Pain Medical Musing

Less than 30% patients respond to antidepressants. Study cataloged depression scale and other features and came up with predictors of depression response particularly to Escitalopram. They included Demographics like black, unemployed, and uneducated; Depression severity and persistence all day ; Longstanding issues with depression;  PTSD symptoms; Anxiety attack fear avoidance; Sleep issues, and some miscellaneous issues like Insight into depression, Energy issues, Psychomotor agitation, and widespread aches and Pains.  People with those features would respond to SSRI’s like Escitalopram. Otherwise SNRI’s like venlafaixine or mirtazepine would be more effective.

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Odd as it sound people allergic to aspirin and arthritis pills can tolerate Sodium salicylate and is non- acetylated. Pharmacy College assures me it is still available as Dodd’s sodium salicylate which is still available through pharmacy suppliers so pharmacy can get in – It is over the counter. Come in 500 mg – maybe start with 500 mg twice daily and work up to four times daily. Full dose in Rheumatoid Arthritis is 4 gm/day.

Found several options:

1) Lay on your back – while on your back, it helps to be in a recliner chair or hospital bed – I found it rubbed the least maybe up two feet at end.

2) I use a 4 inch piece of memory foam that rests over my pelvis at night. Tried to sleep without it and both side s of my ribs were sore in morning. My foam is 26 x 30 inches but doubt if need to be that much. I leave some distance between it and pillow so my shoulders have free space as I have problems there too. The leg end of the foam is sculptured down slowly – it will dig into thigh otherwise.

Other ideas would be helpful