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- Path: sparky!uunet!spool.mu.edu!uwm.edu!daffy!uwvax!zazen!uwec.edu!nyeda
- From: nyeda@cnsvax.uwec.edu (David Nye)
- Newsgroups: sci.med
- Subject: Re: cfs/fibromyalgia/accutane
- Message-ID: <1992Dec22.120041.2983@cnsvax.uwec.edu>
- Date: 22 Dec 92 12:00:41 -0600
- Organization: University of Wisconsin Eau Claire
- Lines: 70
-
- [reply to "chris]
-
- >I'm glad you have found my discovery helpful for your patients. It was
- >a huge vast help to me and I thought others who have what I have should
- >know about it...I didn't want to comment on reoccurrence of symptoms in
- >my earlier messages until I'd given it enough time to be sure. Now I
- >have been back on the accutane at 10mg/day for 3 weeks after being off
- >it for 2 months. And I must say its just amazing how much better I feel
- >back on the accutane. When I went off the accutane the first thing I
- >noticed was a huge improvement in my fatigue level then after the first
- >week there was a slow increase in pain, general sickness feeling, and to
- >a lesser degree fatigue. By the end of two months the pain and the
- >feeling sick got quite bad(1500mg/naproxen SR and 40mg/toradol all at
- >once and I still spent most of my day in bed on my bad days[1 out of 3
- >days]).
-
- >I restarted the accutane 3 weeks ago at a lower dose of 10mg(was taking
- >40mg before I stopped) and within 12 hrs was feeling slightly better,
- >and the 2nd day I felt much better. I now feel less sick, less pain,
- >but more fatigued. A good trade I think. I have constantly felt much
- >better the entire past 3 weeks on the accutane. I'm a lot less fatigued
- >now on the 10mg/day then I was on the 40mg/day. 40mg/80mg was necessary
- >when I was much sicker, now 10mg is fine.
-
- >I read the reposting of your description of fibromyalgia and I'm not
- >sure that's what I have. There is a lot in common, but there are
- >several significant differences. No tender points, no morning stiffness
- >(its better then if anything), no extra pain when sleep is disturbed,
- >but getting up after only 5 hrs sleep would cause the pain to jump up
- >by a factor of 10 (extreme pain when I was very sick, now over a year
- >ago). I also had several symptoms not listed like pain in lymph nodes
- >in neck, swollen throat, and brain damage or impairment(got much better
- >as I recovered).
-
- Myalgic encephalomyelitis appears to be used outside the US for what we
- here call chronic fatigue syndrome. There are many similarities between
- CFS and fibromyalgia. Some investigators feel these are different
- clinical presentations of the same underlying disease process. The same
- treatment often works for both. I have now had a chance to try Accutane
- on four other patients and it works beautifully, additional evidence I
- think that these two conditions have a common pathophysiology. Everyone
- has found it superior to other therapies tried and none have had
- significant side effects except for dry lips which everyone seems to
- get. Most people seem to need 40 mgs. twice a day except for one
- patient who only needs 10 mgs. a day. Now I've got to get off my duff
- and write up a case report. I want to get basic researchers interested
- in figuring out how accutane works. If they can identify a mechanism of
- action, it should lead us to a better understanding of both CFS and
- fibromyalgia.
-
- Although accutane has noticeably fewer side effects than amitriptyline,
- it does have some potentially serious ones which temper my enthusiasm
- slightly, and it is awfully expensive, around $150/month here. The
- biggest problem is that it causes a very high incidence of birth defects
- if a woman gets pregnant on it, so it can't be used in women of
- childbearing age who are not using very reliable contraception (oral
- contraceptives may not be good enough). It may also cause liver
- problems or an elevation of triglycerides, so one needs to follow these
- every couple of weeks, at least initially. It may also cause vision
- problems which can be permanent if the drug is not stopped soon enough,
- but usually the liver, lipid, and eye problems are all reversible when
- the drug is stopped.
-
- >If you like I can mail you the complete description that I typed out
- for my doctor.
-
- Please.
-
- David Nye
- nyeda@cnsvax.uwec.edu
-