neuropathic pain...no response after a week to Amyt

[oilmart]

hI

I have recently been diagnosed with a neuropathic pain after a rabies vaccination adverse reaction and have been prescribed amytriptiline (elavil) 20mg. I have taken it for a week but I am still getting the pain. Is amytriptiline supposed to cure the pain or just mask it? I have taken 40mg tonight in case Im not taking enough. How long does it take to work or should I go back now to my Dr and say it doesnt work?

[MelancholyMama]

Sorry to read this occurred after a vaccination.  Just wondering how things are going, and if you have found anything to be helpful?  

[oilmart]

I forgot to say sometimes though I can just be sitting still and I will feel a mild jab of pain come from the hand/feet for no reason other than it just jabs. I think it might be happening slightly less than about a week ago but it's still there and worrying me cos its after a vaccination.

[oilmart]

hi thanks. I'm still taking the amy to see what happens. WHat I don't get is how this  vaccination can cause aches in my hands and feet. Actually the aches started all over and were more painful but they have decreased to my hands/fingers/wrist and feet/toes.
When Im sitting still there isn't much pain today, but I was out earlier and I just didnt feel right. I felt a bit achey on my feet. I dont get it. My Gp said she thinks it is inflammation around the nerves. But, seeing as I had aches all over in the beginning, wouldnt it be muscle pains instead? I don't really get tingling or numbness (not yet anyway), it feels like someone who has just had flu and when I bend my finger or put pressure on my wrist, I feel a jab of pain or in the wrist its like a joint pain. There is no swelling. The Dr is going to refer me to a neurologist for an assessment though cos I spoke to her on the phone and she's not sure what's going on. any ideas?

[mummy3too]

My son was prescribed Elavil for a concsussion (Post Concussion Syndrome) - It only made him tired. There are a number of other medications out there for neuropathic pain. Lyrica, Neurontin are two commonly used. I would contact your Dr to ask if you can double your Elavil dose (since the single dose does not appear to be working) and to inquire if there may be something else you might try. Sometimes the dosage does need to be increased (like with Lyrica and Neurontin).. I do think that most of the neuropathic pain meds take days (maybe weeks) to really see a difference. They are not like typical pain meds (asprin, Tylenol, narcotics, etc) that work almost immediately.

Please let us know what the dr says... It may help the next person who asks a similar question.

Good luck!!!


Mum

[Jaybay]

Elavil is not a "pain killer" in the sense that most patients understand that term.  It's not like taking an advil or vicodin tablet and getting relief in 20 or 30 minutes.  Taking an extra Elavil won't make it more effective, and it may be downright dangerous to spike your dose depending on what other meds you also take.  

Elavil is an old, tricyclic antidepressent medication that sometimes helps people with pain - usually nerve-related pain.  It changes the way your brain reacts to the pain impulses.  It works great for some patients; for others it does nothing.  If I remember correctly (and someone who takes it will hopefully correct me) it has to be in your system for several days or even a month to build to a therapeutic and effective level.  Taking an extra pill won't speed up that process.

Definitely tell your doctor that the Elavil isn't working.  There isn't any medication that will "cure" pain - if there was such a thing none of us would be on this forum.  LOL!  All pain meds mask pain.  Well, with the exception of anti-inflammatories that actually reduce inflammation and thus decrease pain.  Some medications just do a better job than others, and some work on different areas of the brain.  Narcotics are also not really "pain killers."  They change the brain's response to pain.  It's still there but we really don't care about it.

You and your doctor need to have a talk about your goals for pain management.  If you're expecting to have zero pain, there isn't much he can do for you.  If you have a more realistic goal of reducing your pain so that you can function, that's something you can both work toward without frustration and disappointment.  Neuropathic pain is also notoriously difficult to treat well.  

A necessary evil of pain management is trial and error and time before finding an effective therapy.  We don't want to suffer, and the doctors don't want us to suffer either.  Hard as it is to be patient, I think most of us have had to learn that skill.  Instant gratification doesn't usually exist for us.  

Sorry if all that was a downer for you, but I want you to understand what pain management is - and isn't.  Even though it's the 21 century, medical science is still pretty limited on the tools it has to treat pain, and sometimes the treatment can be worse than the pain.  Please post back and let us know if you and your doctor find something that works for you.  I hope so!  :-)

[oilmart]

HI Huxlett

How did you know when it started working? Does it work all day through once it kicks in then? WHat dose are u on?

[JHuxlet]

Hi

I take amitriptyline for nerve pain. It takes a while for it to start working I think it takes 2 - 6 weeks, it was around the  4th week for me. Google it and you will find more information

[Sarajmt]

Hi!  Yep.  I'd call the doctor tomorrow if I were you.  Just let him know that it is not working for you.  Good luck.