Anyone tried a time release medication for peripheral neuropathy?

Posted by Mary Klimek @brklimeks, Aug 22, 2021

Has anyone tried a time release medication for painful peripheral neuropathy?

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

@jakedduck1 I thought someone on the website said their doctor told them their was no limit to the amount of mg's that could be prescribed for gabapentin.

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@bustrbrwn22

@jakedduck1 I thought someone on the website said their doctor told them their was no limit to the amount of mg's that could be prescribed for gabapentin.

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It was probably me. One of my doctors told me it had more to do with side effects than a particular dose. Although I’m sure every drug has its limit.
The highest dose I know of was 7,000mg.
Jake

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@jakedduck1

Good morning Peggy,
What dose of Gabapentin are you taking?
Do you know the reason your doctor said you were taking the maximum dose? Are you having side effects?
How long have you been taking Lyrica? The drowsiness may lessen over time, usually weeks to months,
Jake

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1200 mg twice a day. The next time I see him I will ask if I can take more. My neurologist told me that the anti-siezure meds relax the nervous system so it stops frantically sending erroneous pain messages. At high doses, the gaba can relax the nervous sytem too much ... our heart goes to sleep - we die painlessly in minutes. Doesn't sound too bad to me but there are two projects I need to finish before I leave this earthly realm ! Thanks for your input ! Peggy

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@artscaping

Good evening @pkagarwal, I couldn't help but notice that you have handled the Gabapentin similarly to what I did. I too am now at 600 mg in the evening and wondering if I should try to go to 300. I was at 1200 like you. I added Cymbalta, first at 30 mg, and raised it to 90 mg as I was withdrawing from Gabapentin. It is working for me.

Have you used in other pain medications for your feet? Do they ever feel like icicles?

May you have contentment and joy.
Chris

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Hi Chris @artscaping I'm so happy that you're finding relief with the Cymbalta. It's great to read something positive in the support groups. My husband has painful peripheral idiopathic neuropathy in his feet and is currently taking 900mg Gaba (300x3), Doxipene 5mg at night (smallest possible dose) and uses THC. He gets out and walks almost every day 3-5 miles and is in lots of pain afterwards but feels it's important to keep moving and keep his body strong. He also does acupuncture and uses Topricin cream morning and night which also helps a little. He has not tried Cymbalta as it's a similar drug to the Doxipene which he's currently taking and has a sleep aid component. I'm wondering if he should try switching the Doxi to the Cymbalta (via a doctor) to see if he can get off of the Gabapentin. I had read somewhere that Cymbalta might work better for women when it comes to neuropathy. I can't imagine why it would matter if you're male or female. Personally, I've learned more from this support group than from several different neurologists, a neurosurgeon and an orthopedic foot specialist. Thank you for your posts. Michelle

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@greenacres

Hi Chris @artscaping I'm so happy that you're finding relief with the Cymbalta. It's great to read something positive in the support groups. My husband has painful peripheral idiopathic neuropathy in his feet and is currently taking 900mg Gaba (300x3), Doxipene 5mg at night (smallest possible dose) and uses THC. He gets out and walks almost every day 3-5 miles and is in lots of pain afterwards but feels it's important to keep moving and keep his body strong. He also does acupuncture and uses Topricin cream morning and night which also helps a little. He has not tried Cymbalta as it's a similar drug to the Doxipene which he's currently taking and has a sleep aid component. I'm wondering if he should try switching the Doxi to the Cymbalta (via a doctor) to see if he can get off of the Gabapentin. I had read somewhere that Cymbalta might work better for women when it comes to neuropathy. I can't imagine why it would matter if you're male or female. Personally, I've learned more from this support group than from several different neurologists, a neurosurgeon and an orthopedic foot specialist. Thank you for your posts. Michelle

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Good afternoon Michelle. Thanks for your reply and the additional information about your husband's efforts to live with and regulate the medication he has tried for idiopathic peripheral neuropathy. First, a question. Has your husband received a diagnosis? Did any of the neurologists request a skin biopsy? There is a difference between Small Fiber Peripheral Neuropathy (SFPN) and idiopathic Peripheral Neuropathy (PN).

The only medication that I noticed might be more helpful than we think is Gabapentin. Three weeks ago I had a Total Knee Replacement. At first, the medications were for the surgery and recovery...delaying my normal daily efforts to mitigate my SFPN. The first thing that happened was a return of intense "tingle tangles" and pain in my hands, wrists, and lower arms. Obviously, those parts of my body missed the daily dose of 600 mg of Gabapentin that I was taking every evening. I have tapered off from 1200 mg but I sure won't go any further.

You are correct, Dioxepene appears to have similar effects to Cymbalta. I replaced Nortriptlene with Duloxetine (Cymbalta). I briefly used Doxipene for a neuropathic itch problem but feel the Cymbalta is better for anxiety and depression which in turn can create more pain.

One more question......what is the purpose of the 3-5 miles a day that is worth such extreme pain? Sometimes we have to let go of activities that are no longer of value. I, too like to walk and most days can do 1-2 miles. The 5 mile days are a part of my past which I have replaced with a wonderful Yoga program that we do every morning to stretch muscles and build stamina.

I am glad that you are finding Connect helpful. We are always here for you.
Chris

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@jakedduck1

It was probably me. One of my doctors told me it had more to do with side effects than a particular dose. Although I’m sure every drug has its limit.
The highest dose I know of was 7,000mg.
Jake

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From Pfizer (mfg of neurontin):
Dosage and Administration
a day using 300 mg or 400 mg capsules, or 600 mg or 800 mg tablets. The maximum time between doses ... of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long-term clinical study. The maximum ... maintenance dose of NEURONTIN is 300 mg to 600 mg three times a day. Dosages up to 2400 mg/day have been well ...

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I was on 2700mg/day. It can cause suicidality. I was also on Cymbalta for pain. I wanted off much of my meds so I could try medical marijuana. I got down to a very minimal dosage of neurontin (Gabapentin) and off Cymbalta. In hindsight, I think I started suffering from withdrawal; shaking, stomach pain… Eighteen months ago I had a spinal cord stimulator inserted which has been my salvation as I was able to cut back my gabapentin in half.

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@brklimeks

I was on 2700mg/day. It can cause suicidality. I was also on Cymbalta for pain. I wanted off much of my meds so I could try medical marijuana. I got down to a very minimal dosage of neurontin (Gabapentin) and off Cymbalta. In hindsight, I think I started suffering from withdrawal; shaking, stomach pain… Eighteen months ago I had a spinal cord stimulator inserted which has been my salvation as I was able to cut back my gabapentin in half.

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@brklimeks
All Anticonvulsants carry a warning of a potential increase of suicidal behavior (which many dispute) warning mandated by the FDA 15 or so years ago. However some seizure medications have been found to decrease suicidal behavior. Additional studies suggest 90% of suicide victims suffer from a mental illness.
I have not visited the Neurontin website. Most seem to believe 3600mg is the maximum dose of Gabapentin but that's not to say physicians can't increase the dose which is usually based on side effect tolerability.
Jake

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@kenc

Don't believe gabapentin is generic Lyrica. However good question for your Pharmacist.

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It definitely is not. Gaberpentin is the generic name for Neurotin.

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A pharmacist friend of mine told me that the suicide warning on most antidepressants is actually because you'll be less depressed, which may give you enough motivation to complete suicide (where prior, you were so depressed you didn't have the energy to even attempt).

Not sure how accurate that is or if I'm conveying it well.

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