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Old 02-24-2011, 11:34 PM #1
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Red face How much is too much? neurotin and lyrica

Hi, I've been dealing with foot numbness and pain after a knee replacement surgery for the last 2 months. I had a EMG and it was determined that I had post tibal nerve damage. I have been using neurotin and it was being increased weekly because it wasn't helping enough. I am now on 800mg 3x a day and taking lycric 50mg at bedtime. I am feeling so much better. I still have the numbness and burning but it is not to a degree that I can't bear it most of the time.

I was wondering what kind of side effects I should be looking for with taking this amout of meds or is it not that much at all? I recall the doc saying that it was major dosage amount but I wasn't maxed out yet. What would be maxed out?

It has been a week since they added the lyrica and it was the turning point in making life so much more bearable. Will I reach tolerance with the lyrica and have to have that increased too?

I know, I might be rambling, but thanks for listening and any offers of advise or info will be appreciated.

Thanks Brenda
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Old 02-25-2011, 12:16 AM #2
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Hi ~ You can go higher on Neurontin ~ I'm surprised you haven't had any side effects from it. Most people notice some weight gain, water retention, and feeling a little "loopy" from it. I'm glad you don't. You would by now if you were going to. The Lyrica has quite a few side effects too - if you look at the top of this page, and click on where it says "Drugs" you can look up ALL the drugs you take and it will tell you all about them and the side effects. No, you're not maxed out on Lyrica either.

I'm SO glad that these are working so well for you. I just wish they had taken away all the burning. I take Topamax and that DOES take away ALL THE BURNING and tingling. Every bit of it!! At least it does for me!!! I hated the Neurontin -- I didn't like the weight gain or feeling loopy. Topamax works the same as Neurontin but for me it works better!

Best of luck to you and God bless! Hugs, Lee
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Old 02-25-2011, 12:57 AM #3
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There is a guy on another forum whos doctor has him on 1500mg of lyrica hes also a SCI.

600mg is max for lyrica
4800 for Neurontin (i think)

they were effective for me sort of , or so I thought. Coming down off 300mg Lyrica has actually improved my Pain however I had issues with water retention and swelling so I spent a year in more Pain and paid for the pleasure

great they are working for you, thats the biggest battle

pain relief = sanity
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Old 02-25-2011, 07:18 AM #4
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Default Zorro is pretty much on the mark--

--for the maximums that most doctors will prescribe regarding Neurontin (gabapentin) and Lyrica (pregabalin).

Nevertheless, I know of exceptions, among them people with Central Pain/Thalamic Syndrome (common among MS and stroke patients) who've gone higher--one I know of went to 7200mg Neurontin and was still getting slightly increased pain relief after ramping up to that point and was still functional.

For most people, the effect of these meds has a downward slope after about 2400-3000mg of Neurontin, 350-400mg Lyrica or so, in that increasing dosage after these levels by a set amount has less of a therapeutic effect than it did at lower dosages--for example, more effect is felt in going from 1800 to 2400mg Neurontin than in going from 3600-4200mg. There seems to be a diminishing returns curve in absorption ability for most.

Everyone is an experiment of one, though.
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Old 02-25-2011, 07:37 AM #5
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Quote:
Originally Posted by glenntaj View Post
--for the maximums that most doctors will prescribe regarding Neurontin (gabapentin) and Lyrica (pregabalin).

Nevertheless, I know of exceptions, among them people with Central Pain/Thalamic Syndrome (common among MS and stroke patients) who've gone higher--one I know of went to 7200mg Neurontin and was still getting slightly increased pain relief after ramping up to that point and was still functional.

For most people, the effect of these meds has a downward slope after about 2400-3000mg of Neurontin, 350-400mg Lyrica or so, in that increasing dosage after these levels by a set amount has less of a therapeutic effect than it did at lower dosages--for example, more effect is felt in going from 1800 to 2400mg Neurontin than in going from 3600-4200mg. There seems to be a diminishing returns curve in absorption ability for most.

Everyone is an experiment of one, though.

"For most people, the effect of these meds has a downward slope after about 2400-3000mg of Neurontin, 350-400mg Lyrica or so"

Agree
Glenn can the same pain relief be expected after remaining med free?
lets say I start lyrica again in 6 months. 100mg gave me super pain relief first up. Im thinking my brain may be hardwired to expect it so may not be as effective next time around?
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Old 02-25-2011, 08:24 AM #6
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Originally Posted by zorrro13 View Post
Glenn can the same pain relief be expected after remaining med free?
lets say I start lyrica again in 6 months. 100mg gave me super pain relief first up. Im thinking my brain may be hardwired to expect it so may not be as effective next time around?
I was told the exact opposite by the ortho-cutter who put us on the low "as needed" dose. He said that since we'd been on it at higher dosages previously (and come back down off it), the lower dose [might/would - don't recall the exact] work. Between himself and the both of us, he's batting 3 for 3, but no guarantees. I've also heard people report alternating between gab & Lyr as each reached tolerance, so there may be something to the tolerance dissipating in time (or not).

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Old 02-25-2011, 08:33 AM #7
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Quote:
Originally Posted by mirandasmom View Post
I was wondering what kind of side effects I should be looking for with taking this amout of meds....

....I might be rambling
Side effects can include: incoherent rambling, yadda, yadda, yadda....

(Seriously, though - I did recently hear of someone who got more "talky" on it, but who knows....?)

For the real side efects, see:
http://www.drugs.com/sfx/gabapentin-side-effects.html
http://www.drugs.com/sfx/lyrica-side-effects.html

Doc
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Old 02-25-2011, 09:10 AM #8
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Quote:
Originally Posted by Dr. Smith View Post
I was told the exact opposite by the ortho-cutter who put us on the low "as needed" dose. He said that since we'd been on it at higher dosages previously (and come back down off it), the lower dose [might/would - don't recall the exact] work. Between himself and the both of us, he's batting 3 for 3, but no guarantees. I've also heard people report alternating between gab & Lyr as each reached tolerance, so there may be something to the tolerance dissipating in time (or not).

Doc
yeah makes sense Doc. When i gave up drinking once for a whole month I found the first few when I started again were almost euphoric in initial effect. but tolerance rose quickly after that. The taste was an extra sensation that you wont get from a pill. maybe liquid Lyrica that tastes like beer?........
Nah!

The dose as you need makes a lot of sense when you think about it. One needs to get off the meds first though and that is extremely difficult since the brain sends compounding signals. Is it withdrawals or is it the P/N

In my case it took several attempts to break through.

I also got extremely chatty when peaking / upping dose of Lyrica I went to 450 one week , wow is all i can say
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Old 02-25-2011, 09:25 AM #9
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Neurontin has a very terrible side effect in high doses, in some people. Fecal incontinence! No one wants THAT one!

That would be a strong signal to discontinue IMO.
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Old 02-25-2011, 10:42 AM #10
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Its the opposite for me (constipation) taking Lyrica
(was neurontin) & tramadol.
I have to take fiber supplements (rather than laxatives) 2-3x/day,
or I'm backed up and have cramps. Extra pain I don't need!
This PN is just one grand, old, experience!
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