Medications to manage neuropathic pain

It's been a bit quiet on this forum recently. Everyone must be enjoying the spring.

I've written a fair amount about my neuropathic pain in the past. I never took medication to help manage it until it started getting significantly worse about six months ago. So far this year, I've tried gabapentin (titrated up to 450 mg), amitriptyline (titrated up to 150 mg), and duloxetine (currently taking 60 mg daily). None were effective at noticeably reducing nerve pain. This is not to state that I do not believe these medications can be effective, as I know others have had great results from each of these. They just haven't worked for me.

I have also tried taking Vitamin D and B12 supplements for the past few months, which I have read can reduce nerve pain. Neither has helped significantly.

So, the question is, what would you recommend that I try next? I've considered, among other things, ALA supplements, Lyrica (although I have some serious side effect concerns), and topical lidocaine. I've also considered trying cold laser therapy, but my insurance doesn't cover it (no big shock there).

Neuropathic pain is no fun to deal with, but it seems that most sufferers eventually get around to finding something to successfully treat it. I just haven't found it for me. Yet.

Cheers, and have a wonderful weekend!

6 Replies

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  • Hi, I suffer pain mostly through the winter and I've tried all the meds you mention! The only thing I now take is 5000iu of Vitamin D3 November to March and it works for me! Was it D3 you tried?

    All the best

    Steve

  • Hi Steve,

    I've been taking 2000 IU of Vitamin D3 each morning since March. I also have a smoothie with about a cup of Vitamin D enriched milk, a banana, and cashew butter each morning. This is a significantly lower dosage than the dose you found to be effective. Do you take any other supplements in combination with the D3?

    How does your neuropathic pain manifest itself differently depending on the time of year? How does it feel this time of year? Mine is fairly consistent. For years, it averaged about a 1-3 on a ten point pain scale, with maybe one day a week at a 5 or 6. For the past several months, it's ranged between 5-9, depending on the day. Some days it literally feels like walking on knives. Not thinking about it, and getting my mind on something else, works some of the time, but not on the really bad days.

    Cheers,

    Aaron

  • Not a lot of Gabapentin, Aaron98 .

    I take more than that in one go. Some countries, 3600mg is the highest daily dose.

    You do stop feeling stoned after a while, still nicely relaxed, but not off your head.

    Lyrica is better, arguably. I don't really think so though.

  • I've actually thought about trying gabapentin again and increasing the dosage, Mr. Monkeybus. My current neurologist agreed that that was a low dose. I absolutely hate the feeling of being doped up. Relaxed is okay, but I know many people simply cannot function on gabapentin.

    Lyrica? I've heard firsthand from some AMNers about anorgasmia, tremendous weight gain, trouble concentrating...I don't really know what to think.

  • First time, I took 200mg. It really spun me out. Didn't take again for months.

    Then I had another go on it, took about 800mg, I was hallucinating.

    It was on/off after that. Mostly on.

    But since December last year I made a conscious decision to take however much I wanted to. The spasms were really getting to me. Legs, stomach, arms.

    Just to stop the spasms, it was well worth it. Used to smoke a lot of weed as a youth, being stoned was nothing new.

    It all passes though. Doesn't get me stoned anymore.

    It does stimulate the appetite, but then the Modafinil kills my appetite. I haven't gained a kilo.

    Even the anorgasmia passes. The SSRI's were worse in that regard.

    It's all priorities with me. I cannot abide any more sleepless nights. Pure torture.

    Looking at the "options" for neuropathy and/or fatigue, Gabapentin and Modafinil seem as benign as you can get. Better than those tri-cyclic antidepressants at any rate.

  • I take 600 mg gabapentin in the AM and 900mg at night. I can take an additional 600 mg in the afternoon as needed.

    This is combined with 20 mg baclofen twice a day. Baclofen is great for spasms.

    I have been using these two for 20 years. Modafinil is a great way to offset the drowsiness.

    Exercise of the legs in any form possible works for me. I have a nustep recumbent elliptical. It allows a great balance of arms and legs to improve circulation. I also recommend motorized pedals. I use them whenever I am sitting around watching TV.

    Finally, I use Motrin at times. Sometimes what I thought was neuropathy often was the inflammation that the muscles and tendons get from the tightness. Don't forget to keep things stretched out.

    I also find Motrin can improve my sleep. Don't know why but it does.

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