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Suggest Treatment For Fibromyalgia

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Posted on Mon, 14 Apr 2014
Question: I am on fentanyl patches 50 mcg 72 hours. I am also on lyrica 100 mg per day and copious paracetamol for treating fibromyalgia. With these medicines I have horrid side effects and am bed ridden 70-80% time and to add insult to injury they are not helping my pain. I have a diagnosis of fibromyalgia. My doctor is wholly unhelpful in the treatment and I cannot change doctors at this moment in time. I want to try LDN. There's no point in talking to my doctor to get his support because he will say no. I have sourced somewhere where I can get my hands on the LDN without prescription, however, I am worried about starting it because of the fentanyl. So if I start it do I have to have come off the fentanyl first or is it that all that will happen is that the pain relief properties of the fentynal will be interrupted? If that's the case, will I still go into withdrawals? I don't want to go cold XXXXXXX without support, but I want to have my life back and here is a medication that is non toxic and could help - I want to try it.
doctor
Answered by Dr. Rohit Gulati (2 hours later)
Brief Answer: LDN not a good idea Detailed Answer: hi, fibromyalgia is a bad thing to be suffering from. In case you are not getting relieved with paracetamol and fentanyl patch, you shall combine Aceclofenac or tramadol to your combination after asking your doctor. Then slowly once your pain is less you can start removing your fentanyl. Starting LDN to get rid of Fentanyl though is not bad but not advisable also, esp. without the prescription. Slowly cutting off fentanyl by decreasing the patch strength to 25 and then one day gap between two patches, simultaneously starting tramadol and aceclofenac in sustained release form to take care of your pain is a better idea.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Rohit Gulati (33 hours later)
I cannot start tramadol and aceclofenac as need a script for these and no. 1 I am in XXXXXXX they don't do either of those tablets, no. 2 I have taken lots of NSAIDS and they don't help for pain at all, neither does anything ibuprofen related, no. 3 my doctor is not helpful in looking at other medications which is why I want to do it by myself. The closest I have taken to aceclofenac from the little I've read up about it since seeing your correspondence is arcoxia and I've had bad reaction to this. I have tried all these other medicines that are NSAIDS etc prior to ever going on fentanyl. I need to try things which I can get without going to the doctor since the doctor will not help beyond Lyrica, Fentanyl, and SNRI's all of which I have tried and had the worst possible side effects from. I've been on steroids and all forms of meds, all have caused lots of side effects and no pain relief so in effect have made me more ill. It's not that I wish to start LDN to get rid of Fentanyl, it's just that I have read that LDN is not compatible with opioids. However, I've also read that LDN is non-toxic and non-addictive and a whole lot of other things including no side effects. More importantly than any of that, there is compelling evidence that it works for a large amount of fibromyalgia sufferers. I have sourced a pharmacy of excellent reputation in mainland Europe that doesn't need prescription. My plan is to try it, and if it works, then talk to my doctor about it and continue it with his awareness and support. The only reason I need to do it this way is that I know from past experience that if I speak to the doctor first, he will say no right off the bat without investigating it first and leave me bed bound and in pain on the medicines that I am on for the next 40 or 50 years, or however long I have left. The only thing that is stopping me going ahead with it, and the only reason for me contacting you first is the Fentanyl. If I weren't currently on Fentanyl I would just have gone ahead with it. I need to know if taking the ldn will cause me to go into withdrawal from the Fentanyl which I obviously want to avoid. Your suggestion of cutting off fentanyl by decreasing the patch strength to 25 etc while simultaneously starting the other medicines will not work because those types of medicines do nothing for the pain and cause me tremendous side effects. So, yes, I want to do exactly that with the Fentanyl, but using the LDN instead of the other toxic and non effective medicines. But I just need to know why is it not advisable? If it's simply that you don't think it's advisable without the prescription, then that's fine, it's my choice to go ahead with it, but if it's not advisable for medical reasons can you let me know what they are please. I am fully aware that anything you're saying is for general information only, and I'm not relying upon it as a substitute for sound medical advice as a complete assessment has not taken place. I just need more comprehensive information in order to complete my decision and I cannot get that information from my own medical advisors. Thank you for your time and attention.
doctor
Answered by Dr. Rohit Gulati (2 hours later)
Brief Answer: go ahead, good luck. Detailed Answer: Hi, I see that you are well read about the drugs. There are no medical reasons as such. FDA had brought this drug LDN, to help opioid addicts. so there is no reason as such to start LDN if you are on fentanyl. besides when you know that other things are not helpful then there is no problem. the only reason I am apprehensive is if there are any side effects how are you going to support your procurement of drugs. Good luck.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Rohit Gulati (5 hours later)
I was being told that there are no side effects from ldn, that it's safe - so the only effects I was worried about were whether the ldn would throw me into withdrawls from the fentynal, even while still taking the fentynal. Ideally I want to come off all drugs except the ldn, since they are the only onces that seem to work for people; if I weren't already on the fentynal I'd just go straight ahead. Do you mean by procurement of drugs, the ldn? or the fentynal? Because the doctor will continue to give those once there are no side effects. So the hope is to go on the ldn, get some relief from them and bit by bit tackle first the opioids and then the lyrica as I've been have untold problems with withdrawals from both of those - however - I'm hoping to build up my strength with the ldn in order to face the problems that these other two tablets are causing. Does this make sense.?
doctor
Answered by Dr. Rohit Gulati (6 hours later)
Brief Answer: does make sense Detailed Answer: This does make sense. Starting LDN doesn throw you into withdrawl as such. This drug as i said was introduced to help patients withdraw from opioids. One more thing that you can discuss with your doctor is needling (dry/saline/local anesthetic) of the tender points. That is supposed to work. Good luck.
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Above answer was peer-reviewed by : Dr. Prasad
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Dr. Rohit Gulati

Pain Medicine & Palliative Care Specialist

Practicing since :1999

Answered : 252 Questions

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Suggest Treatment For Fibromyalgia

Brief Answer: LDN not a good idea Detailed Answer: hi, fibromyalgia is a bad thing to be suffering from. In case you are not getting relieved with paracetamol and fentanyl patch, you shall combine Aceclofenac or tramadol to your combination after asking your doctor. Then slowly once your pain is less you can start removing your fentanyl. Starting LDN to get rid of Fentanyl though is not bad but not advisable also, esp. without the prescription. Slowly cutting off fentanyl by decreasing the patch strength to 25 and then one day gap between two patches, simultaneously starting tramadol and aceclofenac in sustained release form to take care of your pain is a better idea.