Yeah, not so much.
Medicine is ruled by fads, and no, that's not good for the patient. Yesterday, I left my doctor's office with a prescription for Sevella. I've never heard of it, so I looked it up.
Milnacipran is not used to treat depression, but it belongs to the same class of medications as many antidepressants.
Sevella is an SSRI/SNRI, putting it in the same group as Prozac and Wellbutrin (Zyban if you're quitting smoking). When my pain first sent me to doctors for relief, tricyclic antidepressants were the fad, so I took Elavil. Fifteen days after starting Elavil, I tried to kill myself. After that came the first wave of the fad of treating chronic pain with SSRI/SNRIs. "But I'm not depressed," I protested and was assured that these new antidepressants had no effect besides pain relief if you weren't depressed. I can only assume my doctor got that line from the drug rep, because it's not true. My reaction was not unique. Prozac left me despondent, crying until I literally ran out of tears. Wellbutrin turned me into an avatar of rage and I found myself screaming obscenities at some poor guy named Tim when my cable went out. (Sorry, Tim.)
My doctor knows this, I've told him these stories in great detail. My file should have "NO ANTIDEPRESSANTS" written on it in red pen.
After that was the fad for Neurontin, an anticonvulsant. The drug reps were pushing it hard for disorders other than epilepsy, and doctors treating pain patients were delighted to play along, even though there was no evidence that Neurontin did anything for chronic pain. It didn't do anything for me, and my doctor at the time told me that Neurontin was the gold standard for chronic pain and if it didn't work for me, maybe I just liked narcotics too much.
Not one fucking study, no science at all, just a drug rep's assurances, and I was a junkie.
After that came Lyrica. It was a miracle! We would all be saved! I got so dizzy I couldn't stand up. "Wait for it to pass," my doctor said, "This stuff is worth it." I did eventually learn to walk somewhat straight, but my pain didn't go away. After six months, I gave up, but to this day, I still have balance problems, and if I turn my head too fast, I fall over.
Last year, right before my doctor's visit, I saw an ad for Cymbalta. "Here we go again," I said. "He's not going to give you that," my husband said, "He knows what happens to you on antidepressants."
As soon as he walked into the exam room, my doctor was singing the praises of Cymbalta. "Angels deliver it directly from heaven!" I'm paraphrasing, but he was pushing this stuff like the manufacturer had sent an assassin to his house and was holding his family hostage until he prescribed enough of it.
I'd had enough. I refused. He threatened to stop my pain meds unless I tried it. I took the sample pack- and then went home and threw it away. I told him it didn't work, but I had tried.
This year, it's Sevella and everyone's getting a scrip! Pink is the new black, belts are the new gloves and Sevella is the new Cymbalta. Here's a look at the side effects:
Milnacipran may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
nausea
vomiting
constipation
stomach pain
weight loss
dry mouth
feeling of extreme facial warmth and/or redness
increased sweating
headache
dizziness
blurred vision
difficulty falling or staying asleep
decreased sexual desire or ability
pain or swelling of the testicles
difficulty urinating
rash
itching
Would you prescribe that to someone who just got done telling you that they can't sleep and their gallbladder is sending them to the ER every three weeks? If so, you have what it takes to be a pain doctor- a fantastic commitment to fads and a sociopathic unconcern for the wellbeing of other people!
I can't wait for next year.
