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Epileptic medications for CNS pain

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Posted 10/31/2012 3:43 AM (GMT 0)
Good morning everybody.

I am wondering if anybody has had the experience of using medication designed for epileptics that helps with central nervous system pain? I have been on Lyrica and Gabapentine, Lyrica seemed to work well but I got "used to it" and switched to Gabapentine. Now a year later I feel as though it's not working again and asked if I should switch back to Lyrica but my current Dr said you cannot get used to epileptic medications. I am also on Norspan and Cymbalta. I am aware Norspan can produce tolerance, but what about gabapentine?

Any thoughts?

Thanks,

Posted 10/31/2012 4:03 AM (GMT 0)
It could be that your condition has worsened to the point where your current dose of Gabapentine is being overwhelmed. Unless you are already on the max dose you could talk to your doctor about a dose increase and see how that goes.

If you do go off of it I suggest talking to your doctor about doing so slowly. While I do not know whether it is possible to become tolerant of this medication or others like it I do know that your body can and does become dependent on them and going "cold turkey" can and often does create some very unpleasant side effect and in some people it can become dangerous. Cymblata is another medication that you are on to not go cold turkey from.

Nerve pain can and is often hard to manage. I suffer from diabetic nerve pain and so far I have only found 2 medicines that worked well for me out of the 10 or so I have tried. Cymbalta I loved, was taking 90mg/day, but had to go off it because insurance stopped covering it. After a lot of trial and error after that I was put on Effexor and have had a lot of success with that. 37.5 mg of that has worked as almost as well as the 90 of Cymbalta did.

I don't the dosages of the Cymbalta you are currently on or the Gabapentine but unless you are maxed out you could try increasing one or the other or both. I don't know the max dose of "Gab" but Cymbalta is 120 mg/day.

Anyway the anti-depressants and/or the "epileptic" type meds typically do seem to be the most effective for nerve pain. For most people your more standard pain medications often have at best very limited results so I think you and your doctor are on the right path. The only thing I have to question is if maybe you have switched too fast on some of your meds as it is not uncommon to need periodic dose increases to get to and/or maintain effectiveness.

Hope this helps some.
Posted 10/31/2012 4:22 AM (GMT 0)
Thanks for that,

I had not actually thought about increasing the Cymbalta, I'm on 60mg. I'll bring it up with my Dr next time I see him. I noticed a big difference when I went on it so it's worth looking at.
I'm on Gabapentine 800mg twice a day which is supposedly the maximum, although a previous Dr had me on 1600mg a day until my current Dr found out and said to stop it.

That's really bad that your insurance stopped covering Cymbalta. I spend about $60 a week on medications currently and it's a killer I can tell you that much.
Posted 10/31/2012 4:34 AM (GMT 0)
When I was on Cymbalta I started at 30mg. Had some good results and after about 3 months the doc I was seeing put me on 60mg to see how that went.

I was on 60mg for a long time, probably 1.5 years, when I went to see a neurologist for an unrelated issue and as we were talking she asked me about the Cymbalta since at that time it was still fairly new and its use as a treatment for nerve pain was even newer. When I told her it was working good, handling a good 85% of my nerve pain she suggested going up to 90mg. For the next year plus I was on that level and I had 99% of my nerve pain controlled 98% of the time.

While 100% is nice I am a realist I do not expect any medication to control pain 100%, 100% of the time. I only expect it to make things manageable.
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