I want to know what to expect with the meds I am on . i am on Neurontin, 1500mg, and lexapro 10mg, and for breakthrough pain at times, hydrocodone 10mg. ( this is not every day). I have burning nerve pain. today is not a good pain day. I may go up to 1800mg of Nuerontin, but I have only been on it for a month. How long do you give your "main drug" time to work before switching meds?
Are you "pain free" or is the pain just lessened with the drugs and you are able to function with the drugs? I just want to know what my expectations should be? Should I expect to be pain free with the medicinal cocktail or just less pain?

thank you

Jess - I have titrated up to 1200 mgs of gabapentin (neurontin) every 6 hrs. I also take 25 mgs of amytriptylene at bedtime. And tramadal for breakthrough pain. I have had PN since early June and probably got started on these meds about late June. I did not feel immediate relief. It took a few weeks to see improvement in the burning. As you said, you may need to talk to your doc to see about an increase. I surely did not hesitate to call my doc and explain that I was not getting relief. Are you taking any of the supplements that are discussed? I have noticed a great deal of relief from those but please talk to your doc about those as well.

As far as pain free, most morning I have no pain and it increases in the evening and night time. In fact I had no symptoms at all for about a week and told my husband I thought I was getting well. I had a flare up the next day that lasted a week!! But I guess the best answer is that even on the good days/times I can always feel "something" and know that it is there. right now I feel a "stick" in the palm of my hand and my left ankle is burning a bit but it is not uncomfortable, I just know it's there. I put on a lidoderm patch and will get some relief soon.

I may have overlooked this. Have you gotten any tests done to aid in determining what type of neuropathy you have? Are they testing to see if they can determine what has caused the PN?

Thanks Leslie for responding. I have pudendal neuralgia, or pudendal nerve pain that has caused severe burning pain, where I can not sit, and often pain even when i stand. Like you, my pain is lessin the morning, and then increases around 3 or 4. i began Neurontin less than a month ago, and will go up to 1800 on monday, the dr is willing to increase.
Thanks regarding the pain explaination. I also take the meds and at this point don't feel pain free. I always " feel something" that underlying burning, even when I am having a better day. I was just wondering if I will get to the point of being pain free. I am seeing a Pain Management Group at the end of the month, so I hope to talk about medications that will aid in this problem.

Again, thank you and I hope you have better days as well

Is your 1800 a total daily amount or a per dose amount?
Total daily amounts can max up to 3600 or, in my case, 4200mgs/day.
If your 1800 is a daily amount, it is a 'starter dose'.
Wait 2-4 weeks on one level, before upping your dosage.
Do not try other drugs indiscriminately, until you've given any one med a fair chance to discover the proper dosage, or unless you are getting severe bad side effects.
Don't let the stories scare you. We're all different, that's why there are over 75 different meds now Rx'd for PN. You can't try them all, but you've got to give the ones you do try, a fair chance to work.
BTW- Neurontin works best in conjunction with a pain med, as ot is not a pain killer, but a symptom reducer. It is an anti-spasm med that works on the nerve receptors that are mis-firing and your brain interprets with all the symptoms. If used in conjunction with a pain killer, pain levels can be reduced better than if only one med is used.
The two work better than either one, alone.

Thank you for helping, I will be at 1800mg a day on Monday. 3x600mg pills.
I have only been on for less than a month. I want to see how 1800mg does for the burning. I know what you mean about needing another pain med while you ramp up or for breakthrough. I have been taking hydrocodone when I need it for the late afternoon hours. I have several problems, I also have colonic inertia, which means food passes very slowly, and chronic consitipation, so I have to drink more water and take stool softeners more, so the painkillers dont constipate.
It seems like you said, everyone has a "cocktail" that works for them..
I take Neurontin, Bentyl( for muscle spasms), and then something for breakthrough Hydrocodone or ?
I am seeing a pain management spec in 2 weeks, so I will see what will be needed then.

I take no breakthru meds, but I do take a pain killer -
100mg Tramadol (Ultram) 4x day along with my PN meds.
Breakthru meds are usually indicative of improper timing of dosages, IMHO.
If taken at proper dosages, & intervals- during the day, and before bed time,
breakthru meds shouldn't be necessary.

I do know exactly what you mean. I do need something more however, between the hours of 3- 8. That seems like when the pain flares up more. I am not working now, but may have to go back to my job of teaching piano and guitar in January, and sitting is my problem. The other problem is when I have the most pain, are my hours of teaching, so I have some anxiety about that.
I feel like I could use a slow release pain killer that lasts longer, as my current ones hydrocodone 5mg doesn't quite last long enough ( 2 or maybe 3 hours).

take the pain down a couple of notches for many.
The constipation side effect IS common tho and I do believe if you go to the 'search' feature on the top blue bar and key in 'const...' you will find lots of discussion all over about it and what works for some.
In my case, going on various pain meds have always had a side effect or some other price.
This past year I went totally OFF my seizure med and felt absolutely no difference in pain levels either on or off the med. I guess I had acquired a tolerance to the meds but could not 'tolerate' an increased dosage either so it's hard to tell. I do take the Tramadol a couple/few times a week but only to ensure that I can get around without hitting the pain or function brick walls. I personally have found that I must take it in advance or anticipation of problems. Taking it after does very little, unfortunately.
Each of us is very different in this aspect....that of medication effectiveness / tolerance / and side effects. Only you can articulate your concerns about it all to your doctors - you must read the complete 'prescribing information' for each medication you take...and do NOT TRUST those medication cross effect web sites at all! Some things are very very subtle and only come to light much later [and, are usually VERY underplayed]! I learned this all the hard way. I hope you don't have some bad residuals that I have as a result. But then, I take several meds for many diverse issues.
I do hope this helps. We survive, tho get grumpy at times, but we SURVIVE! Diet and supplements and exercise in careful doses all can help us get into a situation where we can heal, but nerves grow very slowly! And we have millions of miles of nerves that can be damaged....patience and hope are the best things to get thru it all. Even tho it may not seem so at times?
's - j

is a better choice for you, Jess.

It comes in a long acting, and also works centrally for
Fibro type issues. And your issues are medically classed with Fibro so far.

There would be less constipation (less irritation in the pudendal region) as well.

Thank you MrsD for your thoughts and advice. What is tramadol? I will look into it. I will be seeing a Pain Management specialist at the end of the month as well as my Neuro dr. I hope to have more relief.