Many people here over the years have used nortriptyline successfully.
If you have the 50mg tramadol...try 1/2 tablet. That works for me when I am having a rare flare. If you only have the ER...well, you can't cut those. I find 1/2 lasts me more than 24 hrs. I must be a slow metabolizer.
I would still try the nortriptyline... there will be some sedation at first, so take it at night. But that goes away quickly. I used a tricyclic for a year (doxepin) for a severe sciatica attack. It worked well, and helped me continue working. I used a low dose only.
The diarrhea from Cymbalta is due to the serotonin overload in the GI tract. Some people cannot tolerate SSRI or SNRI drugs for this reason. The tricyclics are much more gentle.
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All truths are easy to understand once they are discovered; the point is to discover them.-- Galileo Galilei
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Weezie looking at petunias 8.25.2017
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