I take 60mg of Nortriptyline in a split dose, which really tends to make me feel tired out. When upping my dose, it tended to interrupt my sleep pattern. When starting out, my Neuro had me on 25mg, which had my hands shaking like I had Parkinson's. He then reduced my dose, & over 2 years I have slowly upped it with no further incidence. The Nortrip helps me with numbness & pins and needles, mainly. I also take 50mg of Tramadol, in the AM, which relieves foot pain, the achiness and some more of the numb feeling. On "busier days" I'll take 100 mg. I'm more comfortable & stable on my feet, with the combination.

My pain has increased over the course of 4 years, but I'm 65 and am grateful that I'm doing as well as I am, but My PC Dr says he's had better luck with Cymbalta than Nortriptyline, & that drug kind of scares me. And if you're wondering about the 2 & 4 years, I turned down medication for the 1st 16 months, and then went to my Neuro & tried gabapentin for "another worldly" trip.