Posted by Larry Hoover on November 29, 2005, at 16:49:23
In reply to Re: Please tell me, posted by ed_uk on November 27, 2005, at 12:55:54
> Hi Lar
>
> >We may try Neurontin again, but a slow titration.
>
> Could be a good idea, gabapentin was certainly excellent for your pain. Get the 100mg capsules and off you go :-)I've got some of those. Thing is, I couldn't find a way to dose that managed the pain, and still let me sleep, let alone the perceptual hallucinations. I'm just one sensitive guy.
> >It seems to be my pain specialist's "special ingredient", though he usually combines it with Neurontin.
>
> That's interesting. I've never really believed that clonazepam was analgesic, even in neuropathic pain. I've always had the impression that it achieved a reputation for being an analgesic solely because it was used as an anticonvulsant. Of course, all the common benzos are anticonvulsants ...and no one's claiming that temazepam is an analgesic!Once you get into polypharmacy, who knows? I honestly noticed nothing, nada, zero, from the clonazepam.
> I wonder whether this combination might help........
>
> Gabapentin (three times a day?)I could only manage twice, before. Like t.i.d. schedule, but skipping the third.
> Temazepam or zopiclone at night
30 mg temazepam didn't overcome the gabapentin.....although it could well be a tolerance issue. I was started at 1200 mg/day.
Zopiclone didn't work. If I woke up during the night, that was it.
> A low dose of nortriptyline in the morning - might not be necessary if you were on gabapentin :-)
I have been amazed to discover just how important the nortriptyline has been in limiting my pain. Unfortunately, it too has profound side effects. I'm taking 25 mg just now, a.m. dose. 50 or 75 work better, but I really dislike this drug.
> A low dose of trimipramine at night
They took me off that. Can't remember when.
> OxyContin every 8 hours or every 12 hours
> Oxycodone IR prnThat seems to be a given, so far.
> Paracetamol 1g four times a day
> An NSAID prnTried Vioxx just lately. Didn't seem to matter. I haven't used acetominophen/paracetamol except with the Percocet.....I'm not on the oxycodone IR any more. Somehow, it just got changed back, and I didn't argue the point.
> A laxative or combination of laxatives for constipation
One of my biggest complaints. Pass the prunes?
> Kind regards
>
> EdI really appreciate the amount of thought you put into this.
Thanks,
Lar
poster:Larry Hoover
thread:581839
URL: http://www.dr-bob.org/babble/social/20051120/msgs/583408.html