Tegretol for Length-Dependent Small Fiber Neuropathy

Posted by julbpat @julbpat, Sep 27, 2022

Over the past 7 years I have tried Cymbalta and Savella ( no go), Gabapentin, and finally Lyrica for what was initially diagnosed as fibromyalgia, and now confirmed to be SFN. In my reading, I saw a reference to Tegretol as a possible treatment. Interestingly, I had been on Tegretol for 25+ years for seizures. In 2014, I weaned off Tegretol. Within six months I developed mysterious foot pain, swelling and weakness of various joints (symmetrical), fatigue, etc etc.

I was diagnosed and treated for fibromyalgia, even though I always knew there was something else wrong. Today I have full-blown neuropathy, with all the accompanying symptom. Also Dysautonomia, and various symptoms, such as dizziness, palpitations, burning pain, sore tongue, constipation, itching etc etc.

A few months ago I asked about trying Tegretol, as the Lyrica (75 mg four times a day) had erased my memory and made me very foggy. I am now on Tegretol 400mg twice a day. I swear, all of my neuropathy symptoms disappeared. What remains is overall pain and progressive weakness of my extremities, now creeping up my arms. This is handled with opioids, Baclofen, physical therapy. But this pain too is disappearing as we have increased my Tegretol!

Tegretol is not without side effects. I have gained over 10 pounds in two months. I had some mild depression and weird crying episodes as we increased the doses, but I stuck with it, and those went away.

So this might be helpful to anyone who is not getting relief with Lyrica or Gabapentin. I don’t expect this to do the trick indefinitely as my SFN progresses. But the theory is that Tegretol was masking my neuropathy symptoms for all those years.

I am a nurse, and discovered this myself doing some deep research. My doctors were more than willing to try it, and hopefully this will help other patients.

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

Thank you for starting this discussion @julbpat and sharing how doing your own research and being a better advocate for your healthcare has made a difference. It's good to hear your doctors were willing to give it a try!
Was this one of the research articles you found?

-- Carbamazepine for acute and chronic pain in adults:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160789/

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@johnbishop

Thank you for starting this discussion @julbpat and sharing how doing your own research and being a better advocate for your healthcare has made a difference. It's good to hear your doctors were willing to give it a try!
Was this one of the research articles you found?

-- Carbamazepine for acute and chronic pain in adults:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160789/

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Hi John. When I was preparing for genetic testing, I did a lot of reading about voltage-gated sodium channels, and genetic mutations. That's where I saw the reference to Tegretol (carbamazepine) - buried in an article about treatments for certain genetic variants. Turns out I didn't have one of those variants, but since the Tegretol therapy has been kind of amazing, maybe it means something!

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I am also a nurse. I am going to research Tegretol and maybe suggest it to my neurologist. Thanks for the information.

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@26sabrina

I am also a nurse. I am going to research Tegretol and maybe suggest it to my neurologist. Thanks for the information.

Jump to this post

I am on 400 mg twice a day now. Still having slow weight gain, but the burning pain is gone. With good physical therapy, I’m starting to resume more weight-bearing activities, like walking in my neighborhood. It is still painful while and after I walk, but I don’t have hours of red, burning toes and feet that keep me awake.
I’m also scheduled to go to a Dysautonomia Clinic for a full assessment. I’ll keep you guys posted on that. I’m skeptical but agreed to go. I guess Dysautonomia could be a new discussion thread!

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