Medication conflagration

Gabapentin has been raising my blood pressure (and weight) pretty steadily since February, and it hasn’t actually been helping me with my pain issues. Back before I started on it my blood pressure was generally around 115/85, and as of last Thursday my rest blood pressure was 144/98. Which is, you know, pretty darn high.

So on Friday I decided to cut my dose from 200mg/day to 100mg/day, and see what that did to me.

Saturday I felt like crap, but my blood pressure was down to 137/96.

Sunday I felt a lot better, and my blood pressure was down to 122/79.

Today I feel just fine, and my blood pressure is 114/82. And my pain isn’t any worse than it was on Friday, and I’m also not incredibly constipated. So now I’m planning on just discontinuing it entirely next weekend and see how I feel after a couple of days.

I’m going to stick to taking nortriptyline, and I might try increasing that dose back up to 30mg/day. The only alternative to nortriptyline that doctors have suggested is Celexa (citalopram), which I’ve already tried for panic in the past and it just made things way worse, and while I don’t currently feel like the nortriptyline is doing all that much, I just have to look back at old blog entries for a reminder of how much of a difference it made. (But then again, I also felt like gabapentin was helping a lot, until it wasn’t. Placebo effects much?)

Also it’s nice to get the reminder that it was a big part of reducing my anxiety. But then again there was that time that I decided nortriptyline wasn’t helping at all and my doctor at the time agreed so… gah, what the hell, brain? The last time I tried tapering down it went very badly so maybe this dose is pretty okay.

In a couple of weeks I’m starting the “functional restoration” program at the pain clinic, and meanwhile the stretches and exercises I’ve learned during this most recent round of physical therapy have been pretty helpful too. So maybe that’ll help me out more.

I think after I’m off gabapentin I’ll give Adderall another try, as well. At the time I thought it was Adderall interacting with nortriptyline to give me really bad blood pressure spikes (as that’s one of its known interaction effects with stimulants in general), but in retrospect it was probably the gabapentin.

Even if I can’t get back on Adderall, it’ll at least be hopefully possible to go back to self-medicating with low-dose caffeine. I sure as hell miss being able to do that.

(Funny how back when I was doing it I actually credited gabapentin with making that possible. Ugh, brains, ugh, medications, why is it all such guesswork?)


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