[mirandasmom]

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

[Leesa]

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

[zorro1]

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

[glenntaj]

--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.

[zorro1]

Originally Posted by glenntaj

--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?

[Dr. Smith]

Originally Posted by zorrro13

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).

Doc

[Dr. Smith]

Originally Posted by mirandasmom

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

[mirandasmom]

[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

[glenntaj]

--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.)

[stagger]

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.