[DaveD61]

Hi i am a New member,
Has anyone had any luck with Imipramine for pain relief of periperal neuropathy?
Doctor wants me to try this. I will be starting tonight with one 25mg tablet before bed. if it did not help in two weeks he said to take 50mg and let him know how it works.

Dave

[Grizabella]

I haven't tried it for peripheral neuropathy but it's effective for pain control for other conditions, so it might help if you take it in combination with other medications. I take two different drugs for mine and neither is an antidepressant but I've taken antidepressants for pain control in the past.

[Hope15]

Originally Posted by DaveD61

Hi i am a New member,
Has anyone had any luck with Imipramine for pain relief of periperal neuropathy?
Doctor wants me to try this. I will be starting tonight with one 25mg tablet before bed. if it did not help in two weeks he said to take 50mg and let him know how it works.

Dave

I know many people who have found good relief with Imipramine and the other lower dose older antidepressants. My doctor prescribed Imipramine for me over a year ago for another pain condition, but unfortunately, it caused me to have excessive tachycardia and pvcs. I did however, already suffer from these problems previously, but apparently the drug really made it worse. Keep in mind though that we are all different and like any other drug, not everyone suffers the same side effects. Good luck.

[mrsD]

It is worth a try. However there are downsides to imipramine.

If you are <cough> elderly....you could have a problem with it.
http://www.mentalhealth.com/drug/p30-t03.html

In predisposed and elderly patients, imipramine may, particularly at night, provoke pharmacogenic (delirious) psychoses which disappear without treatment within a few days of withdrawing the drug.

Please read all the warnings on the site I am linking.
At the starting doses of 10mg -25mg it is not such a problem.
Above 25mg a day it may become a problem depending on the person, their age, and cardiac status.

All of the tricyclics are anticholinergic in action. This is why they were replaced by SSRIs. Anticholinergics are hard for elderly patients to handle. When younger, this effect is not present or just very much less. Signs to you will be dry mouth, and blurred vision. Those are the most common effects in the beginning. For males there may be urinary retention.

Tricyclic antidepressants work by increasing serotonin in the brain and do so more slowly than the more modern SSRI types.
This is slower for them, so time is needed to see the effects.

One can try to do this without drugs...by using l-tryptophan and B6 which may help the body synthesize more serotonin that way.

[DaveD61]

Doc added Carbamazepine (brand name is Tegretol)
Started first week 100mg 3x a day , 2nd week 100mg 2x per day plus a 200mg. just starting the third week 200 mg 3x a day. Along with the Imipramine it seems to help. Burning level is down to 1or 2 on a scale of 10. With alot of the time burning is at 0.
going for a EMG test next week.
Dave

[mrsD]

While Tegretol has been used for nerve pain for a LONG time, successfully, it has significant drug interaction risks.

Here is a link to 3 moderately severe ones:
http://www.drugdigest.org/wps/portal/!ut/p/c0/04_SB8K8xLLM9MSSzPy8xBz9CP0os3gXDzcPZz8fI0MLLzNjAy NzMzcfCx8zQ5MQE_1wkA6zeAMcwNFA388jPzdVP1I_yhy3Ocb6 YXn5Rbkg-8oyU8v1Q0CmJiaD3KAfmZyRmpztmVeSWgQRKQZJFpekFuhHZua lpFYAzY7Ea3ZBdl55eUhqkm6goiIAN2XQGw!!/dl2/d1/L0lJZ2ttR0EhL3dQRUJKRXBxQU1vQS9ZSTU0NTAtNUZ3ISEvN1 9ESEZIQ05MMjE4SjYzMDI3NkZMOEw2MTRUMy86b19fXzIz/?drugList=340&cD=101&cD=340&dN=Tegretol+Tablets^To franil+Tablets^&step=check&CheckFDA=1#7_DHFHCNL218 J630276FL8L614T3

I would print them out and take to the doctor for evaluation for you. It might be that the Tegretol is all you need at this time and the Imipramine could be dropped entirely.

edit: oooopppssss for some reason the link to Express Scripts drug checker does not auto link here. You have to highlight the whole thing and copy/paste it into a new browser search window.

