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-   -   Tolerance to Meds....... (https://www.neurotalk.org/peripheral-neuropathy/141045-tolerance-meds.html)

invisable 12-17-2010 02:48 PM

Tolerance to Meds.......
 
As was just pointed out to me the weight gain from Gabapentin can level off.

I was wondering if anyone knows if the potential to build tolerance from it working at a certain dose can also level off, or does tolerance continue to be an issue?

rose_thorn98 12-17-2010 06:44 PM

I'd love to see what people say about this. My Lyrica has to be increased every few days and when I get to the top dose, 600 mg, I'm wondering what I'll do then. My Dr.'s act like I will get to a higher dose where I won't have the tolerance anymore, but I'm becoming less optomisitc about that.

I thankfully just got an appt. with the Chronic Pain Dr. I was referred too. But my appt. is 7 weeks away. But I'm rejoicing I even have the appt. and optomistic she will have some better ideas for my care.

echoes long ago 12-17-2010 11:33 PM

this is why a number of people wind up being treated for pain with three types of medication at the same time. An anti depressant, an anti convulsant and an opiod such as oxycontin or some other type of pain medication for break through pain. they each block pain in a different way.

nide44 12-18-2010 03:57 PM

I developed a tolerance for gabapentin after 6+ years taking it. I was up to 4200mgs/day and it no longer was effective. I switched to Lyrica 450mgs/day for 30 days and then went up to 600mgs/day. I've been at 600 for 3+ yrs, now and it seems to be very effective at that level. Dunno what I'll do if it stops being as effective as it is. I feel fortunate to be able to function quite well using it at that dose.

Dr. Smith 12-20-2010 08:53 AM

Quote:

Originally Posted by invisable (Post 726637)
I was wondering if anyone knows if the potential to build tolerance from it working at a certain dose can also level off, or does tolerance continue to be an issue?

That's going to be different for everyone. Some people do reach a certain level (I've heard some chronic pain patients refer to this as "the sweet spot") and can remain there for years (like nide44). Others may gradually increase.

Some folks (as echoes noted) attain balance with different combinations; others rotate medications as they build/achieve some level of tolerance.

A good question to discuss w/ your prescribing doctor, along with "What if..." scenarios.

Doc

echoes long ago 12-20-2010 04:29 PM

another route that can be taken and was taken by a poster here, Brian, who is a PN success story by the way, was to titrate down when he became tolerant at a high dosage level and then slowly titrate back up. worked for him.

Swmnupstrm 12-20-2010 07:43 PM

600 often? Bid, tid???



600
Quote:

Originally Posted by rose_thorn98 (Post 726701)
I'd love to see what people say about this. My Lyrica has to be increased every few days and when I get to the top dose, 600 mg, I'm wondering what I'll do then. My Dr.'s act like I will get to a higher dose where I won't have the tolerance anymore, but I'm becoming less optomisitc about that.

I thankfully just got an appt. with the Chronic Pain Dr. I was referred too. But my appt. is 7 weeks away. But I'm rejoicing I even have the appt. and optomistic she will have some better ideas for my care.


rose_thorn98 12-20-2010 11:37 PM

Lyrica top dose it 600 mg. per Day.

nide44 12-21-2010 09:45 AM

Some have gone to 900mg/day-but very few docs will Rx that large.
Mostly in trials at that level, but it has been done.

invisable 12-21-2010 10:01 AM

Very Interesting........
 
Quote:

Originally Posted by echoes long ago (Post 727495)
another route that can be taken and was taken by a poster here, Brian, who is a PN success story by the way, was to titrate down when he became tolerant at a high dosage level and then slowly titrate back up. worked for him.

I would never have thought of such an approach. Lots of pain filled days, I'm sure, but very clever idea......Thanks for sharing it!


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