switching things up.

and i am officially off of savella. monday was my last day taking it.
 
now, you’d think i’d be done with meds for a while, right? wrong…
 
so i went to the neurologist about my sleep, dr. rozner. fyi: you don’t go to a neurologist for insomnia. i have no idea why jhagroo sent me to him, but i digress. so rozner was beyond confused as to why i was sitting in his office, but to not waste a visit to yet another doctor, he gave me the referral for the sleep study. he definitely did attempt to find the root of the problem. he asked about my daily habits and caffeine intake, and my constant migraines came up. i ran down the list of pills i’ve taken for them: imetrex, aleve, excedrin, prescription strength ibuprofen, etc. he said those are symptomatic medications, and that i need to be taking preventative medications.
 
my options were amitriptyline or gabapentin. sitting in his office, i’ve never heard of either medication; after his explanation, all i understood was “gabapentin will sedate you for about six to eight hours,” so that’s what i chose.
 
i did some research after my appointment:

amitriptyline is used for conditions like depressive and anxiety disorders, adhd, migraine prophylaxis, eating disorders, bipolar disorder, and insomnia. it’s also used in spondylitis for pain relief, the treatment of nocturnal enuresis in children, post traumatic stress disorder, tinnitus, chronic cough, carpal tunnel, fibromyalgia, vulvodynia, interstitial cystitis, irritable bowel syndrome, diabetic peripheral neuropathy, neurological pain, laryngeal sensory neuropathy, and painful paresthesias related to multiple sclerosis. typically, lower dosages are required for pain modification of 10 to 50 mg daily. some side effects are drowsiness and a dry mouth, weight gain, changes in appetite, muscle stiffness, nausea, constipation, nervousness, dizziness, blurred vision, urinary retention, insomnia, and changes in sexual function. some rare side effects include seizures, tinnitus, hypotension, mania, psychosis, sleep paralysis, heart block, arrhythmias, lip and mouth ulcers, extrapyramidal symptoms, depression, tingling pain or numbness in the feet or hands, yellowing of the eyes or skin, pain or difficulty passing urine, confusion, abnormal production of milk in females, breast enlargement in both males and females, fever with increased sweating, and suicidal thoughts.

gabapentin is used mainly for the treatment of seizures, neuropathic pain, and hot flashes., and can be used to treat migraines, bipolar disorders, and pain.  it provides significant pain relief in about a third of people who take it for fibromyalgia or chronic neuropathic pain. it’s also effective in reducing narcotic usage post operatively and is helpful in neuropathic pain due to cancer. it’s approved for treatment of focal seizures, partial and mixed seizure disorders. it can help with acquired pendular nystagmus and infantile nystagmus, menopausal symptoms, and can reduce pain and spasticity in multiple sclerosis. gabapentin has been prescribed in the mental health context. trials show that it is not effective as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. it has limited usefulness in the treatment of anxiety disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia. it can also cause weight gain. a trial found gabapentin ineffective for the treatment of idiopathic subjective tinnitus. it's most common side effects in adult patients include dizziness, drowsiness, and peripheral edema, or swelling of extremities, which these mainly occur at higher doses in the elderly. also, children 3–12 years of age were observed to be susceptible to mild-to-moderate mood swings, hostility, concentration problems, and hyperactivity. although rare, there are several cases of hepatotoxicity reported. it should be used carefully in patients with renal impairment due to possible accumulation and toxicity. gabapentin has been associated with an increased risk of suicidal acts or violent deaths. in 2009, the FDA issued a warning of an increased risk of depression and suicidal thoughts and behaviors in patients taking gabapentin, along with other anticonvulsant drugs modifying the packaging insert to reflect this. in july 2009, the manufacturer of gabapentin (pfizer) went to trial regarding the association between gabapentin and the increased risk of suicide.
gabapentin should not be discontinued abruptly after long term use. abrupt or over rapid withdrawal may provoke a withdrawal syndrome reminiscent to alcohol or benzodiazepine withdrawal. gradual reduction over a period of weeks or months helps minimize or prevents the withdrawal syndrome. side effects upon discontinuation of gabapentin that have been reported in medical literature include insomnia, restlessness, agitation, anxiety, disorientation, confusion, light sensitivity, diaphoresis, headaches, palpitations, hypertension, chest pain, and flu-like symptoms. in at least one case, abrupt cessation of a high dose of gabapentin triggered a seizure in an individual with no history of epilepsy.

that's a whole lot of shit; a little nerve wrecking, if you ask me.

dr. rozner wants me to take one 300mg capsule of gabapentin once a day for a week, then increase to two at bedtime.

today is day three taking gabapentin, and i'm absolutely hating it. it's written across my
face how exhausted i am, and this is only the beginning. 

and i'm in killer pain?! i swear i'm about to have another breakdown.