Just wanted to relate a recent experience. After an increase in P.N symptoms I found that 300mg Lyrica had started to lose its effect. My neuro a few years back prescribed me 25mg of nortriptyline and 300 mg of Lyrica. The combo back then was way to strong so I gave up the nortriptyline

However 3 nights ago I added just 10mg of nortriptyline to my 300mg lyrica.
The result was astonishing. Total pain relief and I had all the zapping deep burn etc. Now the draw back is it made me totally loopy literally zombied.

I stopped it last night but maintained the lyrica and the burning is already returned.

The loopiness i believe was due to the combo being to strong, so i am now titrating down lyrica ( since its losing its effect and dont want to increase dose) and am switching to nortriptyline 20mg and 75 lyrica daily.

Its interesting to note that Dr wise young recommends elavil (same family as nortriptyline) as the first choice for neuro pain. He then goes on to say that neurontin is better tolerated but needs a lot of increased dosage.

Just wondering is there anyone else out there using nortriptyline and what are your experiences with it

I just added 20 mg. (at bedtime) of nortriptyline to my 1200 mg. of Gabapentin, I was having a lot of "breakthrough" zaps and sensations (a continual reminder that something is wrong with me.) For me, it is more mental pain than physical when I feel these sensations. It wiped out about 90% of the breakthrus!

I have the feeling (no pun intended) that the nortriptyline is not as likely to have tolerance issues as the Lyrica & Gab. ......not sure if this is correct, but for I feel more comfortable adding it than to keep going up on Gab. As a matter of fact, maybe I'll try going down a little on my Gab. as you are doing with your Lyrica.

Thanks for sharing your experience.

Invisible, well there you go a small world isnt it. I thought I was imagining the pain releif for a while there lol (i wish)
Thanks for replying amazing what can be gained from this excellent forum.
I find Lyrica easier to tolerate but thinking back it was a night mare to get used to side effects so I imagine the side effects of nortriptyline will diminish with time. Also knocks you out at bed time since its prescribed low dose (20 mg) for insomnia and head ache.

I think its best to have a cocktail all doing different stuff for max pain relief. Like you Im not comfortable going higher on Lyrica alone.

As I mentioned on another site dr young suggests just low dose (25mg) and no combo of anything. I was really getting worried about later down the track if lyrica stopped working.

Still blown away by the pain relief from such a small dose and gives me a better out look for the future now

With time the drowsiness factor from the TCAs goes away.(2 to 3 weeks)

Nortriptyline is less sedating than Elavil typically. However, Elavil (amitriptyline) has new studies showing it is the only TCA that helps with peripheral nerve repair. So therefore, the Elavil works in two places...the other TCAs like nortriptyline only working centrally in the brain.

I have had excellent results with Elavil. I couldn't tolerate Neurontin because of significant mood changes. I also found with the Neurontin that I would have a "honeymoon period" with great symptom relief for a few day after each dose increase, and then my symptoms would gradually return. I started on Elavil in August at 20 mg in the PM. After a few days I added 10 mg in the AM. I initially split the 10mg taking 5mg in the AM and 5 mg mid-day which seemed to decrease the sedative effects that I was experiencing. By September I settled into a dose of 10mg AM, 20 mg pm with excellent symptom relief and significantly improved sleep. The only long-lasting side effect that I've experienced is a bit of tendency towards constipation. About 1 month ago I increased my PM dose to 30 mg because of the return of some sleep difficulties and have had an excellent response. The best news, which I haven't shared with anyone yet, knowing that, in all likelihood, it probably won't last, is that my body-wide symptoms are at the lowest level ever. I'll just have to enjoy it as long as it lasts

I used to take Amitriptyline for bladder pain years ago and it worked great. I was on it for 7 years and never had to increase the dose (50 mg at night). It did have horrible side effects at first. I started it at 5 mg. and increased upt to 50 mg. over a period of several months, which helped alot. The side effects do go away, and for me even the consitipation did too.

Thanks, I may see if I can wean down on the Neurontin and add a little more of the Elavil (I just realized that is what I have, not the nort_ _ _ _ one, but the one that begins with an "A", too lazy to get up for correct spelling. Yes it does make one sleep like a baby. I am a little constipated, but a few tabs of Slow Mag (Magnesium) helps with that (gently.) Magnesium won't hurt you at a low dose, I take 164mg. a day, it also has Calcium in it.

thanks for that, i have heard about nerve repair studies recently regarding amitriptyline. It may be beneficial to switch. A pain killer that works and is good for you?

Amitriptylene. Ive been taking it for several years now. At first it was a little strong as far as being able to stay awake in the morning after taking it the night before. Now it doesnt so much help me to get to sleep but it helps me to stay asleep. Very vivid dreams with it.

I was Rx'd it about 12 yrs ago before I started Gabapentin.
It caused urinary hesitancy, so I stopped it and went on to other trials