Posted by Larry Hoover on June 6, 2005, at 18:13:29
In reply to Re: Neurontin to Topomax » Larry Hoover, posted by ed_uk on June 6, 2005, at 17:47:46
> Desipramime, another norepinephrine reuptake inhibitor, is also sometimes effective for neuropathic pain. It is less likely to cause sedation than nortriptyline. Desipramine is sometimes quite 'activating' - it can cause insomnia. Nortriptyline is much less sedating than trimipramine- which I believe you've taken in the past.
I still take trimipramine, 25 mg QHS. Back on 30 mg temazepam QHS as well, as the Imovane interacted adversely with the Neurontin. Maybe the Imovane caused some of the problems I attributed to Neurontin? It all gets so friggin complicated. What role does the oxycodone play?
> Scott mentioned Cymbalta.
Not available in Canada, yet.
> If you want to try another anticonvulsant, I think Trileptal is worth considering. What do you think??? Depakote is another option - you said your doc suggested it.I dunno what to think about anticonvulsants. I've not had good luck with them so far. I've not looked to them on purpose, ya know?
> >Whoa.... I've got room, there, after all. I'm not even close.
>
> Like morphine, oxycodone does *not* have a maximum dose. Provided that it is titrated *gradually*, tolerance develops to the respiratory depressant effect of the drug, allowing the dose to be increased as required.Maybe that's the answer. The problem is, I don't like the psychoactive effect at all. I know, properly titrated, the psychoactive effect is minimized.....but as the dose escalates, it does get harder to manage, in some respects. I've been using the IR product. Maybe it's time to switch to the XR, or the Contin format.
> RE morphine, doses in excess of 2500mg every four hours have been recorded!!! Obviously, such a high dose would be rapidly fatal to a person who was not tolerant to the respiratory depressant effect of morphine.
Thanks. I grock it. (For any Heinlein fans.)
> >Maybe I need a referral to a pain specialist.
>
> That could be very useful :-)If the queue isn't too lengthy.
> >Or a copy of the manufacturer's recommendations.
>
> Here is the UK data sheet........Ta.
http://emc.medicines.org.uk/emc/industry/default.asp?page=displaydoc.asp&documentid=2579
>
> Kind regards,
> Ed.Thanks, buddy.
Lar
poster:Larry Hoover
thread:508502
URL: http://www.dr-bob.org/babble/20050606/msgs/508715.html