I have idiopathic hereditary sensory neuropathy, pain being the only symptom. I have been taking gabapentin 2400 mg/day and amitriptyline 25 mg/day, at this dose for about 3 years. I am certain that both are helping significantly.

I believe I am having a subtle short-term memory loss and possible loss of concentration, which I would like to eliminate as this doesn't mix well with engineering. Any suggestions on which medication is the more likely cause? I am thinking of reducing one or both and adding Tramadol and/or Aleve (naproxen). Or should I try another tricyclic antidepressant instead of the ami? Any suggestions?

Thanks
Electron

I think both medications are hard on mental functioning.

Amitriptyline in the elderly poses anticholinergic effects on the brain. Depending on your age, that would be something to consider. But your dose is not high, and many others get used to it.

Based on what I have seen on these boards, gabapentin is a serious drug that impairs cognition for most. (I've never used it myself).

Things like Aleve would not affect the brain that you would notice. Other antidepressants may or may not cause side effects.
SSRIs are less sedating than amitriptyline.

I use tramadol, and I could never drive or walk around on that..I reserve it for bedtime. But many can tolerate it well.
You'll just have to try other things if you are highly motivated to change.

Discuss tapering off the gabapentin with your doctor...I'd try that one first. You'll need medical supervision for that. As you taper down, you can see if your mental functions improve.

Hi Electron!
Welcome to the forum!
Sorry you are having difficulties!
Many of the meds used in treating neuropathic pain have the potential for cognitive side-effects. It's really trial and error, as far as finding the most helpful med(s) and the best dose for each person.
I am ultra-sensitive to meds and really struggle terribly in trying to tolerate most of them. Some of them have caused additional neuropathy for me.
I was able to really catch the trends with meds when I had started to keep a simple diary. The diary had also helped me to show the trends to my neurologist(s).
MrsD gives great advice! I would start with one med and slowly taper down or off of it, too. Gabapentin is notorious for causing a slowing in cognitive function.
Hope to see you around!
Take care!
~DejaVu

The memory loss was definitely from the meds, for me.
Topamax made me lose 4 months of my life. No memory retention at all. Could not remember anything short term and quite a percent of long term, too.
Gabapentin/Neurontin has 'Neurontin moments'.
Fuzziness and minor forgetfulness
("Now, where are the keys to the car? - Where did I put that shopping list?").
After about 4-6 weeks, it became manageable, altho I still had post-its all around, as reminders for- things to do, appointments, etc. I also keep a daily appointment book to put notes in, as well. After being on it for over 6 years, you get used to it.
Switching to Lyrica did not affect me negatively at all.

[QUOTE=nide44;673007]The memory loss was definitely from the meds, for me.
Topamax made me lose 4 months of my life. No memory retention at all. Could not remember anything short term and quite a percent of long term, too.
Gabapentin/Neurontin has 'Neurontin moments'.
Fuzziness and minor forgetfulness
("Now, where are the keys to the car? - Where did I put that shopping list?").

*** I used to wonder if my memory deficits were medication-caused; a few weeks ago Newsweek had a "the state of health knowledge" type special edition of the magazine. Lurking therein, was an article with the latest brain information.


*** For those of you of a certain age, the following information may be shocking. Once you read it, you can never "un-read" it (and, even though it involves memory, you can never forget it).


***So, close the thread before reading any further.

*** Apparently, scientists have identified the precise areas of the brain where humans "learn" new things and remember them. Apparently this section of the brain will physically shrink up to 45% over your lifetime.

*** No wonder I cannot learn new stuff so easily.

*** Now granted, the brain is elastic and can apparently figure out "work-arounds" for such losses, but 45%???

Cowboy

what were we talking about again?

Uh...., I forgot..........

Cyclelops was telling us how big her birds are now and that it won't be long before Mere is having us all over for chicken pot pie!

Or...was that a big breakfast? Can't recall, will have to read the invite again!

Hehe--you guys are so funny. Seriously, sometimes I talk that way, wandering away from the original subject...stupid brain fog!

So, MrsD, is Aleve ok to take over time, or does it still have that "only for 2 weeks, then stop using this med" info? I find Aleve helpful, but have always been told you can't use it long term.

Topamax didn't do anything for me. I didn't even lose weight on it, which they said is one of the biggest symptoms, making you feel no hunger. It didn't touch my headaches, which is why that neuro put me on it.

All of the NSAIDs carry the warnings for increased risk of cardiovascular disease. They also block PGE1s that protect the stomach lining (cox-1). So over time one can get erosions, or bleeding, or worse. Of all the ones tested, Aleve (naproxen ) scored lowest on risk of the list. But it still scored something.

I don't take Aleve every day for that reason. Also if you take your EFAs well, you will make your own PGE1s in greater amount and have more protection. It is the people very deficient in EFAs to start with who get the bleeds, I believe.