I hope someone can help me...

[stroppytom]

I am a 58 year old man. I have had chronic depression for fifteen years. Sometimes I also get terrible panic attacks which can last for a few weeks. Recently I had an accident and the outcome of that was that I broke seven ribs. During all the scans done to look at my skeleton the doctors also discovered that I am in urgent need of a hip replacement which is happening in the next few weeks. About a month ago I felt an anxiety attack coming on. I was mortified and didn't know what to do. In hospital I was okay and they were giving me medication for the pain. Anyway...I took my normal medication and prayed it would go away.

Well...the attack continued and my normal meds weren't working so I tried taking other medication I had on hand to see if that would work. It "sort or" did work in that the racing heart slowed down a bit but like with every time I have an anxiety episode, my appetite was gone, I had zero interest in going anything and I was starting to have suicidal thoughts because I had had enough of the fear. A friend suggested that my pain medications may have interfered with the normal meds I take and I had a think about that. When I was discharged from hospital I was told to keep taking medication until I was ready for the hip operation. I hadn't stuck to that regime because I don't like taking painkillers at the best of times. Anyway...I took medication and within 40 minutes my anxiety was gone! My appetite came back and I felt okay and I WAS okay, until the next morning when I woke up with the shakes and the fear again. Once I took the daytime dose of medication all was well again. Bingo! I knew what was wrong.

I am worried that I have become addicted to the stuff. I know it can interfere with SSRIs but my GP doesn't know how else to help me. I am scheduled to have my hip operation in the next few weeks and I am so scared about how to proceed. Can anyone here help me?

[Croix]

Dear Stroppytom~

I've noticed you around giving help and advice to others and it's good to welcome you to your own thread.

I have to say I'm a little unclear on your account of which meds did what, though I suspect for the purposes of my post here it does not matter.

It looks like you have five problems. Long term depression, panic attacks, a forthcoming hip replacement and an unfortunate interaction of medications. All this plus recovery from your accident.

On the good side you have hit on a combination of meds that do provide both pain and anxiety relief. If I understand you correctly you have been back to your doctor recently to discuss the matter and have been told your current regime is the only viable one for the moment.

My apologies if I've misunderstood. I'm not sure how much choice you have at the moment. If you change your regime off your own bat it looks like you will be subject to the anxiety attacks you mentioned plus pain. If the surgery was a long time in the future it might be possible for your doctor to trial alternative medications and dosages until a satisfactory result is obtained. However the hip is only a few weeks away.

After the operation I'd expect the pain meds will be tailed off quite quickly and I would think that is the time to address the medication issues and at the same time see what alterations to your original regime might be necessary to prevent recurrence of panic attacks.

In the meantime it may be a question of trying for some sort of balance between reducing you pain meds as much as possible while not suffering excessive discomfort and not falling back into panic or anxiety attacks.

The only other alternative might be to suffer the pain and not take meds for it, whilst at the same time trying to get your doctor to tweak your original regime, something I would have thought would have been suggested already if practical. Bearing in mind that in a few weeks you may well be put back on the pain meds anyway.

Obviously I'm only guessing based upon what you say. What do you think ?

Croix

[stroppytom]

Hi Croix and thank you for replying. I suppose I didn't make myself clear in my original post so I will clarify things.

I normally take a few different types of medication. This is my "maintenance dose" which I've taken for some years now. After the fall which caused the broken ribs I was kept on that dosage and things were fine until I was sent home after a week in hospital (I was sent home so that my ribs could heal such that the hip operation would then become possible. You can't be operated on unless you have full lung function.). Once home I started to feel a bit better so I cut back on what I was prescribed for the pain in the ribs and the hip. Within two days of doing that I had a sudden onset panic attack which has now lingered for more than a month and a half. Through trial and error I found that if I took it again, the anxiety would disappear and my appetite would return. Once the medication wore off (perhaps six hours later) the panic started to sneak back in. So now I am really worried that I have become addicted to the pain medication. The other problem is that I will need to keep taking the medication whilst I wait for the hip operation (which will be done within a fortnight or so) as my hip condition is getting worse and becoming extremely painful. I suppose what I am most worried about is the addiction aspect. I have started to take a different type and that seems to help a bit. I hope that clarifies things.

[Croix]

Dear Stroppytom~

Thanks for setting me straight. You are certainly having a hard time between the ribs and the hip. My partner had a hip replacement around a year ago and it went like a dream. Pain meds were cut down very quickly and the two worst things were having to put on pressure stockings and not being allowed to drive for 6 weeks (guess who ended up chauffeur:)

Interaction between meds is quite common, and the fact your pain meds trumped your maintenance dose is a nuisance. From what you say when the pain meds wore off each day your maintenance dose did not kick in as you might have hoped.

I've had to take quite strong pain medication for longer than a fortnight due to a spinal condition and when the pain lessened I've stopped and not thought any more about it. I'm no doctor and have no idea in your case, all I can say is that in mine no harm was done. A few weeks in not months or years.

Taking that different type may be the answer to your worries, I hope so

Croix

[cbell]

Hi Stroppytom

Sounds like you have had good advice from Croix. I understand addiction and anxiety and could suggest that you keep your doctor informed about the side effects you have noticed. good luck with the hip operation after which you can switch back to your regular medication.