reducing physical stress-by medication

[carabiner]

A very large part of the problem caused by my (and other) drye eyes is due to the stress the pain deliveres to my body. It's just a normal physiological reaction in which stress-hormones are released in the body. This continues stress is exhausting. In the end even the thought of having dry eyes can cause this stress reaction.

So what I'm just trying to find out if there's any pharmaceutical solution to this problem. In the range of tranquillizing drugs or even beta-blockers and anti-depressiva. Something that can break through the circle of eyepain - physical stress - enhanced sensitivity to pain - eyepain.
Does anyone have any (positive) experience with certain drug that can return a bit of rest to the body and mind? And what are the side effects if there are any?

[Rojzen]

YES! There is definitely help of this kind!

Carabiner! First let me congratulate you on your wisdom. It is often so, so hard to convince people like us that the tremendous stress of dry eye can have many , many effects that themselves pour in to a cycle of distress that later may only worsen our eyes. . .

Each of us is unique, and will respond uniquely to medications, BUT allow me to suggest that the tricyclic antidepressants are a vastly under-rated tool in battling the distress and anxiety that you describe.

Before I found the Dr. Holly drops, which completely turned around my symptoms and prognosis, I suffered endlessly from anxiety over long-term eye symptoms. Eager to reduce my eye pain, I asked my internist for amitriptyline, which is well documented as a treatment for neuropathic pain, and for sleep disorders associated with pain. On a tiny dose of only 10 mg per night, my eye pain was fully controlled for a long time (2 years), and my sleep pattern normalized to the point where my overall anxiety over dry eye diminished tremendously.

Doxepin is another tricyclic medication that can bring about pain relief and improved sleep. Both amitriptyline and doxepin, moreover, in high doses, are still testing as more effective antidepressants, for many, than the chic-er SSRIs and SNRIs that dominate the market today. The tricyclics can end depression in a matter of days, and can do so expansively. The SSRIs (like Lexapro) and SNRIs (like Effexor) work in many people, but take a long while to work, and can be less effective, generally, than the tricyclics. Tricyclics are not prescribed much today for anxiety/depression only because they are associated with side effects that are unpopular. . .But if you've ever been on an SSRI, you know that they are no free lunch, either. . .and if you know anything about the pharmaceutical industry, you'll readily see why tricyclics, whose patents ran out years ago, and which are available as cheap generics now, are not pushed to doctors anymore, despite the fact that they are really wonderfully effective drugs with terrific safety profiles.

Anyway, please discuss with your physician to determine if there might be a medication that may help you.

Please, if you consider a tricyclic, do not be scared off by their association with dry mouth. . .If you're anything like me, your anxiety/depression cause much more dryness than do these valuable drugs. . .People forget that being in a near panic all the time can totally dry up the body. . .Getting help in pain reduction and anxiety reduction can, conversely, RESTORE needed moisture. . .Be open and resourceful, and ye shall find. . That you have asked about all this is a testament to the depth of your understanding of how our syndrome works at so many levels. . .Thank you for that . .and please send me PMs if you're interested in more details on the tricyclics...

[kitty]

A less drastic approach

I have taken antidepressants and they only dry my eyes out more. I have found an amino acid, Theanine, that works wonders at reducing stress and anxiety. It has actions similar to valium. If you want to PM me, I will tell you where I order it from. You can google it, there is lots of info on the benefits of it in the treatment of anxiety and stress.

[stella]

I am ,at the moment on doxepin and only 50mgms ( which is a very small dose)has helped me and has NOT made my eyes any drier
My eyes are much better and i feel i have them under control, and have done for a few months now
As Rojzen says - a tricyclic antidepressant helps you sleep and breaks the cycle of stress and worry which chronic pain gives you
My eyes were better before i went on the antidepressant but i also had constant pain with arthritis and then developed what i thought were allergies - an all-over prickle and itch of my skin The psychiatrist thought it was due to stress and not allergy - and i think he was right 'cos it has gone away since i was on the antidepressant
Anyway i felt i just could'nt cope anymore as everyday was a struggle and i always had something wrong with me and my confidence was at a low ebb.everything was a struggle and that made me sooo tired
I am feeling much better -- so do go on an antidepressant if you need it

[carabiner]

Thanks for al your responses. I'll discuss the options with my doctor. Doxepin sounds promissing, though I had hoped less invasive means would be availuable. So far the theanine (for sale in the stores here) has only a minor effect.

[Rojzen]

relativity: stress may be more toxic than medication

It would indeed be fabulous to be able to take care of our physical and mental needs without use of pharmaceuticals, but everything's relative and contextual, Carabiner. . .Theanine (which doesn't work much for you, (or for me), is herbal/medicinal, and not completely without its own imprint. More importantly, pain, anxiety, and sleeplessness can send abnormally high levels of cortisol throughout your body, which, over time, can be quite destructive to health. Sure, Doxepin is a medication, but if it reduces your pain and manages your anxiety, restoring you to a state of good function and restfulness, is that necessarily more toxic than simply allowing cortisol to ravage your metabolism?

I suppose that my point is that if one's default state is not healthy, then tinkering with it by medications may actually bring about better, rather than worse, health, in the end. . .I used to be a purist, shunning any kind of medication, but later, I realized that life and the environment had already subjected me to all kinds of external toxic influences, over time; and I could then accept that stress may just be more toxic than are certain medications, depending on one's particular state. . .

[carabiner]

The continuation

After reading the above reactions I decided to try out amytriptiline. First 25 mg. I probably used this for just 2 days and transfered to 10mg. Even with this dose the first week I kept feeling like walking with a cotton-wool head. After reading some literature I transfered to nortryptiline 10mg, a metabolite of amytriptiline with less side effects.

Amy did have a very good effect on my eyes, but for me the psychological side effects (a state of feeling very timid) were really to big. Nor had less effect on my eyes, but enabeled me to feel much better. About one month ago though, I decided to decrease the mg to 5 mg. This was to little for me, the eyepain returned. Now I am on 7.5 mg (difficult, because you have to take a little of the pill yourself). There is some more effect on my eye, side effects are minimal. But it's really not enough for severe eyepain.
Because i really feld bad this period I added a small amount of St Johns-herb to the cocktail (1/3 day dosis). This really improves my mood.

Right now the idea is to use 7 or 10 mg in the periods my eyes hurt much (eg. wintertime).
Being able to feel as I allways felt is very important to me. These drugs really alter the way you are able to 'feel' so thats why decreasing the mg is so important to me.
But certainly: when I have to chose between feeling al little more 'dull' and being agitated all day because of eye irritation, I'll choose the first option.


Having found this option in dealing with the pain doesn't mean i'm finished with it. I'm worried about the fact that the effects of this medication could disappear in about two years.Though my docter says that stopping the medication for a week every years could reverse this effect.

Thats all for now. Good luck to you all!!

[Zarla]

Codeine to ease the pain and make you feel happier, plus the occasional Xanax when it's all getting too much. WOuld not advise any type of anti-depressant.

[kurt]

I decided to try out amytriptiline.

amitripyiline is a tricyclic antidepressant, although it is more often used to help pain and sleep (it is not addictive). More info is in thiswikipedia article.