I searched the forum and I didn't see much info on this. I'm recently diagnosed, but have had symptoms for a long time. I first tried Gabapentin, but even at the lowest dose I could not tolerate the side effects. Yesterday I started taking Nortriptyline at 10 mg. I'm groggy and have a dry mouth today, but it is tolerable. I have a couple questions for anyone that takes this. Is 10 mg. the average dose to get some relief? How long did it take to start working for you? Did it help with BOTH pain and the tingling/numbness?

Yes, low dose nortriptyline (or amitriptyline) is typically used for PN symptoms. Side effects usually pass in 2-3 weeks.

I am wondering about this drug also, and plan to google it more. I am not clear how it can help with burning/pain, but I do see people say they use it.

10 mg is the average starting dose for pain. If it works well at that level, great; often the dosage is titrated up until an optimum is found.

AFAIK, when prescribed this way, it's taken at bedtime. The grogginess helps pain patients get to sleep. This effect is immediate. For pain relief it takes longer—up to a month.

I've not heard of anything that helps tingling/numbness much, but everyone is different. I think most will gladly settle for less pain. YMMV.

Doc

I did take this when I first started with SFN. It did work for me somewhat. I think my dose was higher. I was also taking neurotin with it so I was too tired all the time. It did not make the numbness and tingling but as Dr. Smith said I was willing to settle for the pain relief!

Here's an article that I've mentioned earlier, recommending the combination of gabapentin and nortriptyline: http://www.thelancet.com/journals/la...081-3/abstract

I too have found that the side effects from nortriptyline decreased over time and that it took a while for the pain-relieving effects to start. In fact, the first few days that I was on the entry dose of 10mg, I thought my PN pain INCREASED. The benefits didn't really begin till I'd ramped up to about 30 mg.

I asked my doctor about this today and she said the weight gain is pretty bad and does not suggest it at this time, but it was up to me. I am already gaining weight on gaba, it makes me so hungry, so I declined it at this time.