Pain suggestions

January 4, 2010 at 10:46 pm

The biggest reason for neurontin not to work is that the dose may not have been high enough. Many people need as much as 2400 to even 3200 mg a day. You have to start at a much lower dose because of the sleepiness and build up slowly. The second biggest reason is that people can get side effects from it, but you did not say this, so it might be a possibility to try again.

Lyrica is a new medicine that works like neurontin, but some people tolerate it better. It is kind of expensive, but it is definitely worth a try if one cannot tolerate neurontin or does not get enough benefit from neurontin.

A number of people take Cymbalta for neuropathic pain and this can be beneficial.

Many narcotic pain medicines do not work as well after they are taken for a long time and it sometimes can be of benefit to try an alternative pain medication at least for a while. This is called narcotic rotation. For example, instead of percoset, sustained morphine (MS Contin) or a fentanyl patch might be taken/used. Methadone is also a good very long acting pain medication that is good because it does not have a lot of ups and downs in pain. The disadvantage of methadone is that some people think of it negatively because it has been associated with heroin addiction, but it is a good pain medication. It seems really important to not be always playing catch-up with pain as it is hard to get it under control and so it is better to keep pain under control. The long acting pain medications seem to do this better for chronic persistent pain.

Many people on this site have gone to see pain specialists for optimalization of pain medications. Some experiences are good and some are not so good. The main negative reason is that pain specialists may have a lot of rules about pain medications and what else you need to do. This rubs some people the wrong way, so if you were to see a pain specialist the advice is to keep bringing finding a way to make life more livable and the pain more manageable so that life is more livable (emphasis on function). The other good thing about pain management places is that they can help with non-medication ways to deal with pain.

There are other medications that can help with pain including Elavil and other older “antidepressants” as well as many anti-seizure medications since these act on nerves. The website for the Neuropathy Association has a good listing of other pain medicines used for neuropathy. For some reason this is listed under the topic of types of neuropathies as the last topic “neuropathic pain”.

The neurologist at the Neuropathy support group I attend has said that often people have to take more than one medication for neuropathic pain because the different medications affect different parts of the pain pathway–the perception of pain, the feedback component, and the attenuation of the response.

Personally, I think one of the biggest ways to help my own pain when it is really bad is to lie down for an hour. Fortunately, I have my own office so that I can close the door and rest in the late afternoon or evening. I do not care if I work later if I can do it without so much pain. Keeping my mind busy is also terribly important for me.

I hope that you find a way to not be in agony. That is a terrible thing to feel. WithHope