How long do you give the pain meds to see their effectiveness?
 

I just began taking Neurontin for burning pain and have been taking it for 10 days titrating slowly. I am only beginning 900mg today and I know it can take 2-4 weeks to build up in your body. Do you give the drug a few weeks at that dose and if it doesnt help call your doctor and ask for the dosage to be raised? When do you know it is time to try another drug or add another drug? I think I am giving this a shot and either add Elavil if i need to , or if this doesnt work try Lyrica. Is there a mechanism in Lyrica that works differently from Neurontin? Thank you in advance for your help. ;)

Don't have the answers you need Jess, but I can give you a moose-size thread bump!

Thank you...from another North Carolinian;)

What kind of pain are you taking it for?
Maybe we can copy your question to the forum that covers your symptoms/condition.

From what i have read in general for chronic pain conditions -
some take a short term pain med {or for break thru pain} along with a long acting/sustained release med.

If your pain isn't managed then a call to the dr is needed, sounds like you need adjustments to your rx right now.

depending on what your pain is from {muscle, nerve, acute injury or ??}, some other modalities might be good to look into also.

If muscle based- Heating pad, Electrical stim {TENS or IF stim}, ultrasound, low level laser, massage, stretching...

If you can give more info it will help us with ideas for you.


PS- I just noticed your other posts:o

But you might call the dr and let him know your pain levels and ask about a short acting med to bridge the time until the Neurontin kicks in..

Jess--
I am on both Neurontin and Elavil....
I take the Elavil for Allodynia and Neurontin both Nerve Pain AND seizures (I also have epilepsy, but was put on Neurontin initially for the nerve pain-- as the nerve pain dosage is much less than the dosage, ironically it has help my seizures better than the pain, lol)

I would give the Neurontin some more time-- for any condition you are using it for (It took me a good while for me to see any results for either/or both conditions).

I am a little confused about your dosing, but, you mentioned you are on 600 mg right now and you've been on it 10 days. How exactly did you titrate ? And, is 600 mg your target dose or are you still in the titrating phase ? When I first started Neurontin, my target dose was 900. I started at 300 mg and increased it by 300 mg per week (some people titrate faster tho) until I reached 900 mg. HOWEVER, even if 600 mg is your target dose, it can take time to see results. Just like most of the CNS meds it takes your body a while to start building up in your blood. For example when I started Elavil (I was on Elavil before I added Neurontin to it) I titrated faster than I did with Neurontin, but it took about 3 weeks at my full dosage before I saw signifigant results. Thankfully, my doctors -- and the research I did, gave me a heads up on it.....

As for whether to ask the doctor to increase it or not is a descion only can decide. However, a lot of doctors will want you to give it a little more time unless you are having major side effects. In figuring what med would be best (least side, best relief ), I stopped Elavil (it was making me very sleepy, groggy, etc) and did trials of Pamelor and Lyrica. I was on Pamelor for about a week and Lyrica not much more--- BUT, it really had nothing to do with pain relief-- both caused severe and intolerable side effects and I wasn't able to get to my target dose. BUT, as in the case with both Elavil & Neurontin, while I had side effects, none were dangerous and i stuck with my target dose for several weeks, even though it didn't initially, signifigantly, relieve the pain I had to give it some time to see if it would help-- which it did, before we'd (my dr and I) raise the dose.

(Btw, Ironically, I had major, dangerous problems with Lyrica, but none of the dangerous side effects with Neurontin--- the complete opposite of what is most people experience (Lyrica, Neurontin's sister drug, is supposed to be the drug with much less side effects compared to Neurontin))

Good Luck and I hope you are able to get some relief soon !
:) L2L

It is nerve based. Pudendal nueralgia.
My pain level is lower in the morning, and i wish I had my students in the morning and ended at 2. My pain increases as the day goes on and it seems to be really noticable and painful around 4 or 5 oclock.
I read that the thearaputic dose for Neurontin is around 1800mg or more, depends on the individual, so i will call my dr on Monday to see if he can in crease my dosage more. I just wondered once i get to the desired or theraputic dose, how long does one stay on the dosage to see its effectiveness? Would I stay on 1800mg for 4 weeks? I also notice that many people take a tricyclcic antidepressant with an anticonvulsant for nerve pain... would I ask for that? I know it is trial and error, it is just hard to have patience when you can't sit and you have burning pain.

Lovetolaugh---
thank you so much for responding. i hope you are doing better with your pain as well. I don't know what my goal dosage is.. it might be 1800. I started out at 300 for a week, went to 600 for 2 days and then my dr upped it to 900 ( just been on it for 3 days). I know i am impatient, but I have the burning at 900mg and really think more is needed.. although I am not the expert. So it has been about 12 days thus far on the meds. I can tolerate it well, so I thought it would behoove me to see about an increase. I heard about Elavil as well relieving some pain... and I know it can make you tired. I really appreciate your response, and have to see how things work. It is hard to not get frustrated. I don't even know how I ended up with this illness, although it may have been from muscle spasms and chronic constipation irritating the nerve.
I am sorry to hear that you had a bad experience with the Lyrica. So you did like the Elavil for nerve pain? What dosage did you take?

thank you

I've also read that some people metabolize the meds faster or slower than the norm- so that might be something to be aware of also.

