[Tripping On…] Tripping On Mexiletine

My experience with Mexiletine as a medication used to treat my spine pain is succinctly summarized as almost completely useless. Its usefulness is that it acts like other medications I’ve taken before in that it calms my body’s blood pressure, but that doesn’t mean it reduces the pain much at all. This third pain doctor is trying to use this medication as a stand-in for antidepressants, but I think any antidepressants could be the same.

It’s curious reading over all of the medications I’ve taken.

Taken as a larger picture, many of the medications I’ve been prescribed have acted on similar parts of my mind’s perspective on pain. When I take Mexiteline, I still feel the pain but the rest of my body is relaxed more, which doesn’t really make a difference from before since the rest of my body outside of the spine pain was fine. It’s like if you get a deep scratch in a car’s paint job and instead of working on the scratch, you polish the rest of the car. The scratch is still there, but the rest of the car is shiny.

I’m sure this medication is helpful for its intended prescription use.

This medication most closely feels like how Propranolol felt to me, compared to any of the antidepressants or other medications I’ve taken. That my doctor is so insistent on prescribing me an antidepressant is weird because it will have a similar effect except significantly worse. I’ve been talking to many of my friends and acquaintances about these medications – because while the objective medical literature is fine, it should be balanced with the subjective experiences of the patients who take the medications – and most people agree that antidepressants are not a good route to go for me if I’ve had negative experiences with them in the past.

I’m mad that the doctor said there were only three ways to treat pain.

It’s like he’s lying directly to me and he doesn’t understand the nature of my pain symptoms. My primary care physician said that the antidepressant he wanted to prescribe me, “W/r/t duloxetine, we do use it sometimes for depression, but at higher doses it’s a really good chronic pain medication, I don’t think he’s trying to talk you into an antidepressant because he thinks you’re depressed, he’d send you back to me for mood/mental health stuff-[1][sic]” so although I do trust him more than the pain doctor at this point, I don’t think this will be helpful for me much at all.

So I’m trying to explore what this pain is exactly.

There’s the tailbone pain which flares up most when I’m standing, sitting at the wrong angle, and presents as a dull pain when I lie down in bed. I’ve been noticing since the post-injections Methylprednisolone wore off an increase in muscle pain particularly on my left side and the pill-based Methylprednisolone started to make me really sick. So there’s a lot of weakness involved. The spine pain hurts so much it feels psychedelic. It feels like if you’re thinking like this “|” or up and down, then it knocks your perspective off-course to one side like this “/” and then after a while you might go back to “|” but you might forget what you were doing. I think this medication is making things worse.

Here’s what the doctor said about antidepressants during the call:

Well, I, you know, if we get really good relief with the Mexiletine, by all means, you know, this would be a discussion in passing, but you know, I don’t know, I, I’m just gonna let you know, you know, there probably will be another time at which I’ll be pushing a little bit for the Cymbalta/duloxetine even at a very tiny dose because I have seen it to be very, very helpful. And it’s a beautiful, beautiful, when it’s dosed right. It’s a beautiful, beautiful nerve medication, so, again, we don’t have to do that, make that change, right now, but I’ll probably talk to you more about it as we go, if we find some success with the Mexiletine.

Since it’s not effective, I think this doctor’s all out of options.

He said, later on, there’s no quaternary agent or fourth agent for managing pain outside of nerve blockers, antidepressants, and antiarrhythmics, so I guess that’s all his medical schooling has taught him. We’ll see what he says, I guess, at the two-week review but I’m not confident that I’ll get anywhere with this doctor. I feel sick and terrible and everything we’ve tried feels like it’s making things worse. At least now that I’m done with the Methylprednisolone my insomnia is gone. I stopped taking it early because it was making me significantly sick with no positive benefits after the first 8mg dose. I was also reading about how people shouldn’t take that with a weakened immune system, and wow, while I haven’t been officially diagnosed with that, I sure can feel like I have a weak immune system.

If there’s any upside, it’s that I’m learning to tolerate these new pains easier.

Life is still extremely rough living with extreme pain, to the point where it hurts doing much of anything and we’re not even going to mention going out anywhere to pick up my mail or medication, but at least I have the same vigor and passion for life as I’ve had since I started writing daily and then as often as I could. I can safely say that without the effectiveness of Mexiletine to treat my condition, I doubt that the doctor will be dumb enough to prescribe me an antidepressant, since what’s that going to do other than completely kill my passion for anything in life? If I’m thinking charitably, since the Mexiletine didn’t work I don’t think he’ll go with the antidepressant, but I have to be more careful than catching COVID not to get tricked into taking the antidepressant.

Or honestly, anything else that makes me feel sicker.

Quotes[1] Quoted directly from my PCP’s message.
Sources: My personal experiences and reading some drug documents online.
Inspirations: I wanted to summarize this into a bit of a trip report, or, my reactions to taking this medication. This essay also fixed the concern I had with being prescribed the antidepressant. He probably won’t explore that route since, as he said in the blockquote, this medication didn’t work, so I don’t think something similar will be beautiful to him.
Related: Sober Living essays and Tripping On [The American Healthcare System] chapters.
Picture: Template
Written On: 2021 April 23 [10:54pm to 11:23pm]
Last Edited: 2021 April 23[First draft; final draft for the Internet.]


My big goal is writing. My most important goal is writing "The Story." All other goals should work toward that central goal. My proudest moment is the most recent time I overcame some fear, which should have been today. I'm a better zombie than I was yesterday. I'm not better than you and you're not better than me. Let's strive to be better every day.