Suggestions Needed For Nerve Pain Medication

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drjimmy
Regular Member


Date Joined Dec 2008
Total Posts : 110
   Posted 8/26/2010 12:11 AM (GMT -7)   
Hey all, it's been a while since I've posted...I've been in such agony I just haven't felt like going online much lately. I have been on Oxycontin (80 MG 3 times daily) & Percocet (10 MG 4 times daily) for pain. Just abaout all of my pain is nerve related and the meds I'm on just don't do nearly enough. I know they're helping, because when I run out early, or forget to take them or whatever...the pain gets so much worse. However, they don't work enough to relieve more than just a touch of the pain. I'm miserable and in constant pain all day, all night. I've been told recently that there are medications that are specifically for nerve pain and that many people have gotten a lot of relief from them. I need some suggestions and feedback from those who have taken nerve pain meds. Which ones are out there? Which ones have helped the most? I've heard of Cymbalta, Neurontin & Lyrica. I've been on Lyrica and Neurontin in the past and they didn't help much, although that was before my nerve pain got as bad as it has gotten. Any information would be appreciated. Thanks and I hope all of you can find SOME relief from your pain.
Herniated Lumbar Disks L5 S1, L2 L3
Herniated Cervical Disks C6 C7
Spinal Stenosis
Degenerative Arthritis Left Knee
Pes Planus Both Feet
Multiple Neuropathies
Brachial Plexus/Thoracic Outlet Syndrome
Nerve Pain in Arms, Hands, Back, Legs, Feet, Groin, Testicles

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 8/26/2010 2:31 AM (GMT -7)   
I take Cymbalta for my nueropathy and it works well for me.

The thing with any of the 3 you mentioned is that it can take time to build up to a theraputic dose, which depending on the medication, can mean 2, 3 or more med increases. Each of the 3 you mentioned also operate on a cumulative effect meaning the longer you are on them the better they are going to work, if they are going to work.

Probably the most common error doctors and patients both make when it comes to these medications is discontinuing use too soon with out giving them an real chance to work. Too often a person will be given the min dose of these medications and a month later they still have pain and instead of getting a dose increase they give up on it.

For example, the min dose for Cymbalta is 30 mg. For me 30 mg does nothing what so ever. At the 60 mg level I can feel it helping, and at the 90 mg level it relieves 98% of my neuropathic pain. (BTW: The max dose is 120 mg/day).

Now with that said, for me none of those meds does a thing for my back pain caused by herniated discs. I have to take a narcotic pain reliever to reduce that pain.

In the end I would suggest giving any of those, or all of those, one at a time, a try, but give them 3 months or so with regular dose increases to determine if they will help. I am naturally biased towards Cymbalta since that is the one I have had the best luck with, so that is the one I suggest people trying first.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9622
   Posted 8/26/2010 7:59 AM (GMT -7)   
Wish I could help you...the Lyrica made me throw up (every hour on the hour for over 12 hours)
will never do Lyrica again ever...
Cymbalta at low dosage helps but when it goes higher gives me night sweats and wakes me up..
Good luck to you and I hope you find something that helps....
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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painsnbody
Regular Member


Date Joined Aug 2009
Total Posts : 30
   Posted 8/26/2010 10:40 AM (GMT -7)   
You mentioned the big ones. But When those failed I used Topamax.  It is used for many things one being nerve pain. Ask your dr. about it.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13466
   Posted 8/26/2010 11:38 AM (GMT -7)   
Jimmy I have been on Cymbalta and Lyrica. If you are not given the proper dose they will not work. I found that out the hard way with my prior PM dr. It could well be this is what happened to you before. Worth trying again and giving it time plus having the meds adjusted. You are so right about pain meds not being all that effective for nerve pain. Even at high doses they are not effective for it, you need the meds that are for nerve pain to get relief. I sure hope you can get the dr to get something going for you. Susie

