I've been on Nortriptyline for almost 5 months now. I started on 25mg in the evening, then 6 weeks in I increased to 50mg a day, 25 and night, 25 in the morning. Most of the 5 months I have often had breakthrough pain, but it was less severe, and I could live with it. For the last two weeks I have noticed a regular increase in the length and severity of breakthrough pain. It has reached the worst point in the last 24 hours, where I barely feel any relief.
I was wondering if anyone else using this medication had gotten a dose to control the pain, and how long it takes the "average" person to build up a tolerance.
I would love to have a dosage to ask for at my next doctor's visit.
Thank you! ad i hope you are in less pain than I am. :)
Hi. I have been on nortriptyline for over a year. I have been up and down on doses as my pain comes and goes. I was actually able to go off of it last summer but am back on 50mgs now. 75mgs was the highest I went but it made me feel a bit jittery. I always go up or down by 10mgs. I also have break through pain and full scale attacks sometimes. It does help but it is not worth. I find it helps with sleep and anxiety though too so that’s an added bonus
Thanks Justjane,
I might see if my doctor will bring it up over 50 a day. I have had almost constant break through pain this week, a couple of times it felt as bad as it had before I got on any medications. I keep joking about the medications turning me into a wimp. I still have trouble understanding how I lived for months undiagnosed. Do you take any other medications for the break through pain?
I have been appreciating the Anxiety, and Insomna control it has given me, and according to my Gastro doc it is supposed to be soothing to my messed up digestive system. I am really liking Nortriptyline, I am just worried that I will build up a tolerance and it wont be enough anymore.
No I don’t usually take any other meds. I usually just increase and hope that works. I have tried plenty of other meds–pain meds mostly and anti-inflammatories–nothing works. Some people do build up tolerance. That is a real problem with Tn. I always decrease when I have gone say a month pain free. I am always trying to use the lowest dose so I have to for increase later. I was up to 75 mg and I felt like I had maxed out. Luckily Tn decided to give me a break last spring
75mg is still a pretty moderate dose. 150/day (usually taken in two 75mg doses) is the upper limit. BUT it is a significant enough dose that you want to be careful decreasing it much more than 10% or so a month (Its half life can be 6 - 21 days) Decreasing it to quickly can have some unpleasant effects. One of which is headache. NOT a good thing for TN patients) Most experienced patients learn to manage their meds better than most docs/pharmacists can do for them, but one needs to be careful.
YES you can develop tolerance. There are others similar meds you can rotate with if you do. So take care of yourself and don't slight your treatment (and comfort) for fear of the med losing effectiveness.........
I don't disagree with JUSTjane in not taking it when things are "good" but by the same token I don't like to fix what ain't broke. But then I take a lot more meds with a lot more side effects. When things are working I hate to change anything including which side of the bed I get up on. For a "scientist" I'm awfully superstitious.....
I agree with ModSupport about decreasing VERY slowly. I learnt that lesson the hard way. Headaches, body aches, nausea, anxiety, insomnia to name a few.
And ModSupport is right…if something works and u r pain free dont mess with it!! The first year my tn came back I stayed on the same dose and was pretty much pain free. My Tn comes in flare ups and I can have weeks or months of low or no pain. I have had a couple of long remissions too so I tend to be able to decrease sometimes.
I'm 14 months in and the only drug that has gotten rid of my pain on a daily basis was Lyrica, but it caused suicidal tendencies after 3 weeks, so I don't mess around with that. I wont change my dose without doctor advisement, but I have noticed that if I approach my doctor with a plan she is more likely to listen to me. I would rather take it constantly than risk full pain.
I would love having a remission but at this point I can handle even hoping for one. Maybe in the years to come.
Thanks for the advice.