Welcome, Lauren! I'm afraid that I don't have any advice to offer as I'm in a similar situation. I'm new to this with mild pain, scared of the progressive nature of this condition, and tired/foggy on my first med, gabapentin.
I can tell you that I titrated up at my own pace when I realized how tired this drug was making me. I went very, very slowly--much slower than my neuro recommended. I also stopped the titration when the pain dissipated, which was 100mg less than recommended. At my follow-up visit I told my doctor how I was doing things and he totally agreed with me. I have kids. I HAVE to be able to function.
The med-induced fatigue does seem to be improving. I think I started treatment about 6 weeks ago.
What drug(s) are you on, and what is your dosage?
Bluemom