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 8/26/2010 12:08 PM (GMT -7)   
hey there drjimmy, sorry to hear about your neuropathy, that is probably the hardest pain to treat. narcotics have some effect but not much. i am now taking cymbalta for foot nerve pain and it works ok but the 3 meds you mention are the main 3 and the side effect profile is pretty bad.for example cymbalta is liver straining and with the acetominaphen in your percocet the risk compounds. lyrica and neurontin can cause weight gain and high blood glucose. some other meds used are: amitriptyine or nortriptyine usually in low doses at bedtime, topamax which may even help weight loss, trileptal which is closely related to tegretol but has less side effects, lamictal which is pretty safe other than the chance of a rash known as stevens-johnsons syndrome that can be deadly, klonopin and ativan are used for nerve pain because of the effect on the gabanergic system and baclofen which is also a gaba drug, clonidine a alpha adernergic aganist a antihypertinsive calms the sympathetic nervous system along with its cousin tizanidine [zanaflex], gabitril is a anti-seizure med that can also help your sleep paterns,effexor has been used, depekote, tramadol tapentadol, levorphanol with is a potent opiate with norepineprine reuptake properties like nucynta [tapentado l], keppra a anti-seizure med, zonegran another seizure drug. there are more and a lot are new meds are being studied for neuropathys. a few opiates have norepineprine and serotonin effects making them effective on neuropathy but they are availible in europe and not on the USmarket.
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008

current Rx: MScontin 100mgs 2x, dilaudid 8mgs 4x p.r.n., soma 3x, vistaril 25mg 3x prn, wellbutrin 150mg 2x(ADHD),Adderall 20mgs 2x(ADHD)

spinal soldier
Veteran Member


Date Joined Dec 2009
Total Posts : 687
   Posted 8/26/2010 12:15 PM (GMT -7)   
another thought, you should probably check it with your doc but you can get the amino acid GABA [gama-aminobutyric-acid] at the VITAMIN SHOPPE or a health food store and it calms the impulses between nerve ending. also lamictal [lamotrigine] will bind with the sigma-opioid receptor on top of its other actions helping your oxy work better. best wishes
L4,L5,S1 bilateral Laminectomies, Foraminotomies 2002
L4-S1 PLIF with instumentation 2008

current Rx: MScontin 100mgs 2x, dilaudid 8mgs 4x p.r.n., soma 3x, vistaril 25mg 3x prn, wellbutrin 150mg 2x(ADHD),Adderall 20mgs 2x(ADHD)

antbuggey
Veteran Member


Date Joined May 2010
Total Posts : 594
   Posted 8/26/2010 1:47 PM (GMT -7)   
Hello there, sorry you are suffering so much! Nerve pain is awful! I could not take Lyrica because it made me sick and dizzy and off balance, but Cymbalta seems to help me. I do think I need a higher dose because it is not working as well as it did the first time I took it, but it does help! Hope you can find something to help! Take care!

Hugs,
Beckey
Spinal Stenosis L3/L4, L4/L5 & L5/S1 with Nerve Impingement, Fibromyalgia, TMJ, GERD, Severe Depression, VERY Large Cyst Right Ovary causing mild twisting, Small Cysts Left Ovary & 3 Large Cysts Uterus and Possible RA

Medications - MS-Contin, Cymbalta, Famotidine and currently Prednisone

ReactiveConstellationNE
Regular Member


Date Joined Dec 2005
Total Posts : 256
   Posted 8/26/2010 2:07 PM (GMT -7)   
Taking GABA as a supplement is a good idea....you want at least 750mg at a time, sometimes up to 1500mg.
Conditions: Reactive Arthritis (AKA Reiter Syndrome), Crohn's Disease, Chronic Pelvic Inflammatory Syndrome, Sacroiliitis, Costochondritis, As Yet Unknown MS-Like Relapsing/Remitting Neuropathy, and a partridge in a pear tree.

Medications: Currently not that many are taken daily, but there are many at my disposal for part-time use. Low dose pain medication, after years at high doses. Working on innovative ways of taking lesser-known pharmaceuticals and non-prescription supplements to maximum benefit.

hydrangea
Regular Member


Date Joined Mar 2007
Total Posts : 190
   Posted 8/26/2010 2:59 PM (GMT -7)   
my pm doctor did give me metanx two weeks ago. So far noe effect for nerve pain. He did say that it does take about a month for it to start working. Have not checked with insurance yet, but he did say some do not cover it. It is actually vitamin B in a very high dose. Gppd luck as I know that nerve pain is hard to deal with.
Hydrangea
"lIFE IS NOT WAITNG FOR THE STORM TO PASS.....IT IS about LEARNING TO DANCE IN THE RAIN"
Diagnosed crohns Disease, Bladder tumor and inflammation, Herniated disc, spinal stenosis, facet arthritis, degenerative disc disease, siatica, Three laparoscopis, hysterectomy, physical therapy, trigger point injections, spinal epidurals,
Meds lyrica, norco, amrix,metanx,pentasa.
Spinal Fusion 3/20

