no pain relief gotten from combo of Lyrica gabapantin cymbalta at highest possible dosage, Neuralogist says I am a "fast metabolizer" whatever that means.So I have a diagnosis of small fiber axonal peripheral neuropathy and no place left to go as far as recognized treatment. other than the excruciating constant pain I am healthy 63yo female
It may be that they (your doctors) need to chage your meds somewhat, If the Lyrica is not working than the can up the dosage or change you to something else. Neurontin or gabapentin(genereic name) has been helpful to a lot of people including my husband for neuropathy of his legs & feet due to diabetes. At this point, what have you got to lose,? What dose of Lyrica are you taking, & how may times a day.?
I'm a little confused. Your doctor had you on Lyrica, gabapentin and Cymbalta all at the same time? And at the highest dose possible of each?
If the above three medicines do not work, you could try one of the following:
some tricyclic antidepressants, anticonvulsants, sodium channel blockers, and opioids have all been shown efficacious in randomized
controlled trials for treatment of painful neuropathy.
For a list of the top 20 most popular meds for this condition go to:
You will note that Lyrica, Cymbalta and Neurontin (gabapentin) are the top three but there are many more to try most of which are in the anticonvulsant category. You may note that levocarnitine is listed under several brand names and is a nutraceutical that may work. I believe you could purchase levocarnitine at a health food store.
Tricyclic antidepressants you might investigate would include amitriptyline and nortriptyline. Of course, there is always the opioid pain relievers but I would try the other medicines first before getting dependent on an opiate type pain reliever.
Hope this helps some,
My pharmacist advised me that I should only take one of the neuropathy-helpful meds as what they do is scramble the nerve signals in your brain and that your brain doesnt know what to do with this type of medication. Perhaps try one at a time? I know I was on Cymbalta and Lyrica and I've almost gotten off Cymbalta with no increase in leg pain. You might ask your provider if you would qualify for a Spinal Cord Stimulator (most people with nerve pain do). SCS helps a lot of people - google it and see what you think. Have hope - you still have an option or two. I know how frustrating nerve pain is - I have a trial of the SCS coming up soon. Best wishes -
I was diagnosed with small nerve fiber neuropathy in 2007 after many years of pain (~8 years), many doctor visits and many wrong diagnoses. Initially, I was given gabapentin and cymbalta (for the foot pain - in both feet). The dosage of gabapentin was upped gradually and it seemed to work. Then, Lyrica was approved and my doc decided to wean me off of the gabapentin and start Lyrica. For me it was a terrible choice and we went back to the gabapentin. There is a lot of controversy about the maximum daily dosage of gabapentin. I am now on 5400 mg a day (controversial max dosage) and am being watched for kidney problems. I was also given a compound cream by one of the pain doctors that I apply to my feet directly to relieve some of the pain (especially in my feet). It does work and I can give you more info about this if you wish. I also was prescribed a microcurrent electrical stimulator for pain. This is helpful somewhat.
I am still in pain, but it is far more manageable than it was before a real diagnosis and no pain meds at all.
There is hope and help out there. Unfortunately, there is no cure and we are only managing symptoms. Good luck with your pain management.
i so feel for you! i also suffer from terrible neuropathy in both feet and wanted to answer with my 'daily pain management cocktail'! i take a total of 600 mg of lyrica, 200 mg of topamax, 200 mg of tramadol and wear a 25 mg fentanyl pain patch ...
maybe this new combination may be of some relief? the 'mixture' at least takes the edge off for me most of the time ...
Yep, I've got it in both feet, and it's beginning in my hands now. I was on a high dosage of Lyrica and it worked OK, but it was turning me into a Zombie. I got a TENS (Transcutaneous Electrical Nerve Stimulation) unit from my local pharmacy for a 1 week trial, and found that after 3 days it was giving me relief. I bought a TENS for $150 and after using it for a month I was able to halve my lyrica use. Then after another 6 weeks I was able to cut the Lyrica altogether. Now I use the TENS for about an hour each day, and the pain is reduced to a bit of a tingle. The effect lasts for about 36 hours, but to be safe I use it every 24 hours. Believe me it's better than all the pills.
Oh my gosh! I am a 63 year old female with the same problem. I have had this problem for only 5 or 6 yrs and I already take the highest dose of Lyrica, gabapantin and cymbalta too! They say I have sever Neuropathy. I also have Raynauds so I take 4 or 5 other drugs also related to circulation. I also take hydrocodone. It only seems like higher doses of hydrocodone is in store for me. I get electrical shocks in my big toes that make me cry they hurt so bad. Hydrocodone seems to help some. It doesn't take all the pain away. I wonder what is in store for me...
Anna I feel bad for you as this I'd once if the 1 st symptoms I had whenmy PN started. I have never here of the shock thothat they have you. I have had nerve conduction tests various times as I have it in all 4 limbs. I would like to no me about it of it helps because I do not feel the shocks . I have no feeling in my left foot at all from ankle down. Plese me no it helped me with pain when they were just testin me it was just a shot in the dark at the time. As for you Geetchie, you are on meds that do all the same thing. It makes no sense to me. My Neuro Dr tried me on each one seperate times it turned out I was allergic because they ate all the same basically I can't take any of them and i'm just on painanagement the rest of my life or until or if ever they find a treatment for ppl like us. But I am not diabetic.
Mine is hereditary as far as they can tell but my parents are both diseased and I have no one to ask as both sides of the family are basically gone or are very old. I was very healthy until this it hit me when I turned 40. I'm now 46. I feel like I'm 90 most days. My feet burn from the inside out. It's so horrible. Their knumb and tinglingling at the same time I don't get how it can be so painful but it is as you no.
I don't no what to tell you about your meds as I said I have tried them I'm now on oxycodone and methodone tabs. I went thru all different treatments in the last 6 yrs it took 2 yrs to diagnose me at 40. The 1 st yr I went to a chiro. Thinking my back was making my legs hurt. Finally a Dr 2 nd yr. Then a Neuro by the 3 rd. I been going thru this forever it seems. Started on vicodin, can't take the Tylenol to Percocet and kept going I just weined down from all & started this methodone. It seems to work. I can't deal with the pain so I will be happy with anything that works now. I was told 1 1/2 yrs ago theirs nothing left to do for me but pain meds. I hope you have better luck then I do.
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