Disabled by medicine. Advice please.

[jnstaylor98]

The amount of medicine I need to manage my symptoms have in their own way become disabling. Between the medicine I take to control tremors, spasticity, balance, pain and my high blood pressure; I'm fairly strung out. I worry about the quality of my work and the effectiveness of my teaching. Should I scale back on the meds and try less side effects and more ms symptoms? Or is it time to admit defeat. Feeling very frustrated and lost.

[heliotrope]

Have you talked to your primary care physician? They should be able to help you determine if you really need all that medication. In my case, my neuro had me on a daily dose of medication for a symptom that I only have a few times a month. Turning it into an "as needed" drug reduced the amount of medication and saved me money - but I had to know that I could safely go off it.

[pennstater]

Have you discussed with your neuro? Are there other meds you can try? If so, maybe they will have less side effects.

The one thought I have is if you come off the meds and your symptoms are now in full swing, can you be effective then? Think back to when you started taking these meds and what was life like for you?

If you do decide you want to cut back, I would definitely do it with your doc's assistance, only one med at a time, and cutting back on the dosage for drugs you should wean off of. This way, maybe you can find a balance where a lower dosage may take the edge off or lower frequency of symptom, enough to allow you to keep teaching.

Good luck with your decision. Keep us updated.

[rdmc]

Can you identify which meds are causing which side effects?

A caution about cutting back on meds without consulting your doctor or neuro. Some meds have consequences of going cold turkey and you have to wean yourself off them.

Baclofen , for instance, one should never just quit taking it, you must step it down in dosage in order to avoid withdrawal symptoms.

And you don't want to go off your BP medicine...I think if you explain to your doctors about the problems you're having they may be able to switch you to another med with less side effects.

[MSW1963]

I decided pretty early after my dx that I would be selective about which sx to treat with meds and which I could tolerate or otherwise manage without meds. Had I not made that decision, I would still have that bag of 1/2 a dozen pill bottles.

I used meds rx'ed for tremors as sleep aids due to chronic insomnia and the drowsiness effect of the tremor medication. There were a few meds rx'ed for one sx that had side effects that improved other sx, for instance bowel incontinence improved with pain meds that cause constipation.

I chose not to treat bladder incontinence because I couldn't tolerate the dry eyes and mouth side effects. And definitely talk with your MS doc about your 'over medicating' concerns, and your desire to not feel like you are in a drug stupor if that's possible.

I notice the most intense sx are the new ones from new CNS damage or during an MS exacerbation. After a couple of months/years, some of the intense sx subside to a more tolerable level, although the sx may never completely resolves. A lot of sx don't seem worth treating once the intensity decreases, compared to med side effects or feeling overmedicated.

I don't know if similar options are available to you, but I hope you're able to reduce your meds and maintain a better quality of life.

[jnstaylor98]

I have tried fewer meds, and results weren't great. The blood pressure meds are non negotiable. I have cut back on the muscle relaxers when on antibiotics before. 5 days off and I could barely function. There are s few I think at this point I'm dependant on. I'll ask my dr. Next week about this and see what he says.

[palmtree]

The only medication that you mentioned that could be stringing you out are the pain meds, unless of course they are non narcotic. I don't know.

Maybe the best course of action would be to take less of one medication at a time and see how you do. But PLEASE don't scale back on blood pressure meds. I had a know-it-all doctor who thought I was taking too much medication and he cut one of my BP meds. The result was a stroke.

I assume you are taking Baclofen, probably Primidone, Gabapentin. I don't think these medications will make you strung out. I'm strung out by medications because the list is so long. Every time some nurse says, "now let's review the medication list" I become more and more weary. And keeping track of when they all need refilling is very tiring.

You may be just stressed from your job. Another resource might be your pharmacist believe it or not. A good pharmacist knows a lot about how all the medications affect us. Of course, talking to your doctor as others have wisely mentioned may be a good idea.

[palmtree]

If you are taking anything in the narcotic or benzodiazepine family, they are probably the culprits. The others, I don't think so.

If it is something like Xanax it has to be tapered very very slowly and there are still withdrawals. Things that help "strung out" are Gabapentin and hydroxizine. You might ask your doctor if you could try those.

[SNOOPY]

Hi jnstaylor98,

If you would like to share what medications you are currently taking we may be able to offer suggestions. However, it is always best to consult with your prescribing Physician.

If you do not wish to share what medications you are taking that is perfectly fine

Depending on symptoms there can be options other than medications to try and help, improve or decrease them. Sometimes the alternative options help and sometimes they don't.

Or is it time to admit defeat.

