I've found the gabapentin and nortriptyline combo to be helpful, and I don't recall it making me more foggy than the gabapentin alone. The foggyness seems to go away after a while for me. At least it did--I tried lyrica for a while and then switched back to gabapentin and this time around I'm feeling more foggyness. Give it a shot. In it's class of drugs (with amatriptyline, etc), it has a lower side-effect profile

I started off at 25mg and was eventually at 100mg. The side-effect I wish I'd been told about was constipation. Wow. We're all friends here, right? Have something like Miralax (polyethyline glycol) on hand and be aware what's going on in that department -- miralax takes a few days to take effect. For a while I was asking every doctor I saw, and my sister the pharmacist, if Miralax was okay for long term use and they said it was. The warning on the label about not using for more than a week without checking with your doctor is so your doc could check you out for more serious problems (like an intestinal blockage). But if there's a reason for needing it, like nortriptyline, then there's no worry.

Everybody's different, maybe this side effect won't be one you get hit with, but FYI.

Bottom like for me, though, is that nortriptyline helped for about a year, year and a half, and then I realized my pain levels were back up and I talked with my doctor and got off of it. Maybe I'll try it again, or one of the similar drugs. Maybe I'm ready to brave amatriptyline. A year with a lower pain level sounds good to me right now. I still have a costco pack of generic miralax, so I'm ready.