Depression with PHN?

These need to be prescribed by a physician, or physician's assistant or nurse practitioner. I know you're in Thailand and therefore have difficulty with finding docs who speak English well, but there should be someone who can at least guide you and monitor dosages and progress. 

Wellbutrin (bupropion in generic form) is very effective and doesn't have the sexual side effect of delayed orgasm that the SSRI's tend to have for some people. The website drugs.com has a lot of good info on it and other meds. There are standard precautions there, such as not taking it if you have a seizure disorder or plan to stop drinking alcohol, etc.   You should read the site carefully. It notes that Wellbutrin XL, the extended release version, is usually started at 150 mg and the target dose is 300 mg for most people. The non-XL version has to be taken twice per day, so read up on those dosages. 

Celexa is an SSRI that is available in generic form as citalopram. The website can give you dosage and other important info. Starting dosage is usually 20 mg with a target of 40, but this can vary from person to person.

Most docs use the start dosage for a week before increasing to the target dose, to ensure that side effects aren't a problem. 

The site suggests tapering dosage to stop a medication. Never overlap on two meds without a doc's guidance. 

All three of the meds you mentioned are excellent for depression, and have few or no side effects for most people. All take a while to take effect, usually three weeks to begin seeing progress and four or more weeks to get a full effect. So you have to be patient. All must be taken every day. 

I'm not comfortable guiding your use without a physician prescribing and monitoring you, so please go that route. Also, please read up on side effects. Serious ones are uncommon, but I want you to know what they are so you can be aware, since your doc may not speak your language well. 

I've mentioned that as I decrease the Gab, I get nasty side effects, did you have some also? If not, maybe now that you're off it could it now be an issue? Take care and I hope things are back to normal. Ironically (as much as I hate the stuff) I realized today there is an up side to Gab, my stress level is lower at a higher level as I'm so zoned out LOL! We're going thru a few things here as hubby's facing surgery and I find my pre-Shingles Type A frustrations building.  I'm still on 1500 mg/day, so I've got to learn to chill a bit.

As I've gone from 2700 to 1500 in the last 10 months, my pain hasn't really increased. Looking back, probably in the first few months. I was decreasing so I could go back to work, but the pain worsened then. Now, the pain seems to lessen at the same level as the gab.

Thanks for getting back to us, I was wondering how you were doing.

 

Hi Babs,  I did decrease the gab from 900 a day to 600.  That went well as I wasn’t nearly as forgetful.  Then I slowly tried to go 200 am and 300 pm.  At that point I was okay with the PHN  Pain but the itching got worse but the neuropathy was much worse.  That makes my balance worse and my legs get super tired.  Therefore I am back to a total of 600 and think I will stay there.  PHN combined with the neuropathy is a bad combination.  On top of that I am still fighting the leg infection from the skin cancer surgery!  Would love to travel but can’t till this skin thin heals.

I THOUGHT you had the infection, but I couldn't find the exchange of posts we had. Sometimes I think I should create a spread sheet to keep everyone straight. Time, and more time, right? Patience is so hard when it seems we just keep hitting road blocks. Did you always have the itching? I never did, but I've heard that there's a fine line and connection with itching and pain with the nerves. Personally, I think it's common to stay at 600 mg. I've made my peace that eventually I'll have to do that too.

How is the neuorpathy different from the PHN? I thought they were about the same thing. Aren't YOU lucky that you get to be our expert on that. Get up at the lectern and explain please?? i'm familiar with the phrase diabetic neuropathy, and neuropathy after chemo, so as I said, I assumed it was the same sensation.

The difference is that there is little pain with idiopathic neuropathy.  Idiopathic meaning I did not get this by being diabetic or chemo.  They don’t know why I got it.  The symptoms for me are some numbness, a feeling of pins and needles and the numbness progresses.  I can still drive easily.  The only pain is sometimes little sharp stabbing pains, but not too bad.  The bad news is that it is progressive with no cure in sight.  Mine was diagnosed 15 years ago and it never really bothered me, but since I got shingles, it has become much worse.  As in PHN, for some reason, the nerves become damaged.  Guess it is related as it is nerves as well.

"Idiopathic def: Your guess is as good as mine" per medical dictionaries. Thanks for the info, but sorry that you've got the personal background. Yesterday, I was with hubby during his Welcome to Medicare exam. Our doctor's terrific, but I almost started laughing when he explained what the symptoms of shingles are. He knows what I'm dealing with and hubby's third bout was only a month ago. He meant well, but I was so close to saying, buddy I know more about it than our do.

I wonder if that Ted's Pain Cream would help. A friend did get her order, but her pain may not be nerve related. She doesn't like the mint smell from the plant they use, but if she doesn't want it, I'll take it. My order will take 12 weeks and I'll take minty-fresh fragrance over pain any day.

Did you have to pay now tp get the pre-order of Teds?  If that would help this skin sensitivity, I would go for that too.

Hi Ruth,

I just wanted to respond to your post about the numbness and the pins and needles you experience. I got shingles almost a year ago, Nov 2016. Right before I developed the shingles rash, for the first time in my life, I started having numbness and pins and needles in my feet. I didn't have any idea what was happening to me. This numbness went on after I got the shingles rash and continued. I still have the numbness and pain in my feet. I know it is completely related to shingles. My feet pain and numbness comes and goes. Sometimes, it's really bad and sometimes it is not.  My blood tests all come back normal, so I don't have diabetes or anything. I am otherwise healthy except for PHN pain in my upper left shoulder as a result of shingles. I talked to doctors about my foot pain and numbness and explained that it only started after I got shingles. Doctors have told me the nerves that were affected by shingles, all the way down my spine connect to my feet so that my foot numbness and pain is most likely related to the effect of shingles and the damaged nerves. Shingles has left me with many long term after effects, unfortunately. Most doctors don't know much about shingles and all the many symptoms it can cause nor do doctors tell patients that the tiredness and lack of energy associated with shingles can linger for several months or years. I am convinced that the numbness and pain in my feet is also related to shingles. 

Hi Tiffany,  you sound so much like me,  the difference being that I had the tingling and numbness long before I had shingles.  I got shingles 16 months ago and that is when the neuropathy accelerated.  I am totally convinced that you are absolutely right that the nerves are all connected.  The shingles is on my right side about my shoulder blade under my arm and now slightly into my chest.  The initial horrible stabbing pains have gone and it is pretty manageable .  There is still a good deal of skin sensitivity.  I still can’t wear a bra without pain, but it is better than last year.  Has your doctor done tests to see how bad the numbness is?  Like reflexes and electrical things?  I find that gabapenten helps minimally.  Good luck with managing this.

Yes, they used Amazon pay and it went on my credit card. I told my friend to give the cream more time to work. She has sciatica, which is Nerve related, but is normally caused by an actual impingement or mechanical issue. If she does give it to me I will definitely use it and get right back to you all.

I thought I had updated my story. Short version. I found that the gab and tapering was as bad as the PHN. I'm now down to 900 mg/day and during the tapers had withdrawal (I knew nothing about that) which explains the memory problems, increased pain confusion etc. That's what happens, along with other things. The worst was the depression and what it did to my mind. I got a terrific therapist in March and it's helped tremendously. My PHN is much better but still have issues with it but I'm more myself again. Decreasing the meds has shown me how many problems they caused.

My therapist used a type of therapy like CBT, but a close cousin to it. PLEASE seek help with a qualified therapist, it can literally change your life.