Never, never, give in to defeat Sometimes we need to acknowledge our limitations and difficulties and assess if we are doing better, worse or the same on medications vs. off of some or all medications.

Take care.

[palmtree]

If you have an expectation of yourself that taking medications indicates weakness and defeat, that can be a handicap. We need to fight this disease with all the guns we can. But if a medication is making you feel worse, by all means evaluate whether it's worth taking.

[Calamity Grace]

For a long time, I was taking Atenolol for high blood pressure. My neuro prescribed Primidone for tremors, but the side effects were horrible. He tried Propranolol, but before I started taking it hubby noticed one of its side effects were lowered blood pressure. I ended up stepping off Atenolol and started taking Propranolol instead. Took my blood pressure every day for a year and it was fine while my tremors stayed under control, too (except when I'm too tired).

The moral of my story is maybe one med can do more than one job so you don't have to take as many.

[jnstaylor98]

Med List.
welbutrin
gabapentin
clonazepam
tinzanidine
xanax
carvedilol
lisinopril
amlodipine
meloxicam

[SNOOPY]

Hi jnstaylor98,

Xanax and Clonazepam are Benzodiazepines. I would question the need for both Xanax and Clonazepam, I am not aware of any reason to use both. Clonazepam (Klonopin) is a long acting Benzo and the others such as Xanax are shorter acting.

Benzodiazepines can be addictive, although not everyone becomes addicted. I used Klonopin for 10 years and did not become addicted.

Benzodiazepines can cause someone to feel "high" or "loopy." They can cause:

- Loss of coordination (loss of balance)
- Drowsiness
- Cognitive difficulties (thinking, memory)
- Depression
- and dizziness (just to name a few)

Tizanidine is a muscle relaxer and I am assuming you are using it for spasticity? Unfortunately, this medication can also cause:

- Drowsiness
- Depression
- Dizziness (just to name a few)

Gabapentin (Neurontin):

- Shakiness
- Anxiety
- Drowsiness
- Coordination problems
- Memory problems (just to name a few)

Wellbutrin:

If a person has anxiety this medication may cause an increase of anxiety. Wellbutrin can cause nervousness and anxiety. For some it can cause excitement for others, drowsiness. It can also cause shakiness.

Each of us react differently to medications.

We, as patients, need to be aware of medication side effects. Otherwise what happens is you take one medication for a symptom and have another symptom show up which in turn the Dr. prescribes something else to treat that symptom...and the cycle begins.

Some times it's not the MS that is causing symptoms but the result of medication side effects.

As a general place to start for checking on medication side effects: http://www.nlm.nih.gov/medlineplus/druginformation.html

The above site does not list every side effect that can be due to a medication but it is a good place to start.

[Maggie2015]

I can relate

Hi jnstaylor98,

I was a teacher from 1998-2013. I loved it passionately and never would have given it up--but I had a severe relapse, a divorce, and a move across the country and all that led me have to resign. I still hope to get back to teaching if I can find a way to get my chronic pain to resolve.

I would say if you love your job like I did, PLEASE wait until you've had a chance to look into all solutions. I agree with what others have said here to talk to your neuro and PCP and yes! to what palmtree said, your pharmacist. Are any of the meds duplicating each other? And if so, yes! to what everyone said about trying to eliminate one by one and taper off slowly!

I don't know if what I'm about to say will freak people out, but I was on a low dose of Ritalin for fatigue, 1 in the morning and 1 in the afternoon, when I was teaching. It cut back on my fatigue from Baclofen, which I needed for spasticity, massively. I believe it's what allowed me to keep teaching as long as I did, before my relapse.

But it can also make you feel strung out, and I wasn't on Gabapentin or Wellbutrin.

I was on both Xanax and Clonazepam (Clonazepam for sleep at night, Xanax for naps in the day and bouts of vertigo). I slowly eliminated Xanax. That helped with the fatigue, too.

I hope this helps a little. I don't mean to recommend Ritalin. I just know that the fatigue from my spasticity meds made me foggy, and trying to keep going through the fog made me feel strung out, which made me doubt myself and start to feel hopeless. Ritalin for me cut through that fog and actually gave me clarity and perspective.

And a from a teacher to a teacher! Maggie

[Marco]

I struggle with medication side effects so I try to be cautious about adding or stopping medications. Like others have said, I would get to a doctor and have them help you prioritize your list. Determine if any changes can safely be made and try not to make too many changes at one time.

Again, I would start with your doctor and ask for a medication review ASAP. For informational purposes, I put your medications into an interaction checker.

http://www.drugs.com/interactions-ch...440-203,133-54