Please see the disclaimer below.

Below is a diagram I just composed of the potential interactions between medications I’m currently taking. [1]  The dark red line represents a potentially life-threatening interaction, the orange indicates potentially additive / effect-enhancing interactions (CNS depressing, except the C-A interaction), and the yellow indicates a negative effect on absorption (due to digestive effects).  I intentionally left out various over-the-counter medications and vitamins that don’t have any significant interactions; included are just the prescription medications that I use routinely to manage my nerve pain condition.

I’ve been taking these medications at the same dosage for this past year, because they’ve successfully managed my pain and generally enabled me to be functional.  It took a good deal of experimentation and tuning to find this cocktail mix, and once I had it worked out I decided not to make any changes for a while–I wanted to have a stable medical foundation and focus instead on behaviors to cope with my situation.  However, over the past few months I’ve increasingly had a more difficult time concentrating and I’ve been more tired than usual.  It has been very disruptive to my work and life, and more than a little frustrating.

To combat this shift, I recently lowered the dosage of P because I know it to be the largest contributor to CNS depression.  This has resulted in more nerve pain, which is expected.  But fortunately the pain is not as great as I remember it being when I tried this dosage previously (>1 year ago), perhaps indicating some progress in healing etc.   Sadly, the decreased dosage hasn’t done anything to improve my concentration and reduce my fatigue.  In fact, the additional pain is sometimes a contributing factor to my fatigue and a distraction.

So, I’m now directing my focus at D and the potential effect of drug interactions. [2]  It could very well be the source of my recent troubles, which may actually be a sign of something worse developing (i.e. the potentially dangerous drug interaction) in my system.  Withdrawing from D will not be easy.  It wouldn’t be easy even if it were the only drug in my system, but it will be even more difficult given that it has an influence over everything else I take.  i.e. I may find myself needing adjustments to the other drug dosages to compensate.  But I believe it is the most responsible course of action at this time, and I intend to stop taking D (per my doctor’s instructions) in the very near future.

I don’t know exactly what to expect or how this attempt will go.  Certainly I have my fears, but as well I have great hope that my situation will improve.  I don’t have any superstition or religious beliefs but I would appreciate your positive thoughts during this time.  And of course I would ask for your understanding of any behavior that is more strange than usual.   Please let me know if you have any questions–I’m very open about my medical condition and medications, but I have intentionally been vague in this post to avoid leading anybody to medical harm that may be in a similar situation.

[1] – according to http://www.drugs.com/interactions-check.php
[2] – Please note that I am not a medical doctor, I have no medical training, and you should consult with your physician about anything you may be considering as a result of reading this post, which is only intended to relate my interpretations and opinions regarding my own situation.