Gabapentoids ( eg Gabapentine & pregabaline ) , i mentioned, are dangerous, and not that easy to prescribe to a patient. In Eurpoe they call them Budwisers ( Budwiser is a bear brand ) i want to say they are drugs of abuse in high doses. they elevate the mood.
some information about them, at first they were used as antiConvulsants in epileptic patients. these patients are under the catigory of neurological diseases, so some had neuropathic pain. they discovered that these drugs decrease neuropathic pains, like herps zoster pains or periferal neuroalgia…ect then they were tried in other types of pain, they were very effective too. and since they are anticonvulsants, they can be used as mood stabilizers too.
Note now the new trend in perioperative pain, is to use minimal doses,of opiods, but to use them not to forbide at all. and use with opiods other analgesics, like paracetamol ( acetaminofen ), NSAID ( eg brufen, declofenac sodium…ect), although both last two catigories are COX inhibitors, they act in different sites in CNS, so if given in less than full dose, additive effect or they will potiniate the effect of each other with less side effects. side effects are known to all and above the scope of this paragraf. if we use Gabapentoids too this is very effective.
this is called multimodal analgesia.
you do not need to use all analgesics at the same time, but what is avaliable, and not contraindicated, but not one type only.
other analgesic modes is regional analgesia, or infiltration of the wound and surgical site by local anesthetic like lidocaine or marcaine .
This ( multimodal analgesia ) is part of ERAS enhanced recovery programs after surgury. or ERP ( enhanced recovery programs ). i can explain this latter.
any help
note clonazepam too, is addictive, iatrogenic addiction can be the result in treating mood disorder patient.
mao inhibitors has got fetal side effects, if used with other drugs or foods ( drug drug interactions).