I just got back from my psychiatrist whom I see a few times a year for issues related to ATN.
I'm currently using no meds whatsoever but we discussed a few options which could help me with the pain (which is bad maybe 1/3 of the time and tolerable the rest of the time, but I am never pain-free). He asked me to consider the following meds:
-amitriptylene
-prothiaden
-carbamzepine
Please, if you have chronic ATN, could you share with me your experience with any of the above drugs. I'm especially interested in prothiaden since my doctor said he had a success with it in a patient previously addicted to tramadol for pain (wikipedia says it's not used in the U.S., but there may be someone on here who has tried it: http://en.wikipedia.org/wiki/Dosulepin). Of course, advice regarding the other two possibilities is also greatly appreciated!
Hello, I took Amitriptyline for 9 months for my facial pain..I had severe jaw and tooth pain The Amitriptyline worked very well for the pain. In the beginning the amitriptyline made me very tired so I took it at 5 pm every evening. It also gave me dry nouth but I just drank more water ..Now after 9 months my pain is gone...
I have atypical pain and the best thing for me has been nortriptyline.
I currently take 150mg nortriptyline, 300mg effexor which I just switched to from 120mg cymbalta. I feel like having all 3 together worked better than either 2. I was on cymbalta for a year or more with nortriptyline, then wanted to try something new so switched to effexor. All 3 help.
I also take oxycontin which has helped but nobody will give it to you. My neuro gives it to me, the pain specialist told me to stop taking it and see a counselor.
But nortriptyline has always helped more than opiates for me, it was magic stuff for a while...
I also took oxcarbazapine for a good while but stopped taking it after MVD and didn't notice any effect, I tried cutting down on nortriptyline and pain would come back, then the pain came back full blown and I felt like the anti depressants helped more than the anti seizure.
Nortriptyline does make me tired, instead of taking it all at night I take half at night and half in the morning and feel like it works more consistently. It also causes drymouth, especially if you smoke cannabis with it (which also helps).
I have had ATN for 14 years. I started on gabapentin. It made me dizzy at first (but only on the side affected by ATN), but I quickly acclimated to the new drug. It was quite helpful for a while. Later I added carbamazepine at a low dose. The combination was quite successful for several years in keeping the pain either completely at bay or so low it was negligible. Through the years as the ATN progressed, so has my med load. I am now prescribed the max of carbamazepine and almost max of gabapentin. Only in the last year has the pain moved faster than my meds. I hope you find something that works well for you.
I have Type 2 TN affecting my tongue, teeth, roof of mouth, jaw, cheek and ear. I have taken Amitriptyline and it has been very successful for me. I probably would have tried Nortriptyline first if I had of known about it. It is supposed to have less side effects.
Side effects are fatigue, which I did get used to, dry mouth and some weight gain-about 10 lbs, which I have now lost. It just makes me think about food a lot and crave sweets! I have learnt to ignore it. Take it a couple of hours before bed. There is a mouth spray I used called Biotene from the pharmacy that helped with the dry mouth.
I have Atypical TN. I was on neurotin, but my neurologist introduced me to Gralise. I have 1/3 more than the ‘top’ dose. But it is amazing and I only take meds once a day! Ask for coupons or print them out from the website.
I just looked this drug up. Gralise is just Gabapentin. I am glad it is working for you. I took the max dose, 3600 mg, and it worked pretty well for 1 year and then it stopped working. I am glad you are having success.
Carolanne said:
I have Atypical TN. I was on neurotin, but my neurologist introduced me to Gralise. I have 1/3 more than the 'top' dose. But it is amazing and I only take meds once a day! Ask for coupons or print them out from the website.
I just picked up my prescription for amitriptyline, unfortunatelly, I can't get the other brand - nortriptyline - in my country. I looked up Gralise but it's not distributed in my country either. We do get Neurontin (which, I think is the same as or equal to Gabapentin), but I had no luck with it in the past. I will post my feedback on the amitripyline once I know if it works (my doctor suggested starting with a half of a 25mg tablet then going up to 25mg and then to 50mg if tolerable; I have low tolerance to meds).
@Shindig: Cannabis was the one thing that helped me along with Lyrica (which, however, only worked short-term for me, 6 months or so, and an occassional pill of Tramadol combined with paracetamol)
Just to let you know, I am also taking Amitriptyline. My doctor has me up to 100 mg once a day at night. The worst side effect I have seen is dry mouth. I heard it causes drowsiness, but I take it at night before bed so I don't notice it. I thought you may want to see that you can go this high. I am not seeing a lot of help with it. I am also up to 300 mg/day of Lyrica. It seems that my body has become resistant to most every drug. I am thinking of coming off of these since I am not sure they are doing much. I survive on Tramadol and even Percocet on my worst days (I have ATN, constantly). I wish I could try Cannabis but I live in Utah and it is not legal. Good luck!
I will see how it goes on the small dosage, I need to function because of work and I know that on some meds I have problems getting up in the morning and feel generally weak. With Lyrica I went up to 150mg and it seemed to somewhat be working at that level but only for half a year. I didn't want to go any higher because of the side-effects. Instead, I weaned off and now I just take the occassional pill of Tramadol and muscle relaxants but it's not ideal either.
I'm happy that more doctors where I live are now open to learning about cannabis, maybe Utah will legalize it one day too.
Take care, Oli
flute cutey said:
Just to let you know, I am also taking Amitriptyline. My doctor has me up to 100 mg once a day at night. The worst side effect I have seen is dry mouth. I heard it causes drowsiness, but I take it at night before bed so I don't notice it. I thought you may want to see that you can go this high. I am not seeing a lot of help with it. I am also up to 300 mg/day of Lyrica. It seems that my body has become resistant to most every drug. I am thinking of coming off of these since I am not sure they are doing much. I survive on Tramadol and even Percocet on my worst days (I have ATN, constantly). I wish I could try Cannabis but I live in Utah and it is not legal. Good luck!