29 Dec 2014
Question: Ty I need to make a dr. appt. in mexcico, for chronic pain and panic/ anxiety attacks. I have been on oxycodone for some time and seems I've become somewhat imune

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Answered by Dr. Seikhoo Bishnoi (36 minutes later)
Brief Answer:
Panic attacks

Detailed Answer:
Hello, Welcome to Health Care Magic

I can understand your concern. You have recently had meniscus tear and had two surgeries in past also. The pain medicine Oxycodone is not able to control pain. Due to tolerance you are compelled to take medicines in high dose.

Chronic pains, anxiety and panic attacks are main issues. For severe persistent medicines like Pregabalin can prove useful along with Oxycodone. The drug will decrease the need to increase the doses of Oxycodone.

You have been prescribed Valium for panic attacks. Valium is a benzodiazepine drug and it can control the symptoms on SOS basis. This drug can also produce dependence and tolerance, so try to avoid using it on continuous basis. Other medicines like Sertraline, Fluoxetine etc can help to treat panic attacks. The drugs belong to SSRI group and don't have risk of dependence.

Amitryptiline or Nortryptiline can prove useful in your case. These drugs are from Tricyclics antidepressants and have good role in pain and anxiety also. Consult a psychiatrist fro evaluation and treatment of panic disorder.

Thanks, hope this helps you. Ask again for more doubts.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Seikhoo Bishnoi (51 minutes later)
Dr. with all do respect. None of any of the pharmacy's pill's you've offered I've tried have not worked . I do take meloxicam along with the oxycodone which has given me tolerable comfort through out the day along with the braces. When I take off braces at night or get started in morning, I can barely walk! I'm not an addict, alcoholic , abuser of any kind. I don't share, sell or do anything illegal with them. I have taken a few somas and did help. I can buy illegally or I' ve been offered oxy contin which I refused but I may have to because no-one understands the chronic/ severe/ and panic attacks I deal with on a daily basis. Please send me another list of medications I've mentioned in this email and I will place a significant order all in name of comfort. Thank you, XXXXXXX XXXXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (22 minutes later)
Brief Answer:
Chronic pain management

Detailed Answer:
Thanks for asking again

I can understand distress of chronic pain. Meloxicam can potentiate Oxycodone but increasing the dose will result in tolerance.

Other medicines like tremadol can prove useful in severe chronic persistent pain. The medicine in controlled release formulation is very effective in pain condition. It is related to codon but sustained release has good effects. You can consult and take the medicine. The medicine requires prescription but is effective.

In more severe conditions analgesics like celecoxib can prove useful. Nortryptiline and Amitryptiline I have mentioned earlier also. These drugs will potentiate the action of other drugs.
Discuss all about this with your doctor.

Thanks, if you have more doubts ask again
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Follow up: Dr. Seikhoo Bishnoi (37 minutes later)
Again Dr. You are not being helpful or understanding. I do not need a physchiatrist. I need a panel of certified pain specialists. What about pain patches or pumps that I welcome to be regulated?
doctor
Answered by Dr. Seikhoo Bishnoi (1 hour later)
Brief Answer:
Patches

Detailed Answer:
Hello again, I apologise for your inconvenience.

I would like to tell you that Transdermal pain patches, controlled release tablets or intrathecal pumps all are options for chronic pain.

Transdermal fentanyl is one of good option for chronic persistent pain. The patch provides protection from pains especially orthopaedic pain for up to 3 days. It is more effective than conventional opiates. This can be a good option that can help you. Buprenorphine patches are recently launched especially for pain condition, the drug provide sustained delivery and help to control pain without causing sedation. You can consult for these patches.

If we consider controlled release tablets like Tramadol SR, they can also provide good control.

Regarding intrathecal delivery, they are more effective in spinal cord lesions. In orthopaedic conditions the pumps can result in infection. Still they deliver drug to target area directly. The pumps can be kept as last option.

As per my opinion transdermal patches will prove useful in your condition. They don't result in tolerance and help to control pain effectively. Buprenorphine or fentanyl patches are commonly used in severe pain.

Thanks

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5181 Questions

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Suggest treatment for chronic pain

Brief Answer: Panic attacks Detailed Answer: Hello, Welcome to Health Care Magic I can understand your concern. You have recently had meniscus tear and had two surgeries in past also. The pain medicine Oxycodone is not able to control pain. Due to tolerance you are compelled to take medicines in high dose. Chronic pains, anxiety and panic attacks are main issues. For severe persistent medicines like Pregabalin can prove useful along with Oxycodone. The drug will decrease the need to increase the doses of Oxycodone. You have been prescribed Valium for panic attacks. Valium is a benzodiazepine drug and it can control the symptoms on SOS basis. This drug can also produce dependence and tolerance, so try to avoid using it on continuous basis. Other medicines like Sertraline, Fluoxetine etc can help to treat panic attacks. The drugs belong to SSRI group and don't have risk of dependence. Amitryptiline or Nortryptiline can prove useful in your case. These drugs are from Tricyclics antidepressants and have good role in pain and anxiety also. Consult a psychiatrist fro evaluation and treatment of panic disorder. Thanks, hope this helps you. Ask again for more doubts.