Suggest Treatment For Occipital Neuralgia

Posted on Fri, 16 Jun 2017

Question: I am a 69 year old 40% disabled Viet Nam Vet. I've been on Pain managemenr for 21 years. I'm up to 5 Oxycodone 10/325 a day. In the 21 years I have never taken more oxycodone then I was allowed. On rare occasions maybe once a month when I don't catch the occipitol nerve pain in time I do cheat a little by taking 3 oxycodones at one time. But virtually with few exceptions I am a 69 year old guy who walks around with no pain except an occasional SI joint flare up or that occipitol nerve. My main problem is I have 0 testoserone with little chance of ever having any due to no prostate and a missing left testicle. I have been liveing for 3 years by sleeping or laying in bed 16 hours a day. I have 0 energy. Just today my Doctor had me try a MODAFINIL 100mg. It's 5 oclock now and I haven't had a nap. Usually by this time I have had 3 of them. I go to bed at 5 and get up around 3 in the morning and take two oxycodones. That is the best I feel all day. The rest is down hill. Everytime one of my oxycodones wear off it's like a XXXXXXX withdrawall system. I know nothing about these MODAFINIL I haven't had time to investigate. My dodctor just said to try them for a week. If they work like they have on my first day can I take them every day for the rest of my life and what would the setback be. There is always a trade off. Thank You so much for your time. XXXXXXX

Answered by Dr. Dr. Ivan Romich (55 minutes later)

Brief Answer:
Can be used long term

Detailed Answer:
Hi and welcome.
Modafinil is a wakefulness-promoting agent and generally,it was used mostly for narcolepsy and fatigue associated with MS,fibromialgia, and sleep apnea. Also,other forms of sleepiness and fatigue were treated,but there are still no reliable scientific results about long term effectiveness. For fatigue caused by hormonal imbalance such as testosterone or estrogen imbalance,there is no much scientific data. However,as pschomotoric stimulants,it is to be expected that it will work for such people as well. There are some side effects such as hypersensitivity reactions and serious adverse psychiatric reactions, but this are generally rare and many people are taking it for years even lifetime if side effects aren't significant. There is risk of tolerance and addiction,but it can be avoided if dosage is strictly taken;equal dose every day. Indication for permanent prescription should be approved by neurologist,but you have to be aware that tolerance may occur and medicine may not work after some time so it would be better to take it when you need to increase you attention and not regularly on daily basis. Wish you good health. Regards

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Above answer was peer-reviewed by : Dr. Raju A.T