1. < Neuropathy

Has anyone tried anti-depressant medication for neuropathic pain?

Posted by greenacres @greenacres, Nov 13, 2021

I'm wondering how many people in this community with neuropathic pain have been prescribed some form of an anti-depressant along with or without Gabapentin to help ease the pain and if anyone has found this protocol helpful?

Interested in more discussions like this? Go to the Neuropathy Support Group.

greenacres | @greenacres | Nov 15, 2021
In reply to @melody12 "I couldn’t stay asleep with Trazodone and I needed a little bump with pain relief. Dr...." + (show)
@melody12

I couldn’t stay asleep with Trazodone and I needed a little bump with pain relief. Dr. suggested swapping out Trazodone for Nortriptyline (because it does have a bit of pain relief in it) and to stay on course with the Pregabalin. I now sleep more soundly, allowing a good nites rest, no side affects and pain is more tolerable without having to up my Pregabalin mg.

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Hello @melody12 Thank you for sharing this information. I'm so glad to hear that this combo is helping you with no side effects! That's great.

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greenacres | @greenacres | Nov 15, 2021
In reply to @preknight "I take 200 mg Pregabalin 3 times a day (to help with pain), but I need..." + (show)
@preknight

I take 200 mg Pregabalin 3 times a day (to help with pain), but I need 1 mg Clonazepam to help me sleep 7-8 hours each night.

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Thank you @preknight for sharing.

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greenacres | @greenacres | Nov 15, 2021
In reply to @artscaping "Good evening Michelle and others exploring options for medications that can help with neuropathy symptoms. Here..." + (show)
@artscaping

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

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Good morning Chris @artscaping It sounds like you have found a good doctor to team up with. It's encouraging to hear success stories in finding ways to manage living with this disease. I'm guessing your positive attitude plays a huge role in all of this.
As I've mentioned before this research is for my husband.

Currently the medications being taken are 600mg Gaba/day (200 x 3) and the lowest possible dose of Doxepin (5mg) at night...so low it has to be compounded. Medical marijuana on and off but it doesn't effect the pain.

Had tried Amtriptyline early on at night and while it seemed to be help ameliorate the pain the sedating side effects along with the Gabapentin was to much. Perhaps that was because at that time the dose of Gaba was much higher? It also caused issues with dry mouth, constipation and strange dreams. The main complaint was that the waking hours felt like sleep walking.

Was considering trying the Nortryptyline in a low dosage during the day but also the Cymbalta as a different approach/option. While there hasn't been a diagnoses of GAD, some anxiety is present and wondering how much that plays a role in the pain.

Still getting acupuncture and just started with the myofascial release with a Barnes trained therapist and now looking into the Curable Health website for help with managing the pain. I'll keep you and the community posted.

I'm wishing you success with your upcoming surgeries. Thank you for supporting this community with all your helpful posts.

May you be safe and protected,
Michelle

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notgivingup17 | @notgivingup17 | Nov 15, 2021
In reply to @greenacres "Hello @mcd123, @melody12, @willows, @rivermaya34 Thank you so much for responding and sharing. @willows Did you..." + (show)
@greenacres

Hello @mcd123, @melody12, @willows, @rivermaya34
Thank you so much for responding and sharing. @willows Did you have an adjustment period with the Amitriptyline? I'm so glad to know that it has helped your pain. Considering trying the Nortriptyline but meanwhile a big advocate of natural methods such as distraction and neuroplasticity exercises.

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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.

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1 reply
notgivingup17 | @notgivingup17 | Nov 15, 2021
In reply to @willows "Amitriptyline and Lyrica work well for me to control pain. Both agree with me and the..." + (show)
@willows

Amitriptyline and Lyrica work well for me to control pain. Both agree with me and the only side effect is occasional dry mouth. I hope you can find the right combination for you.

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Does Amitriptyline raise your blood pressure or cause irregular heart beat? I'm on a low dose of Lyrica because it cause my heart to beat irregular. I'm in so much pain my doctor has tried everything including LDN. It's encouraging to hear something is working for you. Thanks for sharing!

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1 reply
notgivingup17 | @notgivingup17 | Nov 15, 2021

Has anyone tried LDN Low Dose Naltrexone for chronic nerve pain?

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willows | @willows | Nov 15, 2021
In reply to @greenacres "Hello @mcd123, @melody12, @willows, @rivermaya34 Thank you so much for responding and sharing. @willows Did you..." + (show)
@greenacres

Hello @mcd123, @melody12, @willows, @rivermaya34
Thank you so much for responding and sharing. @willows Did you have an adjustment period with the Amitriptyline? I'm so glad to know that it has helped your pain. Considering trying the Nortriptyline but meanwhile a big advocate of natural methods such as distraction and neuroplasticity exercises.

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

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1 reply
willows | @willows | Nov 15, 2021
In reply to @greenacres "Hello @mcd123, @melody12, @willows, @rivermaya34 Thank you so much for responding and sharing. @willows Did you..." + (show)
@greenacres

Hello @mcd123, @melody12, @willows, @rivermaya34
Thank you so much for responding and sharing. @willows Did you have an adjustment period with the Amitriptyline? I'm so glad to know that it has helped your pain. Considering trying the Nortriptyline but meanwhile a big advocate of natural methods such as distraction and neuroplasticity exercises.

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

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greenacres | @greenacres | Nov 16, 2021
In reply to @notgivingup17 "What is distraction and neuroplasticity exercises? I have severe nerve pain and doctors do not know..." + (show)
@notgivingup17

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.

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Good morning @notgivingup17 Thank you for sharing your experience with the Nortiptyline.
Distraction is what it sounds like. My husband is a musician and some days he can get lost in his work and ignore his pain. Neuroplasticity exercises is something that I'm just now learning about. There was an article recently in The Washington Post about this. I've been listening to a Podcast created by a website/app called Curable Health where they interview researchers, doctors, and patients about this approach. It's interesting but I still don't have a grasp on what the exercises are but it involves a whole method of how to approach your pain. In some other discussions it's talked about. The first person to write about this approach was Sarno in the 1980s and since then there has been research to back up the theory.
May you be healthy and strong.

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greenacres | @greenacres | Nov 16, 2021
In reply to @willows "Hi, I don’t recall any adjustment period however the dose I take is much less than..." + (show)
@willows

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

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@willows Thank you.

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