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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Anxiety And Depression While On Lortab?

I am an obese 58 year old woman I broke my hip when I was 9 years old, it was left untreated for a year. By the end of that year irreparable damage had occurred. At the age of 10 I began what would be the beginning of a lifetime of horrific surgeries on that hip. My hip has been replaced 3 times and cannot undergo another replacement ever because of such horrific scar tissue and damage to that area. I have knee replacements in both knees. In 2013 I had a terrible accident leaving my left femur shattered. At one point having complete metal from hip to knee on the left side. The last hip replacement in 2012 - the doctor had to hammer the replacement in so forcefully that it completely crushed the SI joint in that left hip. I have been on Lortab 10-325 since 2012. Even on a good, medicated day my pain levels never dip below a 5. The trauma of the accident in 2013 left me with PTSD, Anxiety, depression and other anxiety related disorders. I was given clonazepam for a short time in 2013 which greatly improved my anxiety problems but my dr has feared greatly with my taking both clonazepam and Lortab together she has tried several other anti-anxiety medications over the last 2 years but nothing even comes close to treating my anxiety the way clonazepam has. She is telling me I must choose either the pain med OR the anxiety med - but not both. I love my dr - she has been my doctor for nearly 20 years and I trust her completely. Plus, she is the only dr I will allow to prescribe me meds. I see her every 3 months for a meds evaluation. I will see her Monday morning. What options do I have in being able to treat my pain AND anxiety together without harming myself?
Fri, 7 Sep 2018
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General & Family Physician 's  Response
Hi,

I'm sorry to hear your story about all the problems you've had with your hip and all the surgeries you've had to endure. I know it must have been very hard to go through all of that.

I also appreciate your attitude of wanting to follow your doctor's recommendations and trusting her judgment.

I agree with her that using both opiate pain medication and a Benzodiazepine like Clonazepam can be dangerous.

Unfortunately, for someone like you who has severe pain AND anxiety, it will be difficult to find alternatives.

One idea is some antidepressants, like amitriptyline or duloxetine, can be used for both anxiety/depression and pain, and might be able to allow you to at least lower the dose of the other medications you are using.

There are also some treatments that work on your nerves to control pain, like a TENS unit or spinal cord stimulation.

You could discuss with your doctor whether these might be appropriate in your case. I hope that you can find a solution with your doctor that both control your pain and anxiety and avoids too much risk of adverse effects of medications.

Hope I have answered your query. Let me know if I can assist you further.
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What Causes Anxiety And Depression While On Lortab?

Hi, I m sorry to hear your story about all the problems you ve had with your hip and all the surgeries you ve had to endure. I know it must have been very hard to go through all of that. I also appreciate your attitude of wanting to follow your doctor s recommendations and trusting her judgment. I agree with her that using both opiate pain medication and a Benzodiazepine like Clonazepam can be dangerous. Unfortunately, for someone like you who has severe pain AND anxiety, it will be difficult to find alternatives. One idea is some antidepressants, like amitriptyline or duloxetine, can be used for both anxiety/depression and pain, and might be able to allow you to at least lower the dose of the other medications you are using. There are also some treatments that work on your nerves to control pain, like a TENS unit or spinal cord stimulation. You could discuss with your doctor whether these might be appropriate in your case. I hope that you can find a solution with your doctor that both control your pain and anxiety and avoids too much risk of adverse effects of medications. Hope I have answered your query. Let me know if I can assist you further.