RA & depression meds
Hello,
I was diagnosed in November 2008 with RA. My rheumatologist didn't put me on any RA meds then, because I don't mave medical insurance, and because my pain was managable with OTC pain meds, he told me to stay on them till our f/u appt. Today 1/8, I saw him. I also have a herniated lumbar disc that causes additional pain in my back & legs. I have been in a lot of pain the last month, waking at night from pain in my back, hips & legs. I can't get a decent nights sleep & I am constantly tired. During the day, my legs "ache" like I'm dragging tree stumps! I am also under a lot of stress, no job, no medical insurance. My rheumatoid factor was 218 two months ago. He said this is just the beginning stages, not that high, and the pain I'm in is mostly from the herniated disc.
He told me depression meds would ease the stress, thereby reducing the pain. He prescribed Paxil. This kind of makes sense, but I was wondering if anyone else is on meds for depression to minimize their RA pain?
Thanks for any reply!
I was on depression meds (fluoxetine--generic Prozac) before the RA, so I'm not totally in the same boat. However, I can tell the difference in my pain from when the depression is under control and when it isn't. Not being depressed makes me able to enjoy life despite the pain.
My only hesitation is that your stress is based on real problems that the drugs can't take away, rather than a chemical screw-up in the brain, so I don't know how much they will help. If they can at least take an edge off, it might be worth it. For me, the side effects are minimal and both the cost and risks are nothing compared to RA drugs. (Walmart should have at least one antidepressant on their cheap prescriptions list.)
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Having chronic pain often brings depression with it. It's normal to feel down when you are not in control and if you are in constant pain and not getting decent sleep, your ability to cope goes in the toilet and before you know it, you're very depressed. Taking antidepressants will not address your pain, but it may make the experience of the pain easier to handle and increase your ability to cope.
However, as Debra, I am concerned about how effective Paxil will be, as you have some very real problems that will not be addressed by antidepressants. Although Paxil will likely make it easier for you to handle the pain, it won't take it away and antidepressants are therefore just a Band-Aid measure. I used to see a psychiatrist and towards the end, I was going to see him about three times a year, when my coping skills failed me. After a while, I noticed that my depression worsened to a point where I needed to see him only when my pain levels weren't well-controlled. I therefore went back to rheumatologist, got better drugs and better pain control and haven't needed to see him since. Your problem may be similar.
Unfortunately, as I am Canadian, I simply don't know enough about accessing medical care without insurance in the US. There has to be some options, though and I wonder if your rheumatologist would have any suggestions about this. Or maybe your family doctor? Perhaps there's a patient advocacy group in your area or a disability rights organization may also be able to point you in the direction of resources that can help you (look on the internet or in the white pages for numbers). What about Medicare? If you're unemployed, you might qualify for assistance. As well, you could try to call your local Social Security office - they may have a temporary disability program that could help you out.
It does sound possible that your doctor is right when he says that your problems are primarily coming from your herniated disks and if you get those addressed, your pain levels would decrease and your depression lift. However, if you need help with paying for RA drugs, there are programs available - click here for more information.
Don't give up.
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