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    Suggest treatment for headache, depression and body pain

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Posted on Mon, 17 Jul 2017 in Mental Health
Question: I am a 55 year old wife, mother and grandmother, and have long term all over body pain and mild depression, have trouble staying asleep and major neck and shoulder tension. I have headaches at least four days a week and have since I was 10. I am allergic to most pain medication. I exercise twice a week and am always active at home with projects my husband has going. I get a massage once a month. And have had hot flashes sine a partial hysterectomy in 1998.

I was on a ex for paxal 10 mg which w as s helping but my mood swings were like peaks and valleys. I went to new doctor and told her all of the above and she prescribed Cymbalta. I started with 30mg but was back to crying at the drop of a hat so she increased it to 60mg and I have taken that for almost 30 days. The Cymbalta helped alleviate some of the Pain and sleeping. But seemed to intensify my anxiety. Since I have not had an allergic reaction, I was wondering if there is a medication with the same active ingredients with out the depression medication?
doctor
Answered by Dr. Alexander H. Sheppe 1 hour later
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Cymbalta works to alleviate pain by a unique mechanism, through blocking serotonin reuptake. This is a feature of all antidepressants in its class, so there's no way to get these effects without also getting an antidepressant effect. However, if you feel Cymbalta isn't right for you, there are two other medications similar to it that are worth trying: Pristiq or Effexor. Ask you doctor about switching to one of these.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Alexander H. Sheppe 4 hours later
Can c Cymbalta and Paxil be prescribed at the same time? Will Cymbalta help with tension headaches?
doctor
Answered by Dr. Alexander H. Sheppe 31 minutes later
Brief Answer:
Followup

Detailed Answer:
Cymbalta and Paxil should not be used together for more than a few weeks, due to risk of serotonin syndrome.

Cymbalta is not approved to treat tension headaches, so this will need a different treatment.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe 3 days later
I have decided to continue With the Cymbalta due to the pain and sleep benefits. But I feel agitated most of the day and crave sweets. My hot flashes seem more frequent. I am on a 60mg RX do you think this should be increased or decreased for my anxiousness to be reduced? Thank you for sharing your expertise.
doctor
Answered by Dr. Alexander H. Sheppe 26 hours later
Brief Answer:
Followup

Detailed Answer:
I think if you are feeling anxious and agitated, Cymbalta is not right for you. I'd recommend trying a more sedating antidepressant such as mirtazapine. I would slowly wean off Cymbalta if you were under my care.

Dr Sheppe
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Alexander H. Sheppe 23 hours later
What do you know about Lexapro? Is this a sedating antidepressant? I would still like to treat my daily pain and sleeplessness not just the anxiety please. Would the mertazapine address all 3 of these?
doctor
Answered by Dr. Alexander H. Sheppe 26 hours later
Brief Answer:
Followup

Detailed Answer:
Lexapro is not particularly sedating, but mirtazapine certainly is. Mirtazapine is also good for treating anxiety. Pain is a different story... very few antidepressants are helpful for pain, and all of those are activating rather than sedating. I'd give. mirtazapine a try.

Dr Sheppe
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Alexander H. Sheppe 6 hours later
When my doctor prescribed Cymbalta she said it has three active ingredients, dopamine was one of them and the others sounded like that. One for long term pain, one for sleep and the other for anxiety. It is hard to find a paIn med I don't have an allergic reaction to. I know my pain level has gone down and I can actually stay asleep, that is why I wanted something similar to Cymbalta. Is there a pain med with the same ingredient, and that can be prescribed with Mirtazapine? I am trying to get an appt with my doctor Nd she doesn't seem to be willing to look these things up so I really appreciate your input so I can give her the information and see what I can do to start feeling more calm. Thank you
doctor
Answered by Dr. Alexander H. Sheppe 30 hours later
Brief Answer:
Followup

Detailed Answer:
Yes, there are 2 medications similar to Cymbalta, in the same class of medications. The trade names for these are Effexor and Pristiq. You can ask your doctor if she thinks one of these might be appropriate to switch to.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Remy Koshy
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Dr. Alexander H. Sheppe

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