I have been on tegretol for 30 years for epilepsy (600mg, which is a small dose for epilepsy) and I take 20mg of imipramine as a migraine preventer.

I find if I take more than 600mg of tegretol the side effects are awful, but many people successfully take much higher doses than i can tolerate. But then again, I think that around 600mg is the usual dose for pain conditions. I am also on epilim for my epilepsy, which makes up for the smaller than usual dose of tegretol.

I have not experienced any problems with interactions between tegretol and imipramine. I have been on the imipramine for about ten years I guess, so it has been a while. I have taken higher doses of imipramine with no problems, but reduced down to 20mg as it seems to work as well for me as the higher doses and is less sedating. The reason I swapped on to imipramine (was on amytriptaline prior) was because it is the least sedating of the tricyclics. I also find that imipramine really helps with my sleep.

My neuropathy started after I had been on tegretol for 20 years, so it is impossible to say whether it has been good/bad or indifferent for my PN as I have always been on it. It did make it difficult to come up with any rx for my neuropathy when it was very painful as I was already on three meds that are often prescribed for PN. I now have numbness and motor loss so my pain management days are long gone, thankfully.

It is easy to monitor drug levels of tegretol - it is a simple blood test. Actually the worst drug I am on in terms of interactions is not tegretol, it's coumadin (warfarin) - now that does interact with everything.

The joys of polypharmacy is managing interactions unfortunately. Knowing about them is the main thing, as avoiding them is just about impossible as the laundry list of medications grow.

good luck with the meds
raglet