Re: Peripheral Neuropathy

Posted By CCF Neuro MD on September 21, 1997 at 13:55:33:

In Reply to: Peripheral Neuropathy posted by Steve Landers on September 18, 1997 at 22:09:07:







: I have a question about side effects of Nortriptyline.  
I take 50 mg daily, which does only a fair job of ameliorating pain from
an idiopathic neropathy affecting my  feet.  
  
I have experienced mild difficultyu emptying my bladder while on this dose.
One neurologist has advised me not to take any higher does of Nortrityline,
but another neurologist has said the side effect is not a matter of great
concern at this point.  I find the side effect only a minor annoyance now,
but I am concerned about possible long-term damage from a higher does of
Nortriptyline.  Can you shed any light on whether this side effect should
be a major concedrn at this poiont?












  


Hello, Steve,
As a member of tricyclic antidepressants, nortriptyline has been used for a long time.  It is a rather new application to use it to treat neuropathic pain.  Difficulty in emptying bladder (urinary retention) is one of the common side effects of nortriptyline, which is more frequently seen in elder patients.  I was not able to locate any studies documenting the long term outcome of such side effect, to the extend of my literature search.  However, as a general rule, if the symptom persists, switching to another medication should be considered.  Recently, there have been addition of several classes of medicines  to treat neuropathic pain.  These include anticonvulsants such as phenytoin, carbamazepine, and valproate; benzos and baclofen; and certain types of stimulants.  In addition, corticosteroids have been used to treat pain caused by inflammation or by nerve root compression.  Ultimately which medicine is the best is solely dependent on nature of the pain and the clinical profile of the individual patient.  
This information is provided for general medical educational purpose only.  Please consult your physician for the diagnostic and treatment options of your specific condition.