December 2, 2007 - 8:58pm
well my doctor said he dont know where the pain is coming from so therefore he cannot fix it, i have arthritis from where they broke my back up in many places and take celebrex 2 200mg a day and i have muscle spasms, for which i take cyclobenzaprine and valium. I also have nerve pain i used to take nuerontin and now i take lyrica. and i still have pain on top of it. so i wanna live pain free and out of bed for the rest of my life and i was wondering if there is any pain medications where there is no ceiling limit, director says hes on 6x 10mg methadone 3x daily i just wondering if there is a ceiling effect for this.
December 2, 2007 - 10:55pm
#2
There are some narcotic
There are some narcotic medications like Codeine that do have a "ceiling effect". Supposedly the human body can only process/metabolize 400mg of codeine at a time. Without having too much time to look it up right now, my number of 400mg may be off. Also Im not sure if there are any other narcotics that have this unique "ceiling effect". From what Ive read/remember I would agree with dr.lois that most narcotics can be increased, as much as needed, as long as the pt has built up an adequate tolerance.
December 3, 2007 - 11:40am
#3
from my valium it makes my
from my valium it makes my pain less intense i guessing the anxiety made it alot worse
i'm not a pharmacist or doc don't listen to me i just have done alot of research on this stuff. talk to your doctor about it
December 3, 2007 - 1:34pm
#4
Maximums on meds
I have never heard nor been on any maximums due to high doses of my pain meds. When I was on Oxycontin, I took 160 mg TID, which is 480 mg per day and now I'm taking 180 mg of Methadone.
I was always under the assumption, that the ceiling of any medication like these, were what the patient could stand. All meds have side effects and if you take a high enough dose, eventually you'll reach your personal "ceiling". With Methadone, most people (myself included) have to deal with drowsiness when driving long periods of time, getting sleepy when you read and/or watch TV. As long as I'm active, I'm ok and the Methadone doesn't cause me any problems.
December 3, 2007 - 2:19pm
#5
you seem to be confusing
you seem to be confusing tolerance and ceiling effect. A ceiling effect is the point at which a certain amount of narcotic will no longer have any more effect than a lower amount. Buphenoriphine is another narcotic which is said to have a ceiling effect, although I could be mistaking this for suboxone which also has naloxone in it.
Check with a licensed MD before you take any suggestions!
December 3, 2007 - 6:24pm
#6
Casey, I wouldnt doubt
Casey, I wouldnt doubt that the Valium does help with your pain. Not only is Valium a great anti-anxiety medication it is also one of the best muscle relaxants. From a personal point of view when Im without anxiety or excessive tension my pain is usually less severe. But thats only because the majority of my pain is caused by tension in my upper back and jaw.
December 3, 2007 - 7:03pm
#7
I found for me
I found for me that soma works better than valium as a muscle relaxant, but I don't how it would affect your anxiety. It also seems you don't build up as much tolerance with soma as in most benzo's, (i.e. valium, xanax). That's just me, check with your dr.
December 5, 2007 - 12:42am
#8
no im not confusing
no im not confusing tolerance with ceiling effect im aware of the ceiling effect of codeine bupe and tramadol (liver can only metabolize 400mg of codeine into morphine) the others are partial agonist. reason i am asking this is because im tired of living in my bed and hope to be on pain meds that y i asked. i was just wondering once my tolerance get so high i have to taper off wait 6 months then start over.
i'm not a pharmacist or doc don't listen to me i just have done alot of research on this stuff. talk to your doctor about it
December 5, 2007 - 4:21pm
#9
My post was directed at
My post was directed at Director Casey, sorry for any confusion, I know you are going through a rough patch at this time in your life but things will get better. Methadone doesn't have a ceiling effect, although it seems to sometimes.
Check with a licensed MD before you take any suggestions!
December 5, 2007 - 5:09pm
#10
i didn't know codiene had a
i didn't know codiene had a ceiling effect. Probably because I would never give anyone 400mg of codiene! Do you know if this is different for people who have genetic pleiomorphisms of the CYP 2D6 allele?
In theory, there is no limit on the amount of narcotic pain medication you can take. The approved maximum dosage for the fentanyl patch is 300mcg/hour, for oxycodone 360 mg/day, for oxymorphone 180 mg/day, for methadone 120mg/day. For very tolerant patients with intractable pain (like Director) doctors can prescribe even higher doses, although they will usually try to find another treatment or another medication. Just because your doctor doesn't know what is causing your pain, doesn't mean you are not having pain, but if he doesn't know what is causing it, no one can correct the underlying cause of the pain. Living pain free is probably not a possibility for you, but with physical therapy, back brace, cane or whatever else you may need you certainly should be able to get out of bed. Sometimes when people are not getting any relief from narcotic pain medications they choose to stop them because they do not like the side effects.