hydrangea
Regular Member


Date Joined Mar 2007
Total Posts : 190
   Posted 8/26/2010 3:00 PM (GMT -7)   
my pm doctor did give me metanx two weeks ago. So far noe effect for nerve pain. He did say that it does take about a month for it to start working. Have not checked with insurance yet, but he did say some do not cover it. It is actually vitamin B in a very high dose. Gppd luck as I know that nerve pain is hard to deal with.
Hydrangea
"lIFE IS NOT WAITNG FOR THE STORM TO PASS.....IT IS about LEARNING TO DANCE IN THE RAIN"
Diagnosed crohns Disease, Bladder tumor and inflammation, Herniated disc, spinal stenosis, facet arthritis, degenerative disc disease, siatica, Three laparoscopis, hysterectomy, physical therapy, trigger point injections, spinal epidurals,
Meds lyrica, norco, amrix,metanx,pentasa.
Spinal Fusion 3/20

drjimmy
Regular Member


Date Joined Dec 2008
Total Posts : 110
   Posted 8/26/2010 4:59 PM (GMT -7)   
Wow, you guys are great! I got so many helpful responses in such a short period of time...I'm real glad I found this group! Thanks!! Jim, you gave me a lot to think about and talk to my doc about. I'll definitely give each med a thorough trial with dosage increases, before moving on to the next one...I'll probably start with Cymbalta, since you and many others have had such success with it. Chartruex, I think I had a similar experience with Lyrica, if I remember correctly...as for Cymbalta, I sweat all of the time anyway, including nights, so what do I have to lose? lol...Painsnbody, I'll keep Topamax in mind if some of the others don't work, thanks! Straydog...Exactly what I've been thinking...it's definitely worth giving them another shot at this point...it couldn't hurt (which everything else seems to do...lol) spinalsoldier, you gave me so much info it will take me a while to research them/talk to my PM about them...But I WILL research each and every one of them, thanks!! AntBuggey, I think I may have had a similar reaction when I was on Lyrica (I've been on so many it's hard to keep the reactions straight...I guess I should keep a pain journal so I can remember which medicines work and what their reactions are)...Thanks for your advice...Exitwound, thanks for your help...hydrangea, good luck with Metanx...I hope it gives you some relief once it builds up in your system. Keep us posted. Thanks again everyone & I hope we all find something or some combination that gives us some relief...Nerve pain is horrible and no one deserves to suffer like this. Peace, all...byeeeeeeeeee Eric
Herniated Lumbar Disks L5 S1, L2 L3
Herniated Cervical Disks C6 C7
Spinal Stenosis
Degenerative Arthritis Left Knee
Pes Planus Both Feet
Multiple Neuropathies
Brachial Plexus/Thoracic Outlet Syndrome
Nerve Pain in Arms, Hands, Back, Legs, Feet, Groin, Testicles

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 8/28/2010 6:23 PM (GMT -7)   
Jimmy,

Limited medical reporting seems to indicate that traditional narcotics are not the best solution for pain relief when it comes to nerve pain. At the same time, they definately beat a blank and work better than using OTCs alone.

However, nerve pain is a tricky thing because of the factors surrounding it. The cause of the pain, the nerve area affected, depression, person to person nerve sensetivity, ect, area muscle spasms or reactions, ect ect ect.

From what I've personally learned, it seems some nerve pain responds well to GABA enhancement treatment. Thats why nerve pain that is affected by muscle factors (like spasms) might respond best to treatment with a relaxant like soma or valium.

Lyrica does have a connection to GABA but it seems to be different then traditional relaxants. This medication seems to work very well for some FM patients. However, a lot claim it does NOTHING.

For patients with FM or Sciatica, it seems that the Norephindrine pathways can play a role in providing relief. Therefore tramadol seems to work for some of these folks, as its a very weak opiod but has a somewhat stronger NE and SE reuptake ability. More recently, a newer drug called tapentadol (nucynta) has been put our which has 3x more opoid action than tramadol and 2x the NE reuptake action, but it has low SE action so seratonin syndrome is less of a risk. This medication works great for me and others (ive heard it called a life saver, or the pain medication oxycodone wishes it was), but on the same token, ive heard nerve pain patients declare it does not work for them and causes dizzying side effects.

Everyone is different. A lot will depend on your chemistry and the type of nerve pain.

Keep in mind there is more than just medications. You've also got options like epidurals, nerve blocker injections, ect.
 
As for your situation, you do seem to be at a block in the road having tried different nerve pain medication. I would suggest bringing up subonex or nucynta, however considering your response to other medications, keep in mind they might only achieve a limited efficiency.

Post Edited (grainofsalt) : 8/28/2010 7:27:05 PM (GMT-6)

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