- Joined
- Nov 20, 2002
- Messages
- 108
- Reaction score
- 58
70 year old female with bad spondy. Predominant leg symptoms. Too osteopenic for TLF. Moderate dementia and depression.
Lyrica and Gabapentin worsen mental function to the point she can't use. SCS trial failed due to dementia limiting proper management of device. On SSRI for depression (sertraline.) I added tramadol with the hopes it would not worsen mental function and tapered off sertraline. Patient now having crying spells and worsening depression. It was thought if the pain improved the depression would as well. I have added back the sertraline but need something for neuropathic pain. I was thinking of Sevella off label for the depression and add back the tramadol? Just add back tramadol and counsel regarding serotonin syndrome?? Thoughts?
Lyrica and Gabapentin worsen mental function to the point she can't use. SCS trial failed due to dementia limiting proper management of device. On SSRI for depression (sertraline.) I added tramadol with the hopes it would not worsen mental function and tapered off sertraline. Patient now having crying spells and worsening depression. It was thought if the pain improved the depression would as well. I have added back the sertraline but need something for neuropathic pain. I was thinking of Sevella off label for the depression and add back the tramadol? Just add back tramadol and counsel regarding serotonin syndrome?? Thoughts?