I’m taking 1500 mg of Gabapentin daily which has stopped working; higher doses of Gabapentin do not work. I have tried Tegretol, Trileptal, and Lyrica without success so have stopped all of these. Doctor is now adding 25 mg of Amitriptyline to the Gabapentin. How long does it take for the Amitriptyline to work?
This will depend on the individual person. 25mg of Amitriptyline is not a very high dose. I found it works for a while then you have to increase the dose. I hope it helps you.
Hi Pacey
When I started it,it worked within 2 days.I really hope it helps you.if I did not have a bizarre reaction to it I would still be on it.
Thanks Mary and Ellen5, I had body tremors from it last night so will cut it in half tonight and see if it helps to start at a lower dose. If not, I will have to stop it because the body tremors prevent me from sleeping. Thanks again.
Hi Pacey
I really liked the amitryptiline-it was and still is the only thing that made me feel part way normal-but at higher does(40mg) my hands would go numb at night,.I started at 10mg.
I might try prozac in a couple weeks if the next appointments don’t get me anywhere.And I hate the thought of all these drugs.But,man,I hate feeling in pain all the time.
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I took amitryptiline for many, many years (not for neuropathy), and found even 6 mg. had quite an effect (I took anywhere from 6 to 25 mg.). I would start low, like 10 mg. and work up if necessary. Many of the side effects, like morning zombie feeling, dizzyness, constipation, will fade over time.
You might try a topical treatment if it is effective, but you can’t handle taking an adequate dose orally. Or try a similar drug such as nortryptiline, which usually has less side effects.
I am very suspicions that withdrawal from that drug is what brought all this on in the first place–timing was too coincidental.
Hi ellen5, I hope the Prozac works for you. I hate taking these drugs also and at the same time I am hoping to find one that at least lessens the pain.
Ziggy, I took your suggestion and cut the 25 mg into fours so last night I took approximately 6 mg of Amitriptyline. I didn’t get the body tremors that I did on 25 mg but not sure it helped with the pain. I’m thinking of trying the 6 mg for another few nights and if that doesn’t work I will bump it up to 12 mg.
Do you make your own topical or have a compounding pharmacy do it. My PCP is good about prescribing if he thinks it will help. He won’t prescribe any muscle relaxants or benzos though. I don’t think he would even prescribe a topical with either one of those. If you are making your own topical how to you do it. I have an aloe base cream that I can add to.
I was diagnosed with ATN 4 years ago but it was under control with 1200 mg of Gabapentin. Then I was prescribed Ativan for another health issue (severe leg pain) and I think I went off the Ativan too fast and that’s what caused this flare up. I have been off the Ativan for almost two months so I would think the flare up would be over but no luck.
hi Pacey
Wow-Ativan for leg pain?Usually it is for anxiety or to help people sleep.Learn new things all the time.I really hope this works for your pain.If not-I would go back on the ativan and see if that knocks it back down.At the beginning of my pain the ativan was the only thing that would let me fall asleep.
Hi ellen5,
I wasn’t clear. The Ativan was for anxiety connected with the leg pain. The leg pain was so bad they hospitalized me, gave me pain meds, a muscle relaxant and Ativan (Lorazepam) for anxiety. The did lots of test but could not find a reason for the leg pain. When I got home I was on the pain meds, the muscle relaxant and Ativan for about two weeks. The pain eventually went away but the doctors never found a reason for the leg pain.
Pacey, I make my own topical medication, but that is definitely not usual. I use OTC creams as well as diazepam that I got through a prescription. The process is described better in the Capsaicin thread. I checked with my dentist and he is fine with the products I am using.
If you want to try a topical for your skin (not mucous membranes) you should be fine doing a trial with your own concoction. If you take a 25 mg. pill, crush it between two spoons, and mix it with 1 tsp. of lotion (5 ml), that would give you a .5% lotion, which is quite conservative. Amitriyptiline dissolves quite well even in water, so that should work pretty well.
I would let your doctor know what you are doing, and if it helps at all, he can get a compounding pharmacy to make a stronger, better solution for you. If you need to use it on mucous membranes (in mouth etc…) you will want it made up with something for that purpose. Most recipes also include at least one topical anesthetic such as lidocaine or ketamine, and many also contain gabapentin. If that has worked for you in the past, that might be worth including.
Hi Ziggy,
Thanks so much for this. I haven’t tried it yet because I woke up this morning with a rash on my face. Not sure what to do next. Will post to see if anyone else has gotten a facial rash from Amitriptyline. The rash has resolved and it was not painful (other than my regular facial pain) or itchy. I’ll also check with my doctor tomorrow.
Hello
My view of your situation is as follows: your Gabapentin is at a relatively low dosage. Because you can go as high as 800 MVD 3 times a day. The Amitriptyline will take about a week to achieve plasma levels that are therapeutic
I hope it works
E
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Edster,
Thank you.
Hi Pacey
I don’t think I saw this before.I wish something would go right for you.I cannot believe all this stuff is happening to you.I keep walking by these fortune tellers and think should I go in.But I spend my money on drugs .
Hi ellen5,
Thanks for responding. The Amitriptyline caused me problems also so now am back to just 1500 mg of Gabapentin that isn’t working so am thinking of weaning off of that.
So sorry you have to spend so much on medication. Hoping for an answer for us.
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Hi Pacey
Does your doctor have anything else in mind for you?They want me at 1800mg gabapentin but I don’t think I can handle it and not sure if it would work or not.
Do you get anything else.
I am so grateful for the marijuana oil.It lets me sleep.I am ordering some that might work in the day time.
You deserve so much better.
Hi ellen5,
My doctor is out of options for me. I haven’t tried a muscle relaxant or a benzo but I’m not comfortable with either one of those. If it gets bad enough I’m sure I will be willing to try one or both of them. My PCP will not prescribe either one of those. He has referred me to another neurologist; the first one I saw retired. There is only one other neurologist in the are where I live and he is not taking new patients so I would have to travel an hour and a half to see another one. So that would mean a half day or so to see him and I don’t feel up to that right now. I am thinking of asking my PCP to send me to a pain management clinic which is only about 20 minutes away.
Hi Pacey
I am so sorry
I truly wish things would work out for you,faster.We know that they will work out-but really!
I think going to the pain clinic is a good idea.is there any way that you could ascertain that the doctor treating you knows what atypical trigeminal neuralgia is-and how it is best treated?The ATYPICAL is so important.Most doctors don’t like to be told anything.My family doctor does not really get what the differences are-but they are huge.The atypical responds better to the narcotics and to antidepressants.Narcotics usually won’t work with typical.Therefore a whole line of meds are not offered.
Without my tylenol3’s I would be long gone.I don’t take more to feel super happy-just enough so that I can function.
Hi ellen5,
I’m so glad the Tylenol3 helps you.
I am looking for a doctor that knows about atypical. My PCP is understanding but I think he is at a loss right now about trying to do anything else for me.
I’m starting to get headaches now but at least the earache is gone.
I just keep hoping we all find something that works.