Antidepressants and spasticity

Mocco … Valium, or diazepam as it is called these days, it is extremely addictive. Very difficult to reduce the dose, depending on how high the dose is. Years ago the spinal injured friends of mine were regularly prescribed diazepam for the spasms (it was the drug of choice in those days). One of them is still on 30 mg a day, 10 mg in divided doses. He is like a zombie. He has little facial expression and has virtually no highs or lows of emotion. It’s like he’s on a flat plain of existence, his emotions and his character stripped away by the drug. I take it at night on occasion for spasms. The dose can creep up rapidly, the body quickly tolerating ever-increasing doses. I know my mood is one of irritability when I have taken a lot of diazepam. By a lot, I’m talking just 5 mg. What was that Rolling Stones song about mother’s little helper? ‘Oh Doctor please, one more of these. Outside the door, she took one more.’ Now was that a reference to amphetamines or Valium? The problem is, all these drugs have their effects. Baclofen is about the most non―addictive drug for spasms but it makes you feel brain-dead. At least diazepam takes away anxiety as well as spasms and irritation. All the benzo diazepam drugs are deadly. Beware of any drug with ‘pam’ at the end of it. We’re on a road to nowhere … we’re having fun. We are here to go and go we will so we may as well go with a bit of pleasure. Give me that morphine. Now there’s a real drug. Makes you feel king of the road, superman, invincible, warm when it’s cold, full when you should be starving. A year down the line and you are an ulcerated, toothless, skinny half human being, a slave to narcotics. You take your drugs and you takes your choice.

mikeq,
Peter takes 5mg at night every night. Has done since the op that exacerbated his cervical problems 7 years ago. Never increased it or been tempted to. Docs tell us that although he is probably getting no benefit from it now he will "notice" when it is decreased. They have suggested dropping by a quarter of a pill to start with for a few weeks etc etc. Splitting pills into quarters is going to be a challenge in itself!
Trouble is when this was first prescribed, like most others we had no idea whatsoever about drugs, addictions, reactions, side effects etc etc and anything that meant that he (both of us) got some sleep and relief from the pain of tight muscles was very welcome indeed. Neurology consultant made no mention of long term effects with any drug he was prescribed. Of course, 7 years on we do know and what he takes is very much the result of continuous risk assessment . I am sure his decisions will differ from others on the forum.
Peter is definitely not affected by diazapam in the way you mention your friend is - and as to whether it makes him bad tempered, I couldn't possibly comment as I am his wife.........

Weed helps me with my spasms and sleep on the down side among several other benefits. Enjoy the ride.

I think there comes a time when one must accept that pills are a necessary evil and that sometimes it's better to dice with the devil and be comfortable rather than suffer the slings and arrows of outrageous discomfort. The main thing to remember is the addictive quality of certain drugs, so keeping them to a minimum is the sensible option. It is so easy for them to escalate. I have accepted the fact that I'm going to be brain dead on occasion, due to overly medicated myself. I have almost forgotten what it's like to have a sparkling clear intellect, a drug-free mind. I am in discussions with my consultant about having an alcohol injection into my spine, total annihilation of the spinal cord below L1. Then I can remove the baclofen pump in its entirety and I'd at least be free of intrathecal baclofen, which not only bathes the spinal fluid but also migrate to the cerebral fluid which surrounds the brain. My head is saturated with the stuff. It's worse when I'm laying down for long periods. The drug migrates up the spinal cord and floods the brain. It's a horrible brain numbing feeling. Yes, it is a life changing procedure but it's one that I would rather go through then be brain dead. Intrathecal baclofen interacts with every other drug that I take, including paracetamol and especially alcohol. I can't even have a can of beer without getting drunk, and my blood pressure crashing through the floor.  And because it's an implant, I cannot control the dose.  Age makes a difference, too. The older you get the less you can tolerate these drugs. My old mantra, or saying, is more relevant now than ever.  'I spent my youth getting out of my head and my later years desperately trying to get back in it'. I value my intellect and I hate taking drugs but as I said in the beginning of this post they are a necessary evil. Spinal injury ruins lives in so many ways. Personalities change not so much because of injury but because of medication. William S Burroughs once wrote of morphine: God help anybody who has to take this drug for medical reasons. Having experienced morphine addiction myself, I know exactly what he means. Tetra speaks a lot of sense, as always. Gradually reducing the dose is the only sensible way to eliminate or to reduce addictive drugs. Mocco, it sounds like you are very aware of Peter's needs and between you, you should be able to reach an optimum level. All the best in your endeavours for a better life.

I was prescribed diazepam for muscle spasms (not spasticity) and cae-i pain. It definetly helps me to function without reducing my cognitive function or making me sleepy. Helps a lot with muscle spasms and with pain to some extend. I take it only as needed, mostly when I get pain flare ups and muscle spasms at work, not even every day and now 2.5 mg only. No addiction so far:-). It basically meen that there is great individual variability in our reactions to drugs and side effects that individual develops.

mikeq,

To me it is always a question of what allows me to "have a life".