Since both my knees are shot I decided to get the right one replaced on June 1 of this year. Little did I know that he PN pain in the bottom of my right foot would go through the roof. I also contracted cellulitis the day after I got home from the hospital which I think contributed to the increased pain.

Just prior to the surgery (in march) I visited a new neuro who suggested I add Triliptol to my existing cocktail – 1800mg of Neurontin, random Tramadol, B12, Folic acid, Acetyl l-carnitine, R-lipoic acid, Slow mag, Vit D, Fish oil, Lidoderm patches,Epsom salts for soaking and Hydrocodone for flare ups. My heels had been bothering me quite a bit so I went along with the Triliptal.

Initial dosage was 300mg at breakfast and 300mg at bedtime. After about 6 weeks he titrated up to 600 mg at both times. I began to get some trembling/shaking in my hands so he changed the morning dosage back to 300mg which seemed to help the shaking. Pain in the heels seemed to be slightly better.

Following the surgery and the discovery of the increased PN pain under the foot, new neuro prescribed 25mg of nortriptyline. After 1 week, he titrated up to 75mg at bedtime while still taking the 900mg of Triliptal. Foot pain has decreased somewhat but now the trambling/shaking of my hands has increased. I have also noticed a rash on my forehead. Also, the therapy needed for the knee further aggravates the PN.

At this point I am not sure what to do. My neuro wants me to stop the nortriptyline and go back to my 50mg of Zoloft , continue with the Trileptal and add a Butruns patch!.

I am not sure what is causing the shaking and rash? Could be the Trileptal or the Nortriptyline! But something has helped with the burning feet?

Also, after reading some older posts it looks like Amitriptyline is a better choice for PN?

Any help with the combo of drugs I am taking would be greatly appreciated. Thanks.