I wanted to ask opinions about switching meds or med options. I am currently on Gabapentin per my General Practice Doctor. Today I spoke to a Neurologist via Video call and they were really pushing Carbamazapine, which I know is the standard. My current issue is I don’t have access to health insurance so doing lab testing would be something I would prefer to skip. I am unsure how helpful the Gabapentin is because some days its very helpful, others not so much. Is it worth switching at all, and or does anyone have any suggestions or tips for talking to Neuro’s Nurse? thank you.
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I’m currently taking carbamazepine, I fully understand about insurance. I’ve been paying for my RX out of pocket for years. I do take advantage of GoodRx. It helps some. I’ve been on carbamazepine for years and my blood work is always good and it’s just one time a year. Gabapentin knocks me out, only use it for emergencies, like this week bad episode don’t know why??? Except I have noticed when the barometric pressure gets low I’m in trouble 
I always know when a storm is coming. My doctor added Zoloft and I’ve seen improvement. The other thing with Carbamazepine I get tremors and my memory is affected like I can’t remember names, very frustrating but I have to live with that or be in pain, I choose memory loss. I hope I’ve helped somehow. I’m very sorry you have this awful injury. Btw, I’ve had everything done to me, surgery and Gamma Knife. Surgery didn’t work at all, Gamma Knife worked for awhile, had it done twice.
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I tried so many different medications that I don’t even remember everything I tried. Oddly enough, the doctor who first diagnosed my TN prescribed Gabapentin, and I eventually ended up going back to it because it offered me the best combination of effectiveness and side effects I could at least tolerate. (A lot of what I tried caused side effects for me that I could not tolerate. With carbamazepine, that was “pitch shift” so bad that I couldn’t even tolerate listening to music.)
Reaction to medication (both positive and negative) seems to be so individual that it’s difficult to say whether switching from one to another would be good for you. But if your doctor thinks it’s a reasonable plan, I guess the worst thing that will come with trying it is that you might spend more money only to discover that you’d rather return to taking Gabapentin.
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As the above poster mentioned, what is good for one person is not necessarily good for another. And I don’t think you need to give up one medication for another. I am currently taking a combination of: gabapentin, carbamazepine and Vimpat (lacosamide, not generic yet).
Dosing depends upon my day, yes barometric pressure, etc etc. Usually am and pm are the same and evening is a little heavier as I’m going to bed. If I have a string of good days I reduce my “cocktail” during the day so I can have a clearer head and a little bit more balance. When things start to get stirred up I increase my cocktail to help bring the monster back down.
So, I guess I would suggest trying the new medication and see how your body tolerates it. Good luck in your journey. Stay Safe
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Wanted to say thank you to everyone here for their responses, kind words and advice. I am either contemplating on just stopping the meds for awhile and seeing how my pain level is naturally, and/or going to move to another state with better healthcare. I will weigh options carefully and thank everyone for their input.
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When I tried Carbamazapine, my liver didn’t like it, and I had to return to Gab. For years now, I have remained on it. Are you on disability? Medicare will cover gamma knife, which was helpful to me (find an excellent oncologist to do this). The mvd I had I am not so sure was helpful. My skull and muscles are a bit messed up and cause additional pain. Not much was found along my nerve inside, but some protective pads were laid in there hopefully to help. That was done so very long ago, and I suffered pain afterwards, which Gab wasn’t so helpful with. It took years with Gab, but after the radio stereotactic surgery (gamma knife) and, in addition, after I began botox treatments three years ago, wow, did that all help? Yes. I still have to be careful, but all is pretty well, considering. I take three 900 mg gab 3x a day and an extra when needed. Been doing this since I began having TN. tried to decrease, but always hurt. my mind seems fit enough and I haven’t gained too much weight at all. The topiramate must help with that . Botox is for migraine headaches, which I have been diagnosed with too, but it definitely helps with my TN pain. May God bless you.
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