Hiya
Im currently on 900mg of Carbomazipine with limited success.
Instead of increasing the dose, would it be better to add another type of medication? have other people done this, or does this just lead to more side effects, as i'd be mixing other drugs? thanks
Your neurologist can advise you. Normally the maximum recommended dose for Carbamazepine (Tegretol) is about 1200 mg per day in divided doses. If you're still not getting adequate pain relief at an acceptable level of side effects, your doctor might augment your present medication with an anti-convulsive like Baclofen a muscle relaxant such as Flexeril, or even a tranquilizer like Valium -- all of which tend to promote the primary effects of Tegretol. Alternately, depending on the characteristics of your pain, you might be tried on a different drug altogether, such as Oxcarbamazepine or Gabapentin. If you have primarily aching, burning, searing pain on a 24-7 basis, the tri-cyclic antidepressants might be used (Amitriptyline, Nortriptyline, others).
I hope this gives you a place to start discussions with your doctor.
Regards and best,
Red
Hi Gillian.
I'm glad you posted this question as I am in the opposite boat as you. I have taken Lamotrigene (Lamictal) for the past year with fair success up until 4-5 months ago. Lamictal is an anti-convulsant. It have had virtually no side effects from taking it (not all folks are the same). It is not as commonly prescribed, alone, for TN.
I added carbamazepine XR to my pill regime about 3 months ago. So far, I think that the addition of the carbamazepine is putting a dent in some of my pain. I don't have side effects from taking these two anti-convulsants together. I have had some not so great side effects from the carbamazepine, though. I do avoid taking all of my medications at the same time. I have noticed that some of them when taken together cause more drowsiness. I have a very strict medication schedule that I have created for myself to avoid drug/drug side effects or interactions.
So to answer your question in a round-a-bout, yes, I have had success in taking two anti-convulsants. I also take two opiate pain meds, a tranquilizer infrequently and a tri-cyclic antidepressant (Trazodone- for sleep). A note on the tri-cyclics; some folks have pain reduction by taking amitryptaline in addition to their maintenance medication.
Good luck! Take care. Johanna
I started out with only 200 mg of carbamazepine and was also taking 50 mg of nortriptyline for weight gain. After I increased my dose of carbamazepine to 400 mg my pain was much better. I still feel it in the afternoons and evenings but it is definitely bearable. I've only been diagnosed since November 2nd so I think it might get better as time goes on. At first I had some side affects but most have disappeared now. At night when I take the nortriptyline I get very tired but by morning I feel good. My mouth is very dry all day so it's kind of hard to talk alot and sometimes I'm kind of shaky but that's about it. I tried to go off of the nortriptyline since it didn't help me gain weight but my symptoms returned so I found I couldn't. Soooo it was just an accident that I ended up on both but that seems to be what is working for me, at least for now.
Good luck!
I am on Tegretol and have been since diagnosis a few weeks ago. However, it was NOT working for the pain at all. The doctor added a low dose of Gapapentin to it once a day. Strangest thing, all the side effects I was having from the Tegretol (loss of balance, zombie feeling, hyposomnia) went away. I am still not at 100% but close, very close. The pain is tolerable. When I have a flare, then I take a vicodin and I don't feel anything. I was afraid after reading all the drug information, that I would be a zombie on both of the drugs, but not so. This is new, so I am not sure if as the Gabapentin builds up, if the side effects will increase or not. I will say that the only real problem seems to be with speech. I tend to slur my words. Which is not good for my profession. So hoping that one wears off.
If it's of any consolation, I'm on a very high dose of Gabapentin (2,700 mgs. per day) and after my initial adjustment to it, have no speech problems. However, I have developed (unfortunately) memory challenges, which is common among patients taking Gabapentin/Neurontin. It's interesting how we all react to different drug cocktail combinations. There's no One Size Fits All. I went through three different medications (tegretol, carbamazapine, etc.) and had reactions until they put me on Gabapentin and I tolerated it well without any reaction issues.
Please be aware that if you have any itching and/or rash from medication, it could be a very serious condition called Stevens Johnson Syndrome. If any itching and/or rash occurs, PLEASE stop taking the medication and call your doctor immediately. It's very unfortunate that most doctors don't advise their patients to be aware of this very serious, sometimes fatal condition.
iamrite said:
I am on Tegretol and have been since diagnosis a few weeks ago. However, it was NOT working for the pain at all. The doctor added a low dose of Gapapentin to it once a day. Strangest thing, all the side effects I was having from the Tegretol (loss of balance, zombie feeling, hyposomnia) went away. I am still not at 100% but close, very close. The pain is tolerable. When I have a flare, then I take a vicodin and I don't feel anything. I was afraid after reading all the drug information, that I would be a zombie on both of the drugs, but not so. This is new, so I am not sure if as the Gabapentin builds up, if the side effects will increase or not. I will say that the only real problem seems to be with speech. I tend to slur my words. Which is not good for my profession. So hoping that one wears off.