My doctor thinks I should see a p-doc!

I'm angry! One of my physical problems is suddenly feeling weak. It's not a panic attack I don't think. I thought it had to do with blood sugar or blood pressure. My stress test was normal, and so is blood sugar. The gabapentin makes me tired, and allergist just switched me to Allegra instead of Zyrtec. I'm on warfarin for the blood clot. Allergist thinks I should get a chest x-ray. My PCP ignored that and asked, on the medical email I use, what I thought about seeing a psychiatrist.

Maybe I'm overreacting because T suggested the same thing. But I tried antidepressants and they made me shaky! I can't take certain ones with warfarin. I hate them!!!

The weakness is not anxiety, and neither is the sciatica. Maybe some is from stress but I think it's the meds. I didn't like the pdoc I saw. All he wanted to do was give me things like Valium, Zoloft, and Ambien.

I emailed T for the third time today. I really want to call but it's too late. I'm a wreck but I need to try to sleep. I don't want antidepressants!!!

Alas, a p-doc prescribes drugs. That's what they do. As you know, if a doc can't find a physical reason for something, then he/she thinks it's a mental issue. I wish your doc would do more tests. Maybe you need to see another doctor and get a "second opinion!"

I hope you feel better soon. Please realize you don't have to take the meds. There are plenty other doctors you can see. So, sleep, dear one.

No one can make you take a medication you don't want to, rainbow. Perhaps you could think of this as an information-gathering stage, before you decide what you would like to do? And you could do your own reading as well, about your symptoms. You are the one in charge.

Does the weakness feel like specific muscle weakness or does it feel like you might have to lay down or you will pass out? I used to have this second, whole-body weakness at times and it turned out I was hypothyroid, but the normal thyroid tests did not show this, I needed the whole panel of thyroid measures in order for us to see that.

If you take a statin drug you may also need to supplement with coQ10 to replace what the drug blocks, in order to not have muscle weakness. These are just my thoughts -- worth only what you paid for them! -- but I'm sure there is a lot to consider and no one should pressure you into any hurried decisions.

Did your doctor and therapist specifically suggest taking antidepressants? Because psychiatrists can also prescribe anti-anxiety medications. And anxiety can have a huge effect on physical health and increase the side-effects of other medications.

I don't think you are overreacting. Weakness is a common side effect of gabapentin.

I researched weakness extensively because i was weak for a long time. It turned out to be dangerously low blood pressure. Before that was identified, doctors kept trying to convince me to take antidepressants (which are the standard treatment for anxiety).

I've dealt with anxiety my whole life and know what's in my mind and body more than any doctor. People are arrogant to suggest otherwise.

Anyway, sometimes side effects flatten out and dissipate, so perhaps give it more time.

Hey be careful. When I had weakness I fell 5 times within a couple of months and got hurt. I'd be walking out of the gym and be taking a step and would totally lose my balance. It was bad.

If you walk outside, make sure you walk carefully, get your foot firm on the ground with each step. Take care.

Well the job of a pdoc is not necessarily to prescribe but to evaluate to what extent mental illness is contributing to your symptoms. A good one will consider that this could well be medical illness or medication side effect or both or any combination of things along with some element of mental illness. So it's worth considering. You can ask if there's a pdoc in your area who is particularly knowledgeable about pain or chronic illness.

You are not obliged to follow through with their suggestions. They would just adding information and perspective. If you don't think much of them, you don't have to continue seeing them.

Is there a chronic pain excercise, aquafit or yoga class where you live? Or even art or cooking? It could be a non-drug way to help with things? When I was ill for a long period, I didn't get out as much and classes like that became a lifeline.

You might tell your PCP you’d rather rule out other medical issues first. Have they ruled out heart, blood pressure, kidney and thyroid issues?

I was misdiagnosed for years until I asked for a chest X-ray which revealed my enlarged heart. You are wasting your time, money and energy on a psychiatrist/antidepressants until you’ve ruled out other possible health conditions.

Antidepressants are great for many people but not effective for me. I gave them a good try. I won’t take them and no apologies from me, either.

Good luck.

Not sure if it will help or not, but when I was first sent to my recent psychiatrist I was really hesitant about it since I know I won't do psychotropic drugs. Earlier in life I tried them and my experiences convinced me it wasn't for me.

But I went to the psychiatrist anyway, and to my surprise they applied very little pressure when it came to the medication topic. They actually thought it would be better to try other things before visiting the medication route. I had been fully expecting to walk in and get pills shoved in my face the whole time, but to this day it's still not been brought up again.

Maybe who you're being sent to will wind up being like that too?

You ask for a chest xray as advised by your allergist, and the response is that you should see a psychiatrist?

Have any of these doctors even considered gabapentin which has a common side effect of weakness?

Is this odd or am I from a different planet.

Agreed. I'd push for the chest x-ray and also ask if it could be a gabapentin side effect. Did you recently start that or increase your dose? If your PCP refuses to listen, could you go to a different one? Or could your allergist maybe give you a referral (if you need one) to a cardiologist, so you could get the chest x-ray?

Thanks for all the responses. Yes, my doctor knows gabapentin can cause fatigue and weakness. But this has happened periodically over the last month, usually when I start to eat. It's a sudden weak feeling, which goes away but leaves me tired. We thought it was blood pressure or blood sugar. That's why I had the stress test and A1C diabetic testing. I'm prediabetic and sometimes had that weakness, every 6 months or so. Checking my blood sugar and blood pressure when this happens and usually normal.

