I was dx'd with ATN after some dental work that just didn't seem right to me. I didn't have any pain going in, but had plenty of pain coming out, that ended up being permanent. My neuro had me take two MRIs and a MRA. Compressions were never found.

I tried many meds, but they didn't work well and destroyed my stomach. Now, I take a Tricyclic med (tablet form) plus use a specially formulated compounded cream that I rub on my face (right side where the dental work was done). In the cream is Gabapentin, Lidocaine and Capsaicin. This has worked well for a little over a year. Recently, I've had additional breakthrough pain, so we will probably have to increase the dosage or add a fourth medication to the mixture and I see the doc again relatively soon to discuss this.

This med routine has helped me cope physically and psychologically as I feel I have at least a little control of the severe pain.

Right now I have some additional breakthrough pain, so I am considering seeing the acupuncturist for a short while. I saw her for a few months when it first happened and it did help a little.

When you find the right med routine for you, surely you will feel much happier and confident.

I was told that everyone is different but the top combination for ATN is a Tricyclic medication plus Gabapentin, which is also called Neurontin. Others find different meds or combination of meds that work.

It is a difficult diagnosis and seems to require an intelligent and caring doctor plus much due diligence on the patient's part as well.

I tried gabapentin,neurontin,pregabalin and another,all didnt agree with me. I went to docs today as the pain seems to be more frequent,perhaps its good old english weather,it was 27 degrees ,and then suddenly dropped to 19 or 20.I am going to take a herbal combination,doc said it should be ok,so im gonna take 1 st johns wort. I Often put voltarol on my face,and dragon balm,it has that capsaicin in it.I would be interested to know where you get the gabapentin cream from.

I tried many meds, but they didn't work well and destroyed my stomach. Now, I take a Tricyclic med (tablet form) plus use a specially formulated compounded cream that I rub on my face (right side where the dental work was done). In the cream is Gabapentin, Lidocaine and Capsaicin. This has worked well for a little over a year. Recently, I've had additional breakthrough pain, so we will probably have to increase the dosage or add a fourth medication to the mixture and I see the doc again relatively soon to discuss this.

This med routine has helped me cope physically and psychologically as I feel I have at least a little control of the severe pain.

Right now I have some additional breakthrough pain, so I am considering seeing the acupuncturist for a short while. I saw her for a few months when it first happened and it did help a little.

When you find the right med routine for you, surely you will feel much happier and confident.

I was told that everyone is different but the top combination for ATN is a Tricyclic medication plus Gabapentin, which is also called Neurontin. Others find different meds or combination of meds that work.

It is a difficult diagnosis and seems to require an intelligent and caring doctor plus much due diligence on the patient's part as well.[/QUOTE]

The Gabapentin in the cream (along with capcaisin and lidocaine) is a prescription from the doctor that I take to a special pharmacy called a compounding pharmacy. They are getting somewhat common and popular in the US. I do think they are less common in other parts of the world. I had a discussion with another individual from Australia who was in the medical field who had TN. She was familiar with compound medications and compound pharmacies, but could NOT believe that Gabapentin could be compounded into a cream. She and her neurologist had to call all over Australia speaking with various pharmacists, but eventually they were able to make it happen. I don't know how they do it. It involves a base and the actual medicine, but I'm sure it isn't easy.

The really interesting thing for me was that I could not take Gabapentin by mouth, but could rub it as a cream into my face. I was a little nauseas for about three days, but after that, it stopped. When you said it "didn't agree" with you, was it upsetting your stomach? Using it as a cream, reduces the side effects. However, compounding medications into creams is not common everywhere and it can be very expensive.

I too have bigger issues with cold weather and cold winds on my face can make me extremely uncomfortable.

I hope the doctor's appointment went well. Also hope the creams you put on your face helped!!! I use to put capsaicin cream on my face a lot, until I got my prescription cream with capsaicin and the other stuff in it.

Hmmm wonders if i can get it in the UK.May ask the doc about that,i have an appt with pain specialist next month,so may ask. My issues with the pills is i feel like a zombie,all drained out.I drive alot in my job to and from places ,so have to be alert,which tbh im not alert at all times,especially afternoons,but hey ho,i need my job.My doc seems quite fascinated by this,i showed him the MRI,AS well as the dentists response to the MRI ,which conflicted somewhat,so hes quite interested as to what i definatly have.Is it CRPS,or ATN.Wonders if a damaged nerve causes ATN.

The really interesting thing for me was that I could not take Gabapentin by mouth, but could rub it as a cream into my face. I was a little nauseas for about three days, but after that, it stopped. When you said it "didn't agree" with you, was it upsetting your stomach? Using it as a cream, reduces the side effects. However, compounding medications into creams is not common everywhere and it can be very expensive.

I too have bigger issues with cold weather and cold winds on my face can make me extremely uncomfortable.

I hope the doctor's appointment went well. Also hope the creams you put on your face helped!!! I use to put capsaicin cream on my face a lot, until I got my prescription cream with capsaicin and the other stuff in it.[/QUOTE]