Meds for neuropathic pain, how do they work?

[steph74]

I'm taking gabapentin for TN and occipital neuralgia (I assume is probably lessens the tingling in my arm and leg as well) and most of the time I have reasonable pain control.  However, there are times when the pain really flares up and I'm not sure if there's anything I can do for that.  I don't know if gabapentin (neurontin) has a "short term" effect--e.g. if I took an extra dose, would it help?  

(My neuro has encouraged me to titrate up to the point of getting pain relief--unfortunately, I can't seem to tolerate more than 300 mg at one time, no matter how slowly I go up, so I'm taking 300 mg 6 x/day.)

A few times when the occipital neuralgia (which is more constant than the TN) flares very badly I've ended up taking a viocodin or percoset (left over from surgery last year) to help me rest.  I don't know what else to do.  (And that only works at night.)

Are there any options???

Stephanie

[steph74]

Wobbly,

Let me know what your neuro says.  I couldn't go up higher than 300 mg at one time because of the dizziness.  I eventually got past the drowsiness, but even after a few weeks of taking 400 mg 3x/day I was getting dizzy about an hour after taking it.  I eventually split my dose and titrated up to 300 mg 6x/day.  I don't know how to go up more than that, since I can't tolerate the higher doses.  I was thinking about asking if there's something else that would work better or something in conjunction with the gabapentin.  

I seem to have "spells" where it really acts up and it would be great if there was something fast acting and short-term that I could take to help with the breakthrough pain.


Shelly,  Thanks for the links.  I did read them and was left trying to figure out what I could do for this "breakthrough" pain, instead of just taking successively higher doses of gabapentin.  


As of last night, I'm pretty convinced I'm having some type of exacerbation, since my balance is getting much worse, the pain is worse, and I've been having this very odd HEAVY feeling in my left arm where I can't stand to be touched there (even my clothes will bother it when it's acting up badly).

Stephanie

[sllowe]

Hi Steph,

I've no experience w/gabapentin, but we do have 2 excellent health pages on neuropathic pain and treatment...

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/Nerve-Neuropathic-Pain---A-Primer/show/371?cid=36

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/General-Principles-of-Treating-Neuropathic-Nerve-Pain/show/452?cid=36

Hope this helps,
shell

[Wobbly]

hi.. I can't help with this because I'm in the same type of situation and working with my Dr to find the right meds for me.

I'm dx with PPMS and getting meds for symptoms only.. I take gabapentin.. I had uped the dosage to 2400mg a day... and found my Vertigo started up daily and I had to lower my dose to 1800mg..which so far has helped abit with the Vertigo but I seem to have pain in the evening...deep muscle pain in my thigh area.

I will be seeing my neuro in two weeks for a follow up and will tell him that I can't seem to take to high of a dose of gabapentin as it starts my Vertigo which is horrible.

Could I ask why you can't tolerate a higher dose of gabapentin...is it side effects...if so...which ones?  I'm not sure if I will stay on this med or if I should try some other?

take care of yourself and hope you find something to help
wobbly
dx