I am have c3/4 incomplete injury and I am mobile but so far the Antidepressants that they have tried have all made my spasticity worse. Just wondering if any one else has tried and found ones that do not cause the spasticity to get worse.
Hi rwolfjr, and welcome to the forum. Hope you find what you are looking for here. You mention antidepressants. My husband's injury is cervical at C4-C7 and like you he is mobile (but severely restricted in what he can do). Spasticity is one of his biggest challenges. He was prescribed Diazapam several years ago - which I believe is an antidepressant (valium?). But it wasn't to treat depression it was prescribed it to treat his spasticity at night and also to help him sleep. So I guess that might be one answer to your question. He only takes a small dose at bedtime and tbh we are about to try weaning him off it slowly - as although he hasn't increased his dose we have been advised to try and cut it out as it is extremely addictive.
Mocco … Valium, or diazepam as it is called these days, it is extremely addictive. Very difficult to reduce the dose, depending on how high the dose is. Years ago the spinal injured friends of mine were regularly prescribed diazepam for the spasms (it was the drug of choice in those days). One of them is still on 30 mg a day, 10 mg in divided doses. He is like a zombie. He has little facial expression and has virtually no highs or lows of emotion. It’s like he’s on a flat plain of existence, his emotions and his character stripped away by the drug. I take it at night on occasion for spasms. The dose can creep up rapidly, the body quickly tolerating ever-increasing doses. I know my mood is one of irritability when I have taken a lot of diazepam. By a lot, I’m talking just 5 mg. What was that Rolling Stones song about mother’s little helper? ‘Oh Doctor please, one more of these. Outside the door, she took one more.’ Now was that a reference to amphetamines or Valium? The problem is, all these drugs have their effects. Baclofen is about the most non―addictive drug for spasms but it makes you feel brain-dead. At least diazepam takes away anxiety as well as spasms and irritation. All the benzo diazepam drugs are deadly. Beware of any drug with ‘pam’ at the end of it. We’re on a road to nowhere … we’re having fun. We are here to go and go we will so we may as well go with a bit of pleasure. Give me that morphine. Now there’s a real drug. Makes you feel king of the road, superman, invincible, warm when it’s cold, full when you should be starving. A year down the line and you are an ulcerated, toothless, skinny half human being, a slave to narcotics. You take your drugs and you takes your choice.
mikeq, Peter takes 5mg at night every night. Has done since the op that exacerbated his cervical problems 7 years ago. Never increased it or been tempted to. Docs tell us that although he is probably getting no benefit from it now he will "notice" when it is decreased. They have suggested dropping by a quarter of a pill to start with for a few weeks etc etc. Splitting pills into quarters is going to be a challenge in itself! Trouble is when this was first prescribed, like most others we had no idea whatsoever about drugs, addictions, reactions, side effects etc etc and anything that meant that he (both of us) got some sleep and relief from the pain of tight muscles was very welcome indeed. Neurology consultant made no mention of long term effects with any drug he was prescribed. Of course, 7 years on we do know and what he takes is very much the result of continuous risk assessment . I am sure his decisions will differ from others on the forum. Peter is definitely not affected by diazapam in the way you mention your friend is - and as to whether it makes him bad tempered, I couldn't possibly comment as I am his wife.........
mikeq , Peter takes 5mg at night every night. Has done since the op that exacerbated his cervical problems 7 years ago. Never increased it or been tempted to. Docs tell us that although he is probably getting no benefit from it now he will "notice" when it is decreased. They have suggested dropping by a quarter of a pill to start with for a few weeks etc etc. Splitting pills into quarters is going to be a challenge in itself! Trouble is when this was first prescribed, like most others we had no idea whatsoever about drugs, addictions, reactions, side effects etc etc and anything that meant that he (both of us) got some sleep and relief from the pain of tight muscles was very welcome indeed. Neurology consultant made no mention of long term effects with any drug he was prescribed. Of course, 7 years on we do know and what he takes is very much the result of continuous risk assessment . I am sure his decisions will differ from others on the forum. Peter is definitely not affected by diazapam in the way you mention your friend is - and as to whether it makes him bad tempered, I couldn't possibly comment as I am his wife.........
mikeq,moco, My own experience with baclofen is different from Mike's description off it making people feel 'brain dead'. I know many people report this, but probably more people taking it feel they have no problems with it. Reactions to any drug vary widely.
