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Suggest Treatment For Depression And Anxiety While On Pain Management Medication
Question: I had back surgery on aug. 6th. Herniated disc to the right, and the nerve had twisted up side down, and stayed that way. 80% of my pain went away. I also have left hand pain and right shoulder, have been told many times that I have scoliosis, but minor. Since surgery, I cannot work yet because I am a flight attendant and could not handle the physical part of the job. I now have severe depression. I take wellbutrin, estradiol,trazodone,progesterone,ultram, and xanex for big time anxiety. I take dhea and vitamin d. I would like to try ketamine treatments. The only one in Utah is for pain management. For depression I would need to go to XXXXXXX 4 times, once a week. For pain it is covered under insurance, but for mental it is not. I have had suicidal thoughts. I called our physc ward and they will not diagnose. The first Psychiatrist visit open is not until Dec. Do you think It would be wise to try the pain mgmt. for crps? I think ketamine would help? I think not working and being paralyzed on the couch from depression, anxiety, and pain is making life a nightmare! Any suggestions? Our mental system in Utah has not worked.
Brief Answer:
I think ketamine for pain can be tried
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns and impairment in functioning due to pain, depression and anxiety.
In my view you can go for ketamine treatment in your city itself as it is covered by insurance and hopefully it will be useful for both depression and CRPS.
I like to tell you that the dosages of ketamine used for chronic pain do not differ from the dosage used for resistant depression. I am hoping that if you take treatment for one, you will get benefited in another ailment which too is disabling for you.
Another thing I like to mention here is use of lithium for depression and suicidal thoughts. Talk to your psychiatrist at next visit to prescribe lithium to augment current antidepressant. if there is no contraindication for this molecule for you, believe me you will get good results once it is added in lower dosage to current medication.
In case there is some contraindications or side effect of lithium scares you a lot, talking about TCA is not a bad idea. I agree with you that they are not used much these days but depression with pain symptoms, they are the best one among available antidepressants.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
I think ketamine for pain can be tried
Detailed Answer:
Hello,
Thanks for using healthcaremagic.
I read your query and understand your concerns and impairment in functioning due to pain, depression and anxiety.
In my view you can go for ketamine treatment in your city itself as it is covered by insurance and hopefully it will be useful for both depression and CRPS.
I like to tell you that the dosages of ketamine used for chronic pain do not differ from the dosage used for resistant depression. I am hoping that if you take treatment for one, you will get benefited in another ailment which too is disabling for you.
Another thing I like to mention here is use of lithium for depression and suicidal thoughts. Talk to your psychiatrist at next visit to prescribe lithium to augment current antidepressant. if there is no contraindication for this molecule for you, believe me you will get good results once it is added in lower dosage to current medication.
In case there is some contraindications or side effect of lithium scares you a lot, talking about TCA is not a bad idea. I agree with you that they are not used much these days but depression with pain symptoms, they are the best one among available antidepressants.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Yogesh D
what are side effects of lithium. the pain clinic in utah won't use ketamine for depression, only pain. How can I convince them the pain has added to depression?
Brief Answer:
The lithium need tight monitoring
Detailed Answer:
Hello,
Thanks for reverting back to me.
Lithium is a drug which affect kidney and thyroid most. On long term use there is instance of nephrogenic diabetes insipidus and hypothyroidism. Other than that it can cause toxicity if higher dosages are used. It also usual side effects like nausea, vomiting, diarrhea and tremors.
Regarding your question about convincing them you do not need to do anything. At the time of taking details about your illness you need to give slightly more emphasis on your pain symptoms and telling them how it is affecting your life. You can inform them that pain is of most concern for you and once you get treated for this, you will able to start working.
You can tell the that how the depression increase following onset of this pain.
To put your points in better way go through some case histories available over the internet to educate yourself.
I hope this clarifies the situation.
If you have any further query, I would be glad to help you.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
The lithium need tight monitoring
Detailed Answer:
Hello,
Thanks for reverting back to me.
Lithium is a drug which affect kidney and thyroid most. On long term use there is instance of nephrogenic diabetes insipidus and hypothyroidism. Other than that it can cause toxicity if higher dosages are used. It also usual side effects like nausea, vomiting, diarrhea and tremors.
Regarding your question about convincing them you do not need to do anything. At the time of taking details about your illness you need to give slightly more emphasis on your pain symptoms and telling them how it is affecting your life. You can inform them that pain is of most concern for you and once you get treated for this, you will able to start working.
You can tell the that how the depression increase following onset of this pain.
To put your points in better way go through some case histories available over the internet to educate yourself.
I hope this clarifies the situation.
If you have any further query, I would be glad to help you.
"If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health".
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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