a question re medicines / side-effects

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Offworld

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a question re medicines / side-effects

  • on: 26 Oct 2018 12:11PM
Scenario setting ramble before a question....
For years I've been taking St Johns Wort (hypericum) and Nurofen for a pinched nerve in the small of my back, plus sciatica. Neither is on prescription, so that's quite expensive. I also have, on prescription, Baclofen -- and till the medical profession were instructed to develop hysteria about it did have Diazepam (which for me worked much better than Baclofen, but with zero ill-effects).  So no Diazepam nowadays.
Doctors (not to mention ATOS's dismissive "so-called assessors) don't seem to approve of Nurofen and Hypericum and my present GP suggests replacing these with a prescription of Gabapentin plus some as yet undiscussed anti-depressant....
Amitriptyline was initially offered (likewise by a different GP several years ago) but I know of quite enough people that ubiquitously pimped stuff  has adversely affected -- and its potentially serious side-effects with regard to my own overall conditions --  to refuse it and be rather annoyed that it was proposed at all.
 >blush<  Question is ... I have considerable reservations about Gabapentin ... how have others here found it?

neurochick

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I found it completely useless and the side effects were terrible - I slept 23 hours out of 24.  However other people find it absolutely excellent for managing nerve pain.  Unfortunately, the only way to know is to try it because you will get a hundred different experiences from a hundred people!  The same goes for pregabalin which is a variant of gabapentin and is often the next drug they will offer if gabapentin doesn't work.  And your response to one of these drugs doesn't predict your response to the other so there's nothing for it but to give them a try.

Sunshine Meadows

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I agree with Neurochick no one can know how their body will react drugs unless they try them for themselves.
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For me Pregablin which is similar to Gabapentin worked well in the short term but it caused me to put on a lot of weight (two stone) the first time so the second time I tried it I considered it a short term thing to give me a break from how much pain I was in. I put a stone on in three months and have yet to lose it. I have taken Amitriptyline and it made me dfeel to tired all day so has been switched to Noratriptyline which I have to take much earlier in the evening or it makes getting to sleep difficult. Would you mind saying which side effects you are worried about?

« Last Edit: 28 Oct 2018 10:40AM by Sunshine Meadows »

Fiz

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I totally agree with neurochick that the only way you'll know is to try them. Both Gabapentin and Pregabalin are anti-anxiety medications so even though the dose for nerve pain is far lower than is needed for anxiety you may at least initially feel sedated but this usually wears off. I discounted both of those because even at a low dose they often cause weight gain and I'm already significantly overweight already and hate myself for it so I know gaining weight wouldn't be helpful for me. It's by chance that these anti-anxiety drugs were discovered to ease nerve pain. Both, according to people I know do ease neuropathic pain.

I chose the antidepressant Amitripyline because the spinal consultant I saw said it was the most effective drug for relieving nerve pain. I take 30mg at night. Which is far lower than an antidepressant dose. The drug is the second worst antidepressant for causing weight gain but my weight has remained the same on the low neuropathic dose I take. The consultant told me Amitripyline is the most effective drug for easing neuropathic pain and typically reduces pain by 30-40%. For me it's worked better than that. There are times at home when I haven't mobilised much when I'm completely pain free. I do still have neuropathic pain if I venture out and manoeuvre at all. Stairs either up or down though I've discovered my left leg sets off a neuropathic pain surge so I go up and down stairs one at a time leading with my right leg which reduces the pain though I often think I look a right twit and there's no way I can keep up with the people I'm with either on stairs or walking and if I do walk any sort of distance from the car to a shop or doctor's then the neuro pain is still severe but I never had pain free times before taking Amitriptyline so to be pain free sometimes at home is amazing. The neuropathic dose goes up to 50mg and I often wonder how much extra pain relief I'd get by taking that maximum dose but my GP knows my mental health history so this is all she'll allow me to have in my possession. And it definitely helps my pain levels. Before taking it I used to be in excruciating pain getting in or out of a car, or any stairs, or any turn in direction. I couldn't go anywhere.

But just because I chose Amitriptyline it doesn't man it's the best drug for you. I suggest either discussing options with your GP or if they're not the sympathetic type then maybe ask to be referred to a pain clinic to see what would be helpful for you? The staff there are experts in pain management. When I had my referral to a pain clinic I was in too much pain to get there! I actually find that amusing although I didn't at the time.

I do also wear two buprenorphine patches too.

Neither naproxen or diazepam are helpful for nerve pain really. The three drugs above reduce the sensitivity of the nerve receptors inside the brain which specifically reduces neuropathic pain. Before my pain became severe and completely disabling I used to take tramadol on bad days but I went back to the GP when that was no longer enough.

I'd recommend a chat with your GP and/or a referral to a pain clinic because what will help you is specific to you. And will be totally different to what helps anyone else.