Is that even though Neurontin and Lyrica are similar, they must work slightly differently at the cell membrane level.

People who are on Neurontin for a while, the nerves get "used" to that way, and when you introduce the new Lyrica, either it doesn't get "in" the same, perhaps the Neurontin blocks it, or the nerves just have to "learn" to use the Lyrica
slightly differently. In other words an adjustment period occurs.

These drugs are not identical, and the body tends to "get used to things" and readjust etc. It does this with many other types of drugs too.

Thanks for all your input so far. The increase to 450mgs of Lyrica has really helped. I still have most of the feeling in my feet and no problems with my hands yet. I do get burning in my wrists on occasion which may be a sign of things to come for my hands.
I am still a newbie with this wonderful disorder and look forward to the next challenge. (yeah right)

Gerald

to work...that is the way of it all. Give it a month...by then you will know IF or how it is working or not. Transitioning from one med to another is an art, in my book, by docs... Some are subtle - others not? Also each of us react to each med differently... Strange things us humans?

There are times when I would almost KILL for a pain level of a 4 !!!!!! But I make do with what I have... So. keep in mind that some meds work for some folks...others for others. Keep an open mind and be alert to side effects that are good and bad in terms of the meds you are on. Do NOT be afraid to ask questions -test your docs about what all you are experiencing on any med. I've had some that have turned me into a total ZOMBIE! Granted, there are times when being 'zombie-oid' may be preferable to being a semi-functional human being, but I'm not coming up with many?

BTW? Bob? I might do damage to folks to get a 1! Wow, what a thing to aspire to!

Hugs to all - j

I always check at the drugstore,I love the way my girls and one young
man ,run too the phone and insist on talking to the Dr.I agree with J. call
the drugstore..Joan I would give anything to be a 2 today.awww Well
good luck to ya cause burning anything just plain hurts Thank
you I feel a little better,but Bob fell in the driveway and his arm is a mess Hugs to all Sue

Groskilly I agree with your doctor the two do not seem to help in fact after having tried the two together for a week I found that they maybe actually antagonistic. Let me give my view points on this disease peripheral neuropathy. I am a retired physician for many years and I actually retired earlier than planned because of this disorder. Although we feel the pain in the feet the actual disease may actually lie in the brain. The reason I venture that opinion because the sudden episodes of pain are always bilateral. Also because the drugs, gabapentin and lyrica, were really originally developed to control seizures which of course results from firing of cells in the brain. Also many of the side effects are "central" in nature (i.e., in the brain)
Now for treatment. I found that giving a bolus (daily dosage given all at once) seemed to help considerably. There may be a sound biochemical reason for this. By giving a bolus very high blood levels are attained which can then effectively block receptors on the nerve (and brain cells) for a longer period of time. By splitting the daily dosage over 2-3 times a day very high blood levels are never attained since the drug is rapidly cleared from the blood (within 2-4 hours). Now I would recommend this idea only for old veterans like me and then of course only after consultation with your physician. Those of us who have suffered from this disease know that we all search for some satisfatory relief avoiding at all costs using narcotics. Finally I would be amiss if I didn't mention the side effects -- yes dear there are always and always will be side effects to every single medication ever brought to the market. The more dramatic side effects of dizzness, somnolence etc fortunately become less pronounced with time.

In no way shape or form is PN bilateral. If it was it would easily be treated. Ask around and you will find most people suffering more in the left or right foot or leg or side or whatever. It is not at the cellular level at the brain that causes the pain. It is at the lower back region. Spinal cord is the culprit along with damaged nerve cells,even dead nerve cells in the lower back.

I was on Lyrica 400mg after work until the pn "gremlins" started poking me all day long. Then, I didn't work and took it in divided doses during the day. I was given clonazepam to take at bedtime and prn during the day if the lyrica wasn't enough. I was sooooo out of it I couldn't remember! I would get confused during conversations, forget what I was talking about, word recall problems,...but due to the effect lyrica has on me (like smoking really good weed and drinking) and add the clonazepam and I really wasn't aware enough to care. I wore pens around my neck to write on my hand anything I wanted to remember for more than a milisecond. I didn't drive farther than the grocery store for 3 months. I made my UCLA professor of neurology grudgingly give me neurontin as a replacement. I began to like the lyrica so much that I have a friend holding the 400 100mg capsules I have left over. I hope I won't get used to the neurontin and need the lyrica again. It was no life for me.

I was on gaba at 2400 mg/d (4x600 mg doses), then switched to Lyrica at 300 mg/day (2x150 mg doses). I found that Lyrica has a half life that tapers off quickly to the point where it is ineffective well before the next dose. I therefore use one gaba to 'fill in' when I start to get very uncomfortable, and it seems to work.

I asked my pain doc about this and he told me to quit what I was doing (I didn't - sometimes a well informed patient is the best judge in such matters). I think it comes down to how often you mix the meds and what the dosages are.

Before I was taking gaba or Neurontin for many years. Then, as most have discovered, the drug's effectiveness diminished rather quickly, hence the titrating up. However, if you can handle occasionally not using these drugs for 1-3 weeks, much if not most of the durgs' original effectiveness returns. I know this creates a roller coaster but for some it may be well worth it.

Lortab is another example of where getting off of it for a while occasionally will restore the original effectiveness. It will save you from changing to stronger opoids.

Mark

there is a poster Brian on here from time to time who used to titrate down and then back up again on medication for PN when he had become too tolerant of it even at large doses. it worked for him.

How do you wean off so quickly? I assume you need to wean off then wait 1-3 weeks and then ramp back up again?

I was on Gabapentin but could not get past 1500mg a day as it was drying out my throat something God awful.


I am on 600mg lyricia and found that once it hit 300mg I was gettings some positive results that would last a few days. then 400mg. less pain for a week and the pain would come back, 500mg less pain for week, then pain would come back, and then 600mg less pain for a week and pain would come back. Notice a pattern. My Doctor said while you can build up a tolerance to the drug it shouldnt happend that quickly.

My burning pain is up and down so much I can't find a pattern but it seems like the lyrica isnt doing much for it. I should try getting off Lyrica but I am afraid my pain will be worse if I do.