I take 300 mg Gabapentin only at night. It seems to be worn off when these episodes happen. I have to try eating every couple of hours. I don't have the appetite I used to.

Allergist suggested x-ray because my breathing test was normal but I feel out of breath sometimes. Now I have a cold so hard to tell. It will probably be normal but I'm trying to rule things out!

I asked T to call me and she said to call her in an hour and a half. I hope she doesn't try to persuade me to see a pdoc but I think she will! Not because of the weak feeling but because I've been depressed due to all of this. Plus the blood clot!

I'll answer individually too, in a while.

I mean extremely well by this comment , and I am definitely not comparing you to my dog. Gabapentin gave my dog bouts of sudden weakness, that stopped immediately once we backed off to a lower done. I know that may not be meaningful here, but I think of how extreme his reaction was to increased gabapentin and remember how scared I was.

Interesting! I'm only on 300mg at night! Sudden bouts of weakness. No one said that. Going to ask pharmacist. Usually it happens when I start to eat, but not every meal. How is your dog now?

Have they tested your iron and B12 levels? If they're low, that can also cause weakness and shortness of breath. Or thyroid?

I've had a lot of blood tests that are all normal. Not sure specifically about those. Thank you!

Thank you, travelinglady. Echo/ stress test normal. I don't have asthma. Have had blood tests recently but maybe not since the weakness. What tests do you think I should have?

No, it's not muscle weakness. More like faint but not exactly. My face flushes a little and I put my hand on my head. Usually it goes away in 5 or 10 minutes but it's scary. My pulse usually around 100 but blood pressure normal. I've taken gemfibrozil for years. Never had a problem.

No, but when I tried Zoloft I think it was supposed to be for both. It made me shaky and didn't help at all!

Thank you! I'd like to take less gabapentin but then I'd have more nerve pain. Or maybe not. I don't take it during day and I can drive now, for short periods.

Thanks! That's why I won't take Gabapentin during the day.
My PT said no yoga. I tried going in the pool but the water hurt my legs. I'm not getting out because it's hard to sit in a car.

Heart is normal. So is blood pressure. Had blood tests. Kidneys are fine. Thanks!

I think that's rare but I wish!!

Yes, they consider it but my PCP knows I'm anxious, and that I see a Therapist. She thinks they've ruled out physical part of it I guess.

No, I started it in March and didn't increase dose. I could do that but I like my PCP.

He is fine now, but he has spondylosis . I tried to back off tramadol and adaquan injections with more gabapentin, and immediately he got hind end weakness and even some tachycardia . He did great on 100mgs x2 a day, and still takes that, but 300 x 2 was drastic weakness- even collapsing. I was so afraid. I am thankful that reducing the gabapentitn back to prior levels completely cured the problem.

My Drs. message said it could be the gabapentin but consider seeing a psychiatrist for my anxiety. I read it again. Idk what to think.

I'm a believer in getting information even when I think it is unlikely I'd be willing to do what a medical practitioner or any other non Western medicine provider I might see. About twenty years ago when I was in a different round of therapy, I was opposed to AD's but consulted a shrink. She listened to my worries and set about a rather unusual medication plan that would start off in very small doses and increase very very gradually. I was worried about side effects and had other concerns as well. I decided to try them and I was glad I did; it really increased the productivity of my therapy, made me feel less stressed, and in general decreased a lot of suffering I was feeling. I had no trouble getting off them 9 months later.

I'd encourage you to see a p doc and bring your concerns, bring questions like why do you think this will help me or how can I start slow so the side effects might be more minimal. I don't know when you last tried them, but there are new medications all the time and our bodies also respond differently as we age. You might note hate them if you tried them but most importantly, you can just go talk to the pdoc and still decide not to use any medication,.

Very glad to hear that as it would be a big red flag if your Dr. didn't consider. It sounds like you have a decent relationship with your GP, hope it stays sound.

Just like an ultrasound is normally used to find leg blood clots, if the weakness isn't related to Gaba or diabetes, a xray and stress test would not rule out heart issues. If I suspected heart issues I would get at a minimum echo and 24-48 hour holter.

I'm 500% sure the psychiatrist would not be able to rule out all other causes of weakness or even delineate medical vs psychological. It's such a vague symptom it could be 100+ things plus s/he'd check what is in her scope and leave the rest up to your GP and specialists. Gabapentin, like many psychotropics, does affect blood sugar.

I hope this turns out for the best. I'd still be wondering if this was related to what caused the blood clot as breathing problems and weakness could be a pumonary embolism (also an xray wouldn't find it). Please go to the ER again if you are unwell and don't let them tell you it's anxiety.

Keep us updated. Good luck!

Dr. Rayne
(just kidding )

Are you taking anything now for anxiety? this stuff can really make you anxious I'm sure. Gabapentin acts as an anxiolytic too. Same concept that works for helping with pain. It 'dulls' your nerves.

I hope you can figure out what's wrong.

If it happens at the beginning of a meal, i'd be thinking about food allergy/sensitivity or histamine intolerance, and i'd be trying to track trigger foods.

Also sounds like an adrenaline surge.

I would not let a GP or Pdoc anywhere near such thorny, complex issues. I'd go straight to a functional medicine doc, get to the bottom of things. GPs and Pdocs seemingly will just add a new drug for every symptom, creating increasingly convoluted polypharmacy and side effects that cannot easily be traced.