T Nation

MDs to Tell Me About Neuropathic Pain?

I’ve broken a lot of bones in my body and the specialist today wants to put me on:

  1. Epilim - a drug usually used to treat epilepsy but in small doses MAY help people with neuropathic pain

And 2, Amiltrytaline - a drug usually used as an anti -depressant but in low doses MAY help neuropathic pain

This is supposed to be a guinea pig style study that is likely to go on for months before any results if any. He said they USUALLY find a combination of drugs in 40-60% of patients that rids them of about 50% of their pain.

Any comments from someone who knows what they are talking about would be appreciated .

Not sure if I qualify as someone who knows what they are talking about, but I have experience with psychiatric meds and as such got really interested in them and side effects.

First, I always suggest weighing benefits and consequence. IIRC, you were badly injured, so I am unsure how much pain you are in. Look up the side effects, and assess your baseline condition (energy level, body weight, mood etc.). There are things that your doctors may not be monitoring as closely as you can because it is not, in their view, as important as other things.

For example, the epilepsy drug can cause weight gain. Some doctors will accept weight gain, and their tolerance will likely be different than yours - i.e. if you gain 20lbs, YOU may care, but they may think it’s fine, as long as your blood sugar and liver enzymes or whatever are ok, and you are not becoming diabetic. Their thresholds are different

Often, the manufacturer and doctors don’t really know how these classes of drugs work. These drugs are extensively researched, but often the mechanism by which they work are still unknown. SSRIs were believed to affect serotonin reuptake, etc, but they discovered that the depression could not be explained by serotonin levels alone, or levels were not changed, but people still benefited. I don’t think Amitriptyline is an SSRI, just an example.

That’s why many of these drugs are researched then approved and prescribed for different conditions. It sometimes goes from field observations to clinical research.

Wellbutrin is known for this. It’s an antidepressant. Some patients got better, and they observed that a fair number quit smoking. They researched it to see if it could be used as a smoking cessation drug and now it is, under a different name. They are also looking into it for weight loss (not sure if this is already approved).

Make sure you can back out at any point. Epilepsy meds can make you extremely tired, which greatly affects quality of life. The point is to monitor yourself closely, and weigh the benefits vs the side effects. And if there is no improvement, don’t stay on it. I personally avoid most thing s that can affect my brain/mood as much as I can, considering my own health issues.

[quote]SexMachine wrote:
I’ve broken a lot of bones in my body and the specialist today wants to put me on:

  1. Epilim - a drug usually used to treat epilepsy but in small doses MAY help people with neuropathic pain

And 2, Amiltrytaline - a drug usually used as an anti -depressant but in low doses MAY help neuropathic pain

This is supposed to be a guinea pig style study that is likely to go on for months before any results if any. He said they USUALLY find a combination of drugs in 40-60% of patients that rids them of about 50% of their pain.

Any comments from someone who knows what they are talking about would be appreciated .[/quote]

Surprised they didn’t prescribe neurontin, thats actually something that is specfic for nerve pain conditions, it is also an anti convulsant and is prescribed for epilepsy as well… They gave it to me off label for anxiety for a few years at doses up to the higher limit threshold.

I had my nerves shut off so I could never really feel nerve pain until after getting off of it, I didn’t have any neuropathic conditions, I just noticed I would by far less susceptible to pain those few years I was on it. I had my share of side effeccts though, it raised my liver enzyme levels a bit sometimes over the normal range, and I had pretty bad drowsiness and dizziness during the days that I was never really aware of until I got off of it and my energy levels went through the roof.

There is also an anti depressent called Lyrica that I believe is used to treat fibromyalgia, may be another name, I forgot but that would seem a better match as it is more specific for numbing over active nerves.

I did eventually contract lyme disease after sometime of getting off neurontin and now have chronic neuropathy with the ongoing infection, To heal my nerves from this I am using adenob12, methyl b12, methyl folate, l carnatine fumarate, and Lions Mane Mushrooms… Seems to work very well, though this is from nerve issues of a different cause. I am not sure how it would help in chronic pain conditions but if you suffered nerve damage then this would all help to significantly heal your nerves.

Have you considered High CBD Marijuana?

Firstly, thanks for the replies guys/gals and thanks to the MODS for not moving to the injuries thread where it would’ve died in the water.

talc - I have also an interest in anti-depressants and a real aversion to them. Part of the reason is the doctors have over prescribed them, the pharm companies overmarketed and absolutely no one can explain how they work. Ask a doc how an SSRI or a tricyclic works and you’ll either get:

  • Indignation (I’m smarter than you. You wouldn’t even understand)
  • Gibberish (You see the serotonin uptake inhibitors are blocked then flooded with blah blah blah)]
  • Interruption to avoid the embarrassment of explaining they don’t know. etc

Frankly I’d avoid them like the plague.

As to pain, I have a high tolerance. I’ve never broken the pelvis or a femur but when I snapped my tibia apparently I handled it quite well. The problem is actually being able to walk 200 meters without my feet in extreme pain, swollen, shin splints etc. Unable to drive. Unable to travel or do shopping. Even household chores are an ordeal. Perhaps I don’t have a high tolerance. But I always feel like I can through whatever life has in store for me.

Regarding weight gain, the Epilim dosage is less than 10% of what an epileptic would take. Also, with my injuries I think my lifting days are going to be extremely limited for the rest of my life. In fact I was told I may be an arthritic mess in chronic pain for the rest of my life yesterday by a pain specialist.

The Doc mentioned Lyrica and I will look into and research nerve medications. Even though I don’t have kids I have a lot of responsibilities I have to keep on top of.

Thanks again for the comments.

PS - That sounds like a strange remedy cstratton2

XX - I don’t think weed will help but thanks.

You should ask about Gralise, an extended release form of neurontin. Neurontin causes dizziness and daytime sleepiness in a pretty high proportion of patients. Neurontin is taken 3 times a day. Gralise is taken just once a day and causes much less dizziness and day time sleepiness.

My strong inclination is to stay away from these drugs. The doc did mention lyrics and I’ll research the others but right now I think I’m just going to walk further each day and hope the body heals itself.

You may want to reconsider XX’s advice: http://www.ncbi.nlm.nih.gov/pubmed/23237736

[quote]SexMachine wrote:
My strong inclination is to stay away from these drugs. The doc did mention lyrics and I’ll research the others but right now I think I’m just going to walk further each day and hope the body heals itself. [/quote]

get yourself a ninja processor and buy up a lot of spinach,broccoli, turnip greens when on sale at the grocery and start filling your freezer. mix the frozen greens with bananas and any kind of berries. blueberries are best for this. ice cold liquid green - i do add stevia sweetner or sometimes splenda, otherwise i’d give up on the mixture.

drink yourself crazy with these liquid vegetables added to and in between meals for a month or whatever. i had some foot and hand neuropathy. thought i was going to have to quit lifting, but these liquid green shakes did something. i still have the occasional pain but not anywhere as much as before.

don’t ever stop the walking or you’ll lose your sexmachine.