So I am confused. My GP and my Neurologist have never mentioned what exactly to expect from my medication (Neurontin.) When I first started having TN pain it was constant. Constant zaps, constant throbbing and constant burning pain. After a few weeks on Neurontin the attacks lessened noticeably but I still have completely unexpected attacks just not constant like they were. I'll have a few good days or sometimes even a few good weeks and then BAM, attack. Is this normal? Is this what they mean by breakthrough pain? Also why won't they give me anything other than Tramadol to use during these attacks? Tramadol makes me horribly sick (vomiting and severe headaches) and doesn't even touch my TN pain. I keep telling them this and they don't say anything other than "So stop using it then." Okay...so what am I supposed to do then? Just basically stop living until the attack passes? Also with my last 3 attacks I have had these horrible muscle spasms that cause me to smash my teeth together and sometimes bite my tongue to the point that it causes severe bleeding. I have told my GP about this and she said "We'll see how you're doing with that the next time I see you." Like seriously...so until then I should just keep shattering teeth and biting my tongue and cheeks?! Wtf?! I see her today and am going to just tell her, I have never asked for anything before but I need something (a muscle relaxer I would assume) to stop this. Sorry...long rant but I am very frustrated. Any advice?
Hi Tiffers,
Tramadol never worked for me either, it would knock me out and then I’d awake with horrid headaches.
In fact no opiates or pain medication has ever worked for me. I have found over time that 2 Advil every 3-4 hours can minimize the breakthrough pain on occasion.
A good rule to go by is if you’re still experiencing pain that interferes with your quality of life then a slight increase in your medication may be in order. (Get approval from your doctor)
Breakthrough pain is “occasional” pain that lasts a few minutes to a few hours. Sometimes switching to a slow release version of medication can help with that as the medication is in your system more continuously. Adjusting ‘when’ you take your meds can be helpful too. It’s trial & error.
Ask your doctor about whether or not you should be increasing your dose.
Good luck at your appointment.
Mimi 
Yes that is break through pain. And yes, it can be commin to have a few good days and some bad ones. Can you increase your doseage?
Many say that pain killers do not help neurological pain. However, neurotin combined with oxycodone can be helpful in some patients. I am one of thise people. There is literature that supports this position.
Oh and my last bout of pain three years ago, i was on neurotin and trileptal combined with oxy. After six weeks I no longer needed the oxy. After three months I was able to slowly begin to tritate off all meds. I had no lain for 2.5 years.
I hope you were able to be assertive! If not a match…get a better doctor!
Lidocaine patches kept my facial zaps
I have a list of our top 100 meds and combos if you would like.