Hi All! I was wondering if anyone has been on cymbalta or nortriptylin? I have the diagnosis or ATN or Atypical Facial Pain, depending on the neurologist…anyhow, I have been on 4200 mg of gabapentin and then added 60 mg of cymbalta for 6 weeks and it really helped cut the pain down, but I feel that it made me gain weight, sweat constantly, tired, and sick to my stomache. So they switched me to 30 mg of Nortriptylin. The cymbalta has worn off and I have the pain back and am hoping the nortiptylin works. Is anyone else on either of these? And how does it make you feel? I had a really hard time getting off the cybalta, really bad withdrawls…I am afraid to go back on that again.
Hi Katie,
I take 60 mg per day of Cymbalta for the TN with my other meds of Gabapentin, Tegretol & Baclofen. My GP doesn’t think much of Cymbalta either and has asked me to reduce it down by weaning very slowly off of it, his idea is to only take it now every 2nd day and see how I go. To be honest, I don’t know if I’m getting benefit from it either - it’s so hard to tell I’ve been taking it for about a year or more now and I can’t even remember when I started it or who started me on it. That’s my memory for you.
I find it’s not the taking of these meds that is hard, but yes the weaning off of them that is hard. Did your doctor just have you stop cold turkey with the Cymbalta and not explain what could happen? I have not heard or Nortiptylin so will have to look that one up.
I am sorry your pain has returned though Katie, that just plain suxs! I hope you become pain free again ASAP.
I have been taking these meds so long in total now that I’m afraid I’m unable to figure out how one in particular makes me feel unless I have an obvious reaction after taking it. I always take Cymbalta at night time and haven’t noticed anything - bad or good from it yet. Maybe I haven’t been taking enough of it 
Sorry I don’t have anything more helpful to add Katie!
Best wishes,
Kerry
i take nortriptyline. i take 40mg at bedtime. i find it helps my pain; as quickly as the next day if i increase the dose. conversely, if i lower the dose, the very next day my pain levels fluctuate. my energy level is less being on this drug and i need to increase my intake of water. weight gain is common; the amount seems to correlate with your dosage. having said that, , the tricyclics increase pain relieving properties in the brain; they do nothing to alter the function of your nerves. tricyclic drugs work by super ceding the nerve impulses and cranking up the anesthetic in your brain.
cymbalta has been heavily marketed over the last year or so for neuropathic pain; but doctors still don’t get that nerve pain from above the neck is decidedly different than nerve pain below the neck. mechanism of pain, strength of pain signal and how to block these signals are more complex. the closer the pain signal is to the brainstem, the stronger it is and longer it lasts. it’s no coincidence that facial pain is super painful and more often than not continuous.
tricyclics are a good option to help increase your brain’s ability to band aid the pain. cymbalta is a new drug targeted at neuropathic pain, but pharmacologically, does not address the many components of facial neuropathy. any benefit is likely from its ability to boost your brain’s pain relieving properties. nortriptyline does this more efficiently with less side effects, but both drugs do have risks; cardiovascular effects, high blood pressure, tachycardia, etc.
pharmacology must work better to target the chemicals which need to be rebalanced to stop the pain signals.
i am not a doctor, speak to your own about what i’ve said here.
vesper
I agree about Cymbalta. All it did was make me $60 poorer every month from the high copay. That was interesting what you wrote about it, Vesper. Makes sense. Good info.
A side effect of Cymbalta is sweating. I take Lyrica 150MG three times a day. It can make you sleepy but it helps so much. I also took Tegretol. It was only drug that really helped. Good luck.
Katie,
I went from amitriptyline to nortriptylin in hope that there would be less side effects. Brain fog is the best descriptor. I hated both of them. As I have posted elsewhere, if someone would assure me that I would acclimate I would have stuck it out. Ditto for Cymbalta; the nausea was overwhelming. When there is gi distress, the stomach wins and I quit the drug.
fwiw...one source that claims to have clinical experience with the atypical population, likes nortriptylin.
Sleep is my best treatment. And, the problem is that I can not get it, reliably. I take 2mg of lorazepam, but not every night. If I did, I would have to increase the dose.
Cymbalta 6o mg and Teg xr 1000 mg .still have break thru but not as bad as past.
The Cymbalta makes me very tired and the Teg put me in a brain fog that continually gets worse.
I will deal with the tired fog without the crazy pain
thanks for wording this so clearly even I can understand.
vesper venustas said:
i take nortriptyline. i take 40mg at bedtime. i find it helps my pain; as quickly as the next day if i increase the dose. conversely, if i lower the dose, the very next day my pain levels fluctuate. my energy level is less being on this drug and i need to increase my intake of water. weight gain is common; the amount seems to correlate with your dosage. having said that, , the tricyclics increase pain relieving properties in the brain; they do nothing to alter the function of your nerves. tricyclic drugs work by super ceding the nerve impulses and cranking up the anesthetic in your brain.
cymbalta has been heavily marketed over the last year or so for neuropathic pain; but doctors still don't get that nerve pain from above the neck is decidedly different than nerve pain below the neck. mechanism of pain, strength of pain signal and how to block these signals are more complex. the closer the pain signal is to the brainstem, the stronger it is and longer it lasts. it's no coincidence that facial pain is super painful and more often than not continuous.
tricyclics are a good option to help increase your brain's ability to band aid the pain. cymbalta is a new drug targeted at neuropathic pain, but pharmacologically, does not address the many components of facial neuropathy. any benefit is likely from its ability to boost your brain's pain relieving properties. nortriptyline does this more efficiently with less side effects, but both drugs do have risks; cardiovascular effects, high blood pressure, tachycardia, etc.
pharmacology must work better to target the chemicals which need to be rebalanced to stop the pain signals.
i am not a doctor, speak to your own about what i've said here.
vesper
Hi,
I am on Nortriptyline. It works very well for my atypical type of pain. Side effects are weight gain, digestive issues and I feel a little bit edgy sometimes. But overall it has worked VERY well for me. These meds are really hard to wean off of. I missed two dosages of Notriptyline a few weeks ago (I went out of town and forgot my med) and I had so much anxiety to the point of panic attacks. It was a very unpleasant experience and it took a few more days to level back out.
How is Gabapentin for you? My neuro wants me to try it