Mo- you may not have as much problem dividing doses as you think. One hopes the NHS makes it available in 2 mg doses, as it is elsewhere. halving a pill is not difficult, though quartering can be, depending on the density of the pill. Some are easy to quarter, some disintegrate. When I left rehab I started researching my meds online. One was a 1 mg dose of clonazapam. Reading it is highly addictive (not my experience) I reduced slowly, about 1/8 at a time. I could manage that with those pills, and it took me several months. I never had a problem with it and was resolved not to. In my case, as well, I do not think it was doing anything for me anymore.
Any of us can judge our degree of brain fog, the only problem is deciding where it comes from- am I just fading from age, or is it a med? The best thing to to is be active in things that challenge the brain.
tetra, Haha Pat - didn't think of smaller dosage pills! Yes- I already slice baclofen in half so 2mg diazapams shouldn't be an issue. Re Clonazapam - Peter was prescribed this right at the beginning and he took one (can't remember dosage) and slept 10 hrs straight and was hard to wake up then couldn't put 2 words together the next day. They were ditched immediately! Also, like yourself baclofen has never had much effect on his brain fogginess one way or the other. Main issue is that it makes all his muscles weaker - not just the ones affected by spasticity. His right side is not affected by spasticity but it is very weak and baclofen makes it even weaker. Balancing act - lower the baclofen dose so his right side is stronger and his left side gets tighter. The stronger he gets the more control he has of his tight muscles Proper seesaw effect. But we are still persevering with long term reducing of dosage but at snails pace.
I think there comes a time when one must accept that pills are a necessary evil and that sometimes it's better to dice with the devil and be comfortable rather than suffer the slings and arrows of outrageous discomfort. The main thing to remember is the addictive quality of certain drugs, so keeping them to a minimum is the sensible option. It is so easy for them to escalate. I have accepted the fact that I'm going to be brain dead on occasion, due to overly medicated myself. I have almost forgotten what it's like to have a sparkling clear intellect, a drug-free mind. I am in discussions with my consultant about having an alcohol injection into my spine, total annihilation of the spinal cord below L1. Then I can remove the baclofen pump in its entirety and I'd at least be free of intrathecal baclofen, which not only bathes the spinal fluid but also migrate to the cerebral fluid which surrounds the brain. My head is saturated with the stuff. It's worse when I'm laying down for long periods. The drug migrates up the spinal cord and floods the brain. It's a horrible brain numbing feeling. Yes, it is a life changing procedure but it's one that I would rather go through then be brain dead. Intrathecal baclofen interacts with every other drug that I take, including paracetamol and especially alcohol. I can't even have a can of beer without getting drunk, and my blood pressure crashing through the floor. And because it's an implant, I cannot control the dose. Age makes a difference, too. The older you get the less you can tolerate these drugs. My old mantra, or saying, is more relevant now than ever. 'I spent my youth getting out of my head and my later years desperately trying to get back in it'. I value my intellect and I hate taking drugs but as I said in the beginning of this post they are a necessary evil. Spinal injury ruins lives in so many ways. Personalities change not so much because of injury but because of medication. William S Burroughs once wrote of morphine: God help anybody who has to take this drug for medical reasons. Having experienced morphine addiction myself, I know exactly what he means. Tetra speaks a lot of sense, as always. Gradually reducing the dose is the only sensible way to eliminate or to reduce addictive drugs. Mocco, it sounds like you are very aware of Peter's needs and between you, you should be able to reach an optimum level. All the best in your endeavours for a better life.
mikeq, please appease me,...get a zapper and try that before doing something so drastic. The zapper calms me when, for example I wake up gasping for air. This sometimes happens to me when I go to sleep on my back, rather than on my side. Then I wake up feeing suffocated and in a panic. Not often. But when it happens, I go straight for the zapper. After only 7 to 14 minutes, I’m calmed down and ready to go back to sleep. It helps to clear your mind.
The zapper (or SyncroZap) is not a medical device, hence it is not approved by the FDA.
I was prescribed diazepam for muscle spasms (not spasticity) and cae-i pain. It definetly helps me to function without reducing my cognitive function or making me sleepy. Helps a lot with muscle spasms and with pain to some extend. I take it only as needed, mostly when I get pain flare ups and muscle spasms at work, not even every day and now 2.5 mg only. No addiction so far:-). It basically meen that there is great individual variability in our reactions to drugs and side effects that individual develops.
mikeq, I smiled at "have almost forgotten what it's like to have a sparkling clear intellect, a drug-free mind." as you have one of the most interesting brains I have encountered. You always seem intellectually sound and clear to me and your posts are always reasoned, thought provoking and intelligent! I am slightly scared/in awe of the Mike we might encounter if you ditch the baclofen brain interference. Big decision Mike and I know you will not decide lightly how to proceed. I hope you find peace with making a decision.