Good evening Michelle and others exploring options for medications that can help with neuropathy symptoms. Here is another option. My neurologist started with Nortriptyline when psychologically I was depressed as the physical pain from SFN began increasing. That medication made it possible for me to find sleep and rest. When the neuropathy pain and discomfort kept increasing we (my PCP and I) decided to taper off Nortriptyline, my nighttime helper, and relace it with cannabis. The urgency was to address the diagnosis of GAD in the mornings. The level of anxiety was causing more pain making it tough to get up and get going. We decided on Duloxetine (Cymbalta) for the morning when I really needed to calm down and go with the flow......so to speak.

The tapering off of the old, uptaking of the new, and rearranging of other dosages has been very successful. We will take a look at the entire situation again in February. This lady, my PCP, practices shared decision-making with me. It has been several years now and we are still reviewing and researching at least once a year. I will have had two additional orthopedic surgeries this year so we will begin by reviewing the impact of those procedures on the major ongoing concern of SFN and its progression.

Your contributions are very helpful. Do you plan to make medication changes for next year? Will you share your decision-making outcomes?

May you be mentally healthy
May you be physically healthy

Chris

What is distraction and neuroplasticity exercises? I have severe nerve pain and doctors do not know why, they thought it was from a herniated disc. I had surgery in May this year and the pain hasn't changed much, it seems to be spreading up my back. PT exercises seems to make the pain worse. I'm on Lyrica but can't go higher than 100mg per day due to side effects. I hope Nortriptyline helps you it made my mouth very dry but I did notice a change in my feet pain just can't tolerate the side effects.

Hi, I don’t recall any adjustment period however the dose I take is much less than a person with depression would take.

Agreed. Natural methods are better than a medication providing they work for the individual.

In response to your question regarding an adjustment period I would say that no, I had been on amitriptyline for awhile and when the Pregabalin was added everything was fine right away.