Med Q while waiting for pdoc to call

[gizmo]

I went to the urgent care, yet again, for morphine shot to break a six day migraine that my fioricet didn't touch.

I always, always feel like shit for about two days following the shot. Residual head pain, nausea and stomach upset, and extreme lethargy. I asked the dr if there was something she could give me to help get me through the next couple of days and to use when my fioricet doesn't work. She scripted me tramadol.

I was able to enter all my meds into the drugs.com drug interaction checker, and the results scared the crap out of me! I only slept four hours last night and didn't take any of my metal meds.

The main interactions were between the tramadol and the trazodone and the Zoloft for serotonin syndrome. Also, there were interactions between several meds regarding lowering seizure threshold.

I know no one can replace my pdocs advice, but does anyone take (or stay away from) some of the meds I take? Anyone concerned about taking tramadol with their mental meds?

There were even major interactions listed between adderall and Zoloft and trazodone.

Thanks for any assistance.

[Screamingbutterfly]

I know migraines are horrible, I used to get them really badly. Yes, I am concerned about taking Tramadol with mental medication. In general tramadol interacts with a lot of medications. In my opinion it never worked well for my pain either. Even when I was scripted it after surgery I didn't even bother taking it, I don't know if you get your medication from a chain pharmacy, usually if it has a severe interaction they will warn you or call your Dr. and state you need a different medication. If the possible effects make you uncomfortable I would see if there is something else you could take. Sometimes it's best to go with your gut feeling.

[notfred]

Pretty well you have to mix a MAOI with another serotonin reuptake inhibitor or serotonin releaser to get significant Serotonin Syndrome. Tramadol is pro-seizure and should be avoided in those who have existing seizure disorders.

In summary: Morphine, codeine, oxycodone, buprenorphine do not precipitate serotonin toxicity with monoamine oxidase inhibitors. Pethidine (meperidine), tramadol, methadone and fentanyl, propoxyphene, dextromethorphan, are borderline. They are weakly serotonergic and some may precipitate serotonin toxicity which must be assumed to be dose dependant.

My conclusion in the BJA paper was: ‘In summary, morphine, codeine, oxycodone and buprenorphine are now known not to be SRIs and they do not precipitate serotonin toxicity with MAOIs. Pethidine, tramadol, dextromethorphan and methadone definitely are weak SRIs (see Table 2), and may infrequently precipitate dose-dependant serotonin toxicity (when administered in conjunction with any type of MAOI), but perhaps only in large doses or susceptible individuals. Our ability to estimate the risk with particular drugs with any precision is compromised by a lack of systematically recorded data on the clinical toxicity of these drugs, and also by the lack of pharmacological data concerning their precise potency, as SRIs or releasers, using the latest assay techniques. For some drugs (propoxyphene, pentazocine, fentanyl, remifentanil and congeners) there is no SRI affinity data at all, and we have to rely on interpolations and the presence or absence of clinical reports (Table 2). It is to be hoped that increasing understanding and awareness of this situation will stimulate further research that will answer these remaining questions.

http://www.psychotro...nalgesics.shtml

[yara]

Sorry to take so long but I had to check with my pharmacist because I didn't remember all the shit I have taken and hasn't worked. According to my walgreens pharmacist there is no bid deal with tramadol and trazadone. However, he says trazadone can give you headaches and sensitive to light. Take it for what it's worth. In other words, go by whatever your pdoc tells you to do because s/he knows more about it than my pharmacist and I.

Good luck

ps- I'm a glutton for punishment so I take Tylenol extra strenght and if it gets bad, a good massage usually kicks me on. Of course, I haven't had bad migraines since I had my hysterectomy 7 years ago. Go figure. Keeping my fingers crossed for you.

[melissaw72]

Have you tried acupuncture or chiropractor? I'm not saying you shouldnt take the meds, but in the meantime it might help.

[netsavy006]

I'm not asking this to question what you wrote, I'd like to know for my information, how does a chiropractor and acupuncture help migraines?

Have you tried acupuncture or chiropractor? I'm not saying you shouldnt take the meds, but in the meantime it might help.

[gizmo]

My pdoc called, and he doesn't want me to take the tramadol with my mental meds. Mainly due to the lowered seizure threshold and increased risk of seratonin syndrome (remote though that may be).

I'm gonna call my GP tomorrow and ask to get in. If that's going to take the expected month, I may just go ahead and call my non-HMO neuro and see if I can get in to discuss a different med for pain treatment. We'll see how my insurance pays for that.

My pdoc said that if the adderall is causing me continued migraines when I see him in a couple of weeks, then we will discuss another medication.

I'm just so damn sick and tired of being sick and tired! This constant pain just has to stop, and I wish someone would give me something that would actually stop the pain!

[Gearhead]

I'm not asking this to question what you wrote, I'd like to know for my information, how does a chiropractor and acupuncture help migraines?

Have you tried acupuncture or chiropractor? I'm not saying you shouldnt take the meds, but in the meantime it might help.

I'm not sure how it works, but it does, at least for me. I think-and this is my impression of how my body works only-that since correcting the misalignment in my neck causes me to get far fewer and less severe tension headaches, the tension headaches I'm not getting cannot trigger a migraine.

I found these two links on the subject. There are loads more, but my dinner is almost ready.

http://www.umm.edu/a...ache-000072.htm

http://www.isischiro..._migraines.html

[melissaw72]

I'm not asking this to question what you wrote, I'd like to know for my information, how does a chiropractor and acupuncture help migraines?

Have you tried acupuncture or chiropractor? I'm not saying you shouldnt take the meds, but in the meantime it might help.

Chiropractors help relieve the tension in the head, neck and lower back, and at the least lessens the migraine (if that is what you are there for). If you go on a regular basis, they might get to the point where they (migraines) aren't a big deal. Everyone is different though. I went to one for about 8 years, at least once a week (more than the average person goes), and I don't have migraines, but got bad headaches and they were relieved to a small headache that I could take Excedrin for. It might take a few appts with a chiro to see results, but usually you can feel something that first appt.

Acupuncture works better IMO. I specifically went to one for chronic headaches. Typically it take 12 sessions to get good results. Even though it didn't cure the headaches, it made them less frequent. Just be careful if you decide to go this route ... some acupuncturists can milk you for money. I had this experience and stopped seeing her. It wasn't covered by insurance either, so it was expensive. (chiropractors are covered by something usually, at least in part).