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Pain Management/Lyrica timing and synergy

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Question
I am currently on Lyrica and tramadol for fibro. I usually only take the tramadol once per day 2 times if i really need to and the lyrica late at night since it makes me slow and foggy mentally. Do any over the counter drugs have synergistic effects with either of these or prolong their half life?

Answer
Dear Rick,

The combination  of tramadol (37.5 mg) and acetaminophen (325 mg) is shown to be effective and safe in the treatment of chronic pain as shown in a randomized, double-blind, placebo-controlled outpatient study. Lyrica can be used in combination with benzodiazepines but it's of course not OTC drugs. However, you might want to try mild herbal supplements instead, such as lemon balm or passion flower teas as well as St Johns's wart. Melatonin, 0.5 - 3 mg, is shown effective for severity of pain at selected tender points and for sleep quality. It may take up to 30 days to see the effect.

Sources

Clinical Therapeutics, 2003, Volume 25, Issue 4
Clinical rheumatology. 2000;19(1):9-13
Current pain and headache reports. 2007 Oct;11(5):339-42

My personal 30-year experience with fibromyalgia allows me to recommend looking into an effective no-drug technique called mechanical tactile stimulation therapy, for example here: http://ashatherapy.com/ - the site contains research summaries as well as practical advice.

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Tatiana Zilberter

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I'll do my best to answer any question, which can ease your pain. My stronger topics are:
- General pain mechanisms: explanatory answers
- Pain neuroscience you can use
- Pain management without drugs
- Alternative/holistic techniques
- Pain education for self help

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