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I am an 85 yr. old retired orthopedic surgeon. For the past 8 to 10 years, I have had a peripheral neuropathy generally without pain, but with proprioceptive problems and debilitating light-headedness. I,constantly feel as if I were having orthostatic hypotension. I use a cane regularly. I’ve been taking gabapentin 900 mg. at bedtime for several years. I recently have been cutting the dose down on the advise of my best friend who is a retired vascular surgeon. No change. I also take 0.5 mg alprazolam at bedtime for sleep. I’m also taking 15mg. morphine sulfate twice daily for hip pain due to an infected prosthesis. I’ve been taking the MS for 10 years. I;ve cut down the dose frome 30 to 15 mg. This is enigmatic at best. Any thoughts? PS: I also have COPD due to chronic aspiration, not smoking.
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Please define: " proprioceptive."
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I have idiopathic small fiber PN also with no pain and have had it more than 20 years before seeking a diagnosis in 2016, mostly because all of my prior PCPs had told me there is nothing they can do for the numbness I was feeling. My PCP in 2016 prescribed gabapentin ( I think it was 200 mg daily) but I stopped taking it two weeks after starting because it wasn't helping the numbness. Then after a short conference with my Mayo PCP and her team and a few questions about my symptoms, they agreed and their team lead told me that gabapentin doesn't help with numbness, only for the related pain with neuropathy.
Just a thought but I wonder if your retired surgeon friend may be onto something with drug interactions with gabapentin. I have read that there are some drug interactions with morphine listed as one of the drugs.
"Gabapentin can interact with losartan, ethacrynic acid, caffeine, phenytoin, mefloquine, magnesium oxide, cimetidine, naproxen, sevelamer and morphine. Gabapentin use is contraindicated in patients with myasthenia gravis or myoclonus."
-- Review about gabapentin misuse, interactions, contraindications and side effects:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308580/