The 'zombie' effect can occur at any dose, even low ones when you first start. It usually subsides after time, if you can hang tough for a bit. But then you will likely increase the dose and go through the same each time. That's why it's important to make note of the PN symptoms and if the med is helping. If so, then wait out the zombie side-effect. Hope this all made sense.

That's too bad about the lip biopsy keeping you from a positive Dx at JH. Mayo, JH and other large institutions are known for not looking outside the box in cases like this. But I'm glad you got a Dx anyway from your new Rheumatologist.

I will add that neuropathy caused by Sjogren's should be treated aggressively (especially in early stages) as Sjogren's can attack the dorsal root ganglia causing ganglionitis/ganglionopathy, which is permanent.

Do you have any autonomic dysfunction with your PN?