Jess--
I am still on Elavil (in addition to Neurontin). My current dose is 20 mg but I've been on as low as 10 mg and as high as 30 mg. With the Elavil I did a lot of trial and error to try to find a dosage that helped with the pain, but with the least amount of side effects---ithe goal being quality of life. Side effects wise, it usually makes me sleepy (& depending on the dose I might have other side effects such as grogginess, cognitive problems, etc), but I take it right before bed to minimize that and any other side effects I may have.

As for the Neurontin, when I first started it, my target dose was 900 mg and I stayed at that dose quite a while (or slightly more when I had some new pain). About four months ago my former neuro and my current one have made a lot of changes (my former neuro decreased it, current neuro increased it) and I am currently at 1800 mg. We didn't increase it so much for the nerve pain factor, but rather for the seizure factor (in the beginning no one expected it to help my seizures as I was on a "pain dose" vs an anti seizure dose; but it did help both).

Normally, the dosage is lower for people using it for nerve pain vs seizures; same with Elavil and depression--- a lower dosage for people taking it for pain vs people using it for depression.

I am glad you are tolerating it well--thats a wonderful thing. I have some side effects from it, (but I am also on many other meds for various neuro issues, so....) but just taking things day by day, making adjustments when I need to, working with my doctors, figuring out ways to combat side effects and achieve the best possible quality of life (balancing benefits of the meds and the side effects they bring).

Hanging in there and keep trying-- whether it be a different dose or a different med. I understand how frustrating it can be.

Good Luck and Keep Smiling :) --- L2L

Another point to consider......

If you have the medical coverage or availability of other doctors, be aware a second opinion can help you a lot. I am on my -- hmmmm -- uh ---fourth Neurologist and fifth Urologist and fourth Cardiologist, fourth Pulmonologist and so on.

If you are close to a large city, look for a local magazine that might poll medical professionals as to who they consider the "best" in their profession. Sacramento Magazine sends out questionaires to something like 3000+ medical professionals asking those questions, then they publish it. All of my doctors (now) are in the top group. And my health is REALLY showing it.

U.S. News & World Reports has an annual issue listing the best hospitals in many different categories. It is on the internet as well.

I am not trying to tell you how to lead your life, but just mentioning how I have battled for almost 22 years to insure I am seeing the best doctor FOR ME.

If you are concerned, you might go to your State Gov't website, under "State Medical Board" to see what your rights are. I learned a lot doing that.

I wish you well, you seem so young to be having medical problems (like one of our daughters) ... Don't give up. If you have any questions you don't want to list here, PM me.
Last example: My "allergies" led me to investigate further. I now know I have Vocal Cord Dysfunction, brought on by a bad diagnosis of GERD. More pushing on my part led to a sleep study I did not want, but the sleep study showed I had every bad breathing problem you can think of. I kept pushing and wound up being gone almost 6 weeks to the National Jewish Hospital in Denver, CO in June-July 2007. Their one week of testing lasted about 5 weeks+ before I was released. The allergy problem led them to find a hole in my heart, which they fixed and CCHS. My body is "devolving" (as opposed to progress when we humans evolve). I now fall asleep while people talk to me, but it isn't Narcolepsy. I am still pushing the medical community to figure out what is causing this. CCHS will be fatal one morning. I sleep on a Ventilator, with oxygen now. All because I refused to accept that my problems started with allergies. Don't accept poor performance from the medical community. As I have told many medical professionals: "Are you here to relieve my stress or create it?" Don't give up. Get the right doctor and medications (and vitamins).

Thank you dllfo for your response. I am sorry to hear of all of problems.
I know what you mean about doctors. I agree wholeheartedly. I have an excellent GI doctor, who spends the time to talk and LISTEN, calls me to see I how I am. A great PCP who also listens, explores my ailment further etc.
I was referred to the Neurologist and just saw him once so far. I will be seeing him again in Nov. He listened quite well and was willing to answer all of my questions. I was prescribed Neurontin, and at that visit I knew nothing about the drug. After my research, I could probably now tell you the molecular structure of the drug! I just didn't understand why he had me on 600mg and the next time I was to see him was 6 weeks away!! what was that goin to do. So, I have been working in conjunction with my PCP on upping the dose and I am now at 1800mg. Believe me, I made some mistakes when i was younger and wasn't my own advocate, just basically did what the doctor told me to do. Now I am at the other end of the spectrum where I can be obsessive about looking up drugs and taking notes.
I will see how this appointment in November goes with the Neuro, but if it is not satisfactory, I agree, I will need to see someone else.
Thank you also for the " too young" comment. hehe. I am 40, not so young. :winky: