I have an appointment with my neurologist next week and I have a question I was hoping you might be able to help me with. I am currently on Gabapentin and Cymbalta for the pain. This combination has been working fine for a few years, but over the past month or so, the effectiveness seems to be wearing off. Instead of maybe 1-2 bad days a week, it is now more like 4-5. My question is, do you think I am better off asking for new medications or just suggesting that the dosages of the Gabapentin and Cymbalta just be tweaked some? My concern over new medications is getting used to the new side effects. Also, I'm hoping to not add another daily drug to the two I am currently taking. Another question, is it out of line to ask for a pain killer such as vicodin or oxycotin for the extremely painful sessions. Is this something that a neurologist would typically prescribe? Thanks for all your thoughts, I truly appreciate it!

Marty

You could ask, it's your body and pain. If he says no, have you considered a pain management doc? Mine has really helped me.

Hi Marty ~ Being a chronic pain patient myself, I've dealt with situations like this myself. If I were you, I'd just ask for increases in the 2 medications that have been working well. Why change when they have worked so well in the past? You've just gotten used to the present dosage - an increase in dose is called for, that's all.

As far as a pain medication - NEVER ask for a specific drug. That will automatically make them say NO. You have to let THEM decide which is best for you. They don't like it when YOU choose - besides, that's sends them a red flag that you might be a "druggie." They should know better by now, but still - that's what they think. And usually, they would leave the prescribing of pain meds to your GP or your pain doc. Neurologists normally do NOT prescribe pain medications - they don't have time to monitor patients.

Best of luck, and I hope everything works out. Let us know how you come out with your Neuro. God bless. Hugs, Lee

Depends on your current med levels,
as to whether or not increase or change.
I didn't change from Neurontin to Lyrica
until I'd been on Neurontin at 4200mgs/day
for quite a while.

I am on Cymbalta 60mg and Lyrica 75mg. From what I've read on Cymbalta and Lyrica are used for diabetic PNP although I am idopathic. Here's the info on from the prescription guide (good info in the prescription guide):

Peripheral Neuropathic Pain — The recommended dose for Cymbalta is 60 mg administered once daily. There is no evidence that doses higher than 60 mg confer additional significant benefit and the higher dose is clearly less well tolerated.

The maximum recommended dose of LYRICA is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 mL/min. Although LYRICA was also studied at 600 mg/day, there is no evidence that this dose confers additional significant benefit and this dose was less well tolerated.

I'm on less Lyrica because the fact I also take Cymbalta. For me Neurotin did not work at all. Cymbalta worked for awhile and now I'm not sure if it is no longer working or the pain just got a lot worse and I'd be in severe pain without it. The doc added Lyrica and that helped a little but I'm still getting worse. She finally said, "I don't know what to do with you. I don't want to give you anymore medication" I asked my neurologist for a referral to pain management. Because I'm not that far away she referred me to the Johns Hopkins pain treatment center. Took 6 weeks for next available appointment. I go in a little over a week.

Hermes
I have had one Lidocaine Infusion for Ideopathic SFPN and had nearly 4 weeks free of pain, I am due to have another on the 29th Sept and will keep evryone posted on how this one goes, they are lowering the dosage this time so I am apprehensive that it wont work.