Quote:
Originally Posted by justjane37
Hi,
The description of your pain, location and experience definitely fits with Neuropathic pain. Especially that you had the tooth extracted and are still in pain. Have you heard of Trigeminal Neuralgia? I have Atypical Trigeminal Neuralgia and I can relate very closely with your experience. You should do some research on TN (Trigeminal Neuralgia).
I am on Amitriptyline and have been on it for about five months. It has been my lifesaver. First of all, I increased dosage very slowly. I started off on 10mgs and worked my way up to 40mgs over a month and a half. How long did you try taking the Amitriptyline? and at what dosage?
I understand why you stopped taking it. The fatigue is a lot to handle but as you get used to the med that goes away. I feel completely normal now. When I started taking it I would take it in the evening, pass out by 8pm and wake up feeling hung over. Through the day I just felt very blurry and lacked energy big time. Now I take it around 6pm (once I am settled at home for the night), am asleep by 10pm, have an amazing sleep and feel pretty good when I wake up.
This medication really takes some time to start working, about four or five weeks. It is commonly used for this type of nerve pain. There are other medications to try such as Nortriptyline and Lyrica.
You are not alone in the pain you are feeling. There is a serious lack of information amongst the medical and dental communities regarding neuropathic pain and trigeminal neuralgia.
Any other questions you have feel free to ask.
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Hi thanks. The consultant said it wasnt TN as the pain was constant, wasnt worse in the morning, was only at one location. The consultant prescribed just 10mg amitryptaline for three months. I did reading up on the internet found out that amytryptaline was 1 of four first line drugs (here in the UK) the other 3 are duloxetine, gabapentin & pregabalin. They all have side effects and help around 30%. Everything i read said that the dose should be titrated to as high a level as possible. Medscape actually suggests that 150mg is a typical dose to go up to.
I spent about 9 days on 10mg, I went to my GP and asked for higher doses. I tried 30mg and felt no effect. I then went straight to 50mg and it zonked me out badly, gong to bed early and feeling drowsy during the day. After about 10 days still on 50mpg I felt absolutely just as bad so i gave up, partly because i thought i was obliged to keep pushing up to as high a dose as possible. Amitryptaline only helps about 30% of people and i thought at a low dose the success rate would be even less.
Another strategy i was trying to do was to get as fit as possible by going to the gym which should help me sleep better and therefore tolerate the pain better during the day even if it remained. The amytryptaline completely undermined that, it made me groggy just couldnt make it to the gym and i felt worse than i did before even with the pain affecting my sleep.
At present im back to trying to get fit again and taking food supplements Benfotiamine and R-Lipoic Acid which do help some people (maybe around 30%) as many helped by amytryptaline. At least they dont have side effects. Other options are cannabis or acupuncture.
A few years ahead, if you can wait that long there may be better drugs for NP on the market.
At some point in a few months if the food supplements and maybe acupuncture dont work i was thinking of trying duloxetine, gabapentin & pregabalin which have different side effects to amytryptaline. But your experience with amytryptaline suggests that even 40mg may have been helpful to me so ill consider trying that as well. Amazingly some patients taking amytryptaline for depression can be given daily doses of 300mg !
My pain level is medium, it isnt that terrible but all the same id like to get rid of it. If i was a superfit musclebound guy (something ill never be) id probably just ignore it as minor. I certainly wouldnt like this pain with me when im old and grey.
Are you going to try stop taking amytryptaline anytime ? Were you tempted to push to go for a higher dose?
Yes incredible ignorance amongst dental profession. Original dentist just threw me out when i suggested nerve damage, I saw an expensive private endodontist as i though root canal treatment was worth trying - afterwards when he didnt work he tried to refer me to someone called a "dental psychologist" !. That rather threw me off the nerve damage scent as I just couldnt believe at the time that a top expert in his field could get it so wrong.