I just tried that and it worked. If you fail somehow doing this go to
this link
http://www.drugdigest.org/wps/portal/ddigest
click on check interactions
and put both drugs into the search box and hit enter.
3 interactions will appear.
this is a quote from the first one:

CARBAMAZEPINE (in Tegretol Tablets) may interact with IMIPRAMINE (in Tofranil Tablets)

Carbamazepine and imipramine are both broken down and removed from the body by the liver. Carbamazepine may cause imipramine to be broken down at a faster rate than normal. If this happens, then potentially less imipramine would be available for the body to use and blood levels could become too low. This could make imipramine less effective. On the other hand, imipramine may block the breakdown of carbamazepine by the liver. If this happens, blood levels of carbamazepine could be increased and this could increase the risk of side effects. Side effects that may occur with the use of carbamazepine include drowsiness, dizziness, headaches, and blurred vision. More serious or potentially life-threatening side effects include repeated infections due to a decrease in white blood cells, excessive bleeding due to changes in the blood's ability to clot, a rare type of anemia that comes on suddenly and can be fatal if left untreated, damage to the liver, and a loss of effectiveness in some type of seizure disorders that normally affect children. If carbamazepine and imipramine are used together, your doctor may want to monitor you closely when therapy with either drug is started or stopped. If you are experiencing problems, it may be necessary to adjust the dose of either drug.Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is well-documented and is considered moderate in severity.

The others involve use with grapefruit juice and food interactions.

[Raglet]

I have been on tegretol for 30 years for epilepsy (600mg, which is a small dose for epilepsy) and I take 20mg of imipramine as a migraine preventer.

I find if I take more than 600mg of tegretol the side effects are awful, but many people successfully take much higher doses than i can tolerate. But then again, I think that around 600mg is the usual dose for pain conditions. I am also on epilim for my epilepsy, which makes up for the smaller than usual dose of tegretol.

I have not experienced any problems with interactions between tegretol and imipramine. I have been on the imipramine for about ten years I guess, so it has been a while. I have taken higher doses of imipramine with no problems, but reduced down to 20mg as it seems to work as well for me as the higher doses and is less sedating. The reason I swapped on to imipramine (was on amytriptaline prior) was because it is the least sedating of the tricyclics. I also find that imipramine really helps with my sleep.

My neuropathy started after I had been on tegretol for 20 years, so it is impossible to say whether it has been good/bad or indifferent for my PN as I have always been on it. It did make it difficult to come up with any rx for my neuropathy when it was very painful as I was already on three meds that are often prescribed for PN. I now have numbness and motor loss so my pain management days are long gone, thankfully.

It is easy to monitor drug levels of tegretol - it is a simple blood test. Actually the worst drug I am on in terms of interactions is not tegretol, it's coumadin (warfarin) - now that does interact with everything.

The joys of polypharmacy is managing interactions unfortunately. Knowing about them is the main thing, as avoiding them is just about impossible as the laundry list of medications grow.

good luck with the meds
raglet

[mrsD]

My son used Tofranil as a child for ADHD. After about a year
he developed a photosensitive rash with it. We had to discontinue it.

So sun exposure should be done very carefully if at all, and sunscreen is advised. In the event of a rash, you will have to stop the drug.

[Raglet]

I have been on tegretol for 30 years for epilepsy (600mg, which is a small dose for epilepsy) and I take 20mg of imipramine as a migraine preventer.

I find if I take more than 600mg of tegretol the side effects are awful, but many people successfully take much higher doses than i can tolerate. But then again, I think that around 600mg is the usual dose for pain conditions. I am also on epilim for my epilepsy, which makes up for the smaller than usual dose of tegretol.

I have not experienced any problems with interactions between tegretol and imipramine. I have been on the imipramine for about ten years I guess, so it has been a while. The reason I swapped on to imipramine (was on amytriptaline prior) was because it is the least sedating of the tricyclics. I also find that imipramine really helps with my sleep.

My neuropathy started after I had been on tegretol for 20 years, so it is impossible to say whether it has been good/bad or indifferent for my PN as I have always been on it. It did make it difficult to come up with any rx for my neuropathy when it was very painful as I was already on three meds that are often prescribed for PN. I now have numbness and motor loss so my pain management days are long gone, thankfully.

good luck with the meds
raglet

[DaveD61]

Well since I upped the dose to 200 mg 3x a day the burning returned. So I lowered back to the level I was taking on week two (100mg 2x per day plus a 200mg at bed time) and 50mg of Imipramine also at bed time. The burning level is back to a 1 or a 2.
The EMG showed no large nerve problems will talk to the doc next week after he checks my blood to see how the Tegretol is treating me.
Looks like I will be on these meds for along time. I just hope that I do not have to increase the amounts over time. So far I don't notice any side effects. Just a little swelling in my left ankle after working all day, but I always had a little swelling after working all day. I work on my feet most of the day. I’m 47 so I still need to work for another 10 to 15 years on these feet.
But at least I can live with only small amounts of the burning. It’s a little scary when a doctor says the words "there is no cure"
Dave