From TN1 I've seem to have made a major switch to TN2 just about overnight. Roof of mouth, moving through teeth, gum line etc. If I hold my mouth still, not much pain. But talking, eating, swallowing, etc is very painful. Too bad I make my living by talking. Eating and drinking comes in handy too. So tomorrow I will call my doctor. He is receptive to suggestions. Now the kicker, he is my internist, but was very quick to pick up on TN. He did send me to ENT and dentists etc, to rule out.
He wants me to have an MRI? But why?
According to the reading here, some sort of anti-depressant, rather than gabepentin will be the new drug of choice. Any suggestions? How long before they kick in?
When should I start looking to visit a neurologist? O should I skip that step?
I have TN1 and TN2. In the past, I found that nortriptiline or amitriptiline helped me with the throbbing, TN2 symptoms. These drugs are anti-depressants but the dosage that helped me was very low, not the normal dosage for depression. I think it took 2-3 weeks before I saw a difference.
As far as seeing a neuro, I had very bad experiences with neurologists. If you have a good doctor who is willing to treat you, work with you and try different things, I don't see why you would need to switch, unless you are considering surgery. (I know some people have had good experiences with neurologist. But alot of times, it is hard to find a good doc. So if you have one, don't let him/her go).
I hope this helps and I hope you begin to feel better soon!
I have 24/7 pain in my teeth, and like Karen, Amitriptyline has helped me significantly. I've taken just about everything, and have had the most success with the Amitriptyline. For facial pain, the standard dosage is 75-100mg. Some people find relief at a lower dose, but that seems to be the norm. For me, once I hit 100mg/day, the pain levels decreased. Notriptyline is said to have fewer side effects; I never tried it though because I started with the Amitriptyline, and it worked well so I didn't want to switch. They're very similar though, cousin drugs, I think.
If you can see an Orofacial pain specialist, that is probably your best bet. They deal with all types of TN patients daily, whereas a Neurologist may have never seen one TN patient. However, if your GP/Internist works well with you, stick with him and discuss your research with him, and he can probably do just as much.
I do think you should have an MRI to rule out any other conditions that could be contributing to your symptoms, as well as ruling out a compression on the nerve.
Btw, you can take the Amirtipyline with the Gabapentin - it doesn't have to be one or the other, and most people get the best results by taking a combo of meds. I always make sure to start one new med at a time - that way I know which one is working and which isn't. Good luck. I hope you find some relief soon.
I've heard back from doctor's office, gave the nurse the info from here. So I shall see what happens. I've never taken an anti-depressant before. So I guess if it doesn't help much with pain, I will still be happy?
I don't notice the Amitriptyline helping my depression. I believe that it would be a much higher dose for depression, hence why they usually prescribe newer meds for that, SSRIs or SNRIs. To be honest, when dealing with situational depression, I'm not sure any of those meds can truly help. You know what helps my depression? No pain! :)