My Navy buddy, who said he got laid out on the floor, even on a small dose, never did say what his "small" dose was. I just figured that 90 - 100mg pills with upping the dose every other day would run you. When you get to your second dose of 100mg, make sure you've spaced it out in the day. When you get to 4 pills & more, daily, probably work your way around the "route". My Nero started me on 4-100mg daily & that sure wasn't enough. On that first prescription of 120 caps, I moved up to 600mg daily & then 900mg daily, without the desired effect on my "folded sock" behind the toes. I'm at 600x3 daily now & I really could use a 4th dose, and probably 300mg would do it. Half another pill. (600's are scored hard oval pills). I really don't want to give you any personal recommendations if you need to go beyond 300x3, but by that time, jumping 300mg a day shouldn't knock you on your butt, after your body gets used to the stuff. You might get a bit light headed for a short time, but not too bad.

When my son was home last year he had an attack of post-herpetic neuralgia, he had shingles on his face as a child. I know that this is an on-label use for gabapentin, so I gave him one. It worked like a charm, but knocked him out. Evidently much lower dosages than the 600 mg. I gave him would have been better. He is a very tall man, and a heavy drinker, so I was surprised. He also has CMT, but no pain yet.

Gabapentin is made in 100, 300, 400, 600 and 800's. I hope he headed for the couch quick when he felt it coming on. LOL. Seriously, I don't think most Dr's know that many can't just jump into any dosage they think is necessary. My Neuro started me with 4-100mg caps a day, but previously, when I told my GP my symptoms, he wrote me a script for 2-100mg caps a day. He said it would take a couple of months to start working. Knowing what I know now, I probably would have laughed at him. I'm aware the some may get away with a small dose, but I weigh 230#, and either of those dosages wouldn't put a dent in my discomfort.

I am on Gabapentin since October 2011. I started at 300mg 3x/day. I had difficulty adjusting to this dosage. I experienced all sorts of side effects -- light headedness, sleepiness, brain fogginess/memory lapses -- and the worst was the negative thoughts. The negative thoughts have long been gone but I still have all the rest. At one time, I was washing dishes, unknowingly, I dropped it because I fell asleep. I wanted to stop the medication but the pain was the big motivator for me to continue using it. My neuro offered no alternative medicines except an additional Nortriptyline (not as a substitute) but I refused for personal reason.

The 300mg did not work for me. I played around with my dosage trying to find the most minimum dosage that will work. I was concerned of increasing it too early as I realized this is for the long haul. Little by little I increased it to where I am now -- 600mg 3x/day. My neuro said that when you find hte right dosage, you will stay there for a long time (that was a consolation!). Everytime I increase my dosage, the light headedness is more pronounced, but after awhile, my body gets adjusted, but the somnolence and memory lapses still remain.

The Gabapentin, for me, only weans off some of the symptoms like - zapping, electric jolts but not the pain in hte feet and legs. I can tolerate walking but not standing (strange).

Hi Groucho,

I have been on gabapentin for a year now. I initially started last October at 300mg 3x/day and within a month moved up to 4x/day spread evenly throughout the day. (I don't have trouble with pain at night while sleeping.) It works great for me with no side effects, for which I know I am lucky. My pain is exacerbated by too much walking, standing or other stress on my feet. When I am having a flare, I can tell when the doses wear off because I look at the clock and my next dose is usually due within the hour. However, I have also discovered the gabapentin to have a cumulative effect in that it loads up in your system and is more effective. I tried to go off it over the summer and successfully reduced my dosage for awhile, reducing by one pill every two weeks. But, it all caught up with me and after 3 weeks I was in horrible pain, I believe, because my overall system level finally caught up with the lower dosage I was taking daily. My psychiatrist explained to me about the system load and like he said, it took 7-10 days to start feeling better after I went back to 4x/day dosage. (Incidentally, the pharmacist told me it would only take 2-3 days to ramp up.) I will be paying attention to any tolerance build up with this drug, but so far so good. Hope this is helpful for you!

I appreciate everyone's personal experiences. I am presently taking 600mg x3 daily of the gabapentin, and have played with all dosages that these scored pills will allow me, from 900-1800mg daily. My Neuro said to see if I could cut out a half pill daily, when he put me on this dosage, but that's not going to happen. I find that 600mg x3 starts wearing off between doses. I feel I'm really close to "comfort", and I have extra pills, from playing with lower doses. I'm going to try out a 4th dose of a half pill (300mg) in the evening, so I don't have a down time in between the 3x doses.

My Neuro said he would give me either Gabapentin or Nortriptyline or a combination of both, if I felt I needed it. I dislike so many doses with the Gabapentin, but can tell it's working. It's not perfect, but will take what I can get. I really don't want to start over right now, as I live in the Northeast, and snow & the extra activity is just around the corner. I'd rather deal with the devil I know, that experiment right now. I'm strongly considering asking my Neuro to switch me to the Nortriptyline in the Spring, and since there seem to be few that have been on both Gabapentin and Nortriptyline, I will share that experience with you. Pros & cons.

Can someone tell me more about Nortriptyline, please? This is the first I am hearing it being used for nerve pain. I'd like to know the pros and cons, please. My interest was piqued by Mrs. D's comment about it encouraging nerve repair.

Here is the article to copy for your doctor:

http://psychcentral.com/news/2009/06...tors/6761.html

Nortriptyline is the active metabolite of the older drug amitriptyline. So they would both work I would imagine.

http://en.wikipedia.org/wiki/Nortriptyline

Thank you Mrs D!

I thought you might enjoy an update on my Navy buddy with PN that he had develop over the years. About 6 months ago, he stepped on a twig while wearing flip flops and drove it into his foot. He felt no pain & only found out about it after his wife saw the trail of blood. He was really dragging his feet about a med for his pain. (No pun intended) He started Nortriptyline a couple of months ago, since he couldn't tolerate Gabapentin. He previously only took Atenolol for BP, but he's already thinking of asking the Dr to up his dose again from the 20mg daily of the Nortriptyline he's presently on. I told him about a month ago, about the possible benefits of the tricyclics on PN, that mrsD mentioned. I don't think he's a "believer" in meds, and only as a necessity. Here is a quote from his email to me:

"I always have the folded sock feeling. I always have tingling and numbness. Although yesterday i was walking the driveway from house to shop and stepped on a rock (in slippers) and low and behold, I felt pain in my heel! Now mind you the pain in not nice, but I felt it!"