Posted by Larry Hoover on February 28, 2006, at 8:24:20
In reply to Peripheral Neuropathy- Tricyclics, posted by cecilia on February 28, 2006, at 1:17:11
> I have painful diabetic peripheral neuropathy.
I am sorry to hear that you are, with me, a member of the neuropathy club.
> Neurontin does nothing.
Have you tried pregabalin (Lyrica)? Although it was supposed to be "improved Neurontin", at least by some people, I consider it to be different enough that a lack of response on the one does not properly predict responsiveness to the other.
> Tricyclics are the other thing you usually see recommended, but I've tried several tricyclics (for depression) and the only one I was able to get to a therapeutic dose on was nortriptyline and that had terrible side effects too, just not as bad as the others.
I hear you on that. I am absolutely *sick* of prunes right now.
> I've read some places that only small doses of tricyclics are needed for neuropathy and and other places that you need to get up to the full dose to do any good. If the latter is true there's no point in bothering, but if a small dose would work it might be worth trying. Anyone know?
I think it's most important to figure out if you can answer that question for yourself. I was prescribed nortrip at 150 mg/day? (something like that, maybe higher), but I couldn't get past 75. I struggled with those side effects for a number of weeks, and none of them were remitting with the passage of time, so I reluctantly backed down in dose. I now take 25 mg a day. I still think it helps, but I also clearly noted greater pain as I reduced the dose, both from 75 to 50, and during the later reduction to 25.
I can say that I get some benefit from nortrip at 25 mg/day, but that a higher dose would provide stronger relief. That is my personal nortrip dose/response.
> Oh, I've tried Cymbalta too (for deprssion) couldn't tolerate it. I haven't tried Lyrica, but doubt that it would be that different from neurontin. Cecilia
Oh, you mention Lyrica. It might be different. You won't know until you try. From what I understand, responders know that they are responders within days, if not a couple weeks. So, a three week trial would totally answer that question.
I know this may not be an option for you, but my biggest "breakthrough" on the neuropathy front came when I added medical marijuana to my regimen. I get cannabis-butter infused chocolate bars from a clinic in Toronto, and one square of chocolate twice a day does the trick. It hasn't helped with the pain, really. What it did was it increased my ability to cope with the pain. A dramatic increase in my pain threshold. I hurt just as much, but I'm not being dragged down by it, day by day by day.
If I smoke marijuana, I get high. And that's not what I'm after, although it would probably also do something similar with my pain threshold. The cannabis chocolate does not make me high. It's a very different animal.
Lar
poster:Larry Hoover
thread:614127
URL: http://www.dr-bob.org/babble/health/20060202/msgs/614193.html