I hear that. I was getting what seemed like rebound after taking the gabapentin.

Have you tried/considered the R-Lipoic? It's made a believer out of me, and I'd put it more in the "supplements" than "meds" category.

Doc

Bob, I think the Tramadol is countering the Lyrica.

Tramadol is constipating for me, even at the low dose I use.

I could be wrong but I was thinking the OP meant long term issue with taking the med at a high dose for a long time?
When I first started neurontin I thought it really helped and as I increased I felt less so. I am thinking though it may have just been a better time so often I wonder if it is hard to tell if meds are working or not. My pain seems like a rollercoaster and sometimes for no reason.

[QUOTE=Dr. Smith;747845]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....?)

You make me laugh, really. I went out to lunch today with a friend and I had to smile and think of you, when I couldn't seem to shut up and kept rambling and rambling. eventually, I let her talk too.

Brenda

--who've reported that for Lyrica, Neurontin, Topomax, and a whole lot of other anti-seizure drugs, that they worked well early on as the dose was being ramped up, but some degree of tolerance occurred after having been a on a stable dose for some time.

This is not unusual--it happens with many meds, as the body "upregulates" its responses to adjust to the drug action. It's also the reason why quitting meds "cold turkey" is generally not advised--that upregulated body action often results in withdrawal symptoms as the body is forced to "downregulate" too rapidly for easy adjustment.

Some people have said, though, that when they experienced this tolerance, switching to a related med helped, or adding a new med while slowly ramping down the original one helped, and then, after a period of "rest", starting the original med back up at a lower dose gave them a greater effect than the one they had gotten used to. Some people even go on med "holidays" for this effect, though they have to get through the period of reduced med levels and, often, symptom increase for a while.

But hey, we're all experiments of one. (I know I say that a lot, but no two people seem to have the exact same reaction to anything. Except, maybe, cute kittens and puppies.)

Hello,
The only medication that did not require increased dosage was Methadone, I started at 10mg 3times a day, but found 10mg 2 times a day worked the best, this was over a three year period. The only side effect was severe constipation, no buzzes, no brain fog. Its very cheap and has been around a long time.

I think there are some cultures that would consider these a gastronomic specialty .

Mmmmm.... Pass the barbecue sauce!

That's interesting, stagger. Methadone was suggested by one of my docs recently, and I don't feel like I know enough about it to have an informed opinion. I've wondered if I would build up a tolerance to it. Tramadol became pretty much useless to me within a few weeks, so I always figured it would be the same with anything else that is an analgesic. Maybe it's worth trying.

And Dr. Smith, I am apalled! How could you? The very idea of puppies and kitties done in anything but a Bourguignon is unthinkable!

Hi JoanB,
Have your doctor check heart and you should maybe start at 5mg twice a day. In Virginia you have to see a Dr. to get a refill, the VA is not very high on Tramadol usage (was on it with Lyrica) and at max dosage fell a lot and cut off a finger in my wood shop. Quit neurotin when on high dosage 3600 didn't work that well. I'm only taking amitriptyline 12mg at night its great for sleeping, but might go back to 5mg Methadone in am as the pain is in the 4 to 5 range. Thought about dying a lot when on Tramadol-Lyrica and had breathing problems. One does sweat more while taking Methadone. Also take Mythl B-12, R-lipoic acid, L-Carnitine, Benfotiamine, plus other basic vitiams. There is a web site Askapatient.com that patients comment on the meds they take, I suggest this site for those seeking info on medicines. Just type in the name and read the reviews. Methadone is rated very high for pain. Tramadol gets a poor rating. Hope this helps.