I thought this would be more helpful separate from the Neurontin thread...
I had surgery on 17 May 04 to remove part of the severly damaged lateral plantar nerve in my right foot. Since then, I have experienced shooting pains, which have been treated by my orthopaedic surgeon with a number of drugs. I didn't like Elavil or Zoloft, and Vicodin only took the edge off. I experienced terrible side effects with the Elavil and Zoloft, so when Neurontin was prescribed a few days before my family vacation, I didn't start it right away because I didn't want to feel crappy on vacation! Finally, my physical therapist convinced me to start it, at least during therapy so we can get further... I started last week, at 100 mg twice daily for 7 days. Yesterday night, I upped my dose to 200 mg twice daily for 7 days. Next week, I will increase to 300 mg twice daily, and at the fourth week, I will reach my maintenance dose of 300 mg 3 times a day. My pharmacist tells me that my maintenance dose is a median dose; some take more, some take less.
I followed his instructions, and started the first dose at night... that helps a lot, especially if you're worried about side effects, like I was. I took it when I was exhausted, and it helps me fall asleep quickly. I do feel pretty tired throughout the day though, and I'm wondering if this effect lasts throughout the day for those of you taking Neurontin. I'll sleep 8-10 hours, and am still tired when I wake up! If this is because of Neurontin, will it get better as I get up to my maintenance dose and my body gets used to it? I don't think I'm more tired than when I was taking 100 mg doses, though. My OS told me that this is the number one complaint with Neurontin.
I'm just wondering if this is something I'll adjust to or will still happen... at this point, I am going to continue taking the Neurontin. It's only making me sleepy, unlike the Zoloft and Elavil, which was keeping me jittery, shaky, and on edge. I'm worried about when I go back to school though... that means a lot more driving, and having to be super alert in classes.
Also, a question for down the road--the prescribing information says that if taken for seizures, you should gradually step down when stopping Neurontin. Is this true for those of us that take it for pain? And one more question--does anyone take Neurontin with prescription pain meds? I know it's okay to take Neurontin and Vicodin, but since I'm so sleepy, I've been avoiding the Vicodin, even though PT is killing me. Will the mix make me even more drowsy than I already am?
Thanks in advance for the help... these boards have been sooo helpful!
I think you will find that the sleepy/tired feeling from the neurontin will modify after you reach a dose that keeps you comfortable (whatever that might be) and take it for a while. I can understand your feelings about driving and school while feeling "sleepy". Sometimes the fact that we can be more mobile when we aren't in so much pain helps the "tiredness". Try to stay as active physically as you can. Activity is something that "revs up" our systems and keeps us going. Diet is helpful, too. Caffeine doesn't do much for me, but some folks find that a soda or cup of coffee helps perk them up. A good balanced diet with appropriate portions is helpful. Avoid things that you know are going to make you slow down.
Actually, I would be more afraid of driving after taking Vicodin than the Neurontin. That's just me, though. Have you tried taking ibuprofen before your PT? Sometimes a simple anti-inflammatory like that can help. Keep us posted!
Sending good thoughts your way!
Karyn: My experience with Neurontin is that it is great for nerve pain. I started on it 4 1/2 months ago for a pinched nerve in my neck due to bone spurs & herniated disks. I started at 300 mg at night for a week and then to 300 mg twice a day. I did experience, especially as it built up in my system, a deep sense of fatigue. I talked with my doctor last week and she told me to go back to only the night dosage and see if that controls the pain and also decreases the fatigue. The fatigue is definitely much better after only a week at the lesser dose. The pain is also manageable at the lower dose. Not completely gone, but bearable. She had also said that I could take both doses at night if the pain was not OK. I take it from that, that only those with seizures have to be concerned with taking their doses under very controlled circumstances.
Also, I was prescribed Vicodin too at the very beginning when the pain was so horrendous. Vicodin & Neurontin did not mix well together for me. When I took them together, I had horrible nightmares. If I would separate the doses by as little as 4 hours, then I would be OK. But I did not take the Vicodin for longer than a week and a half. I did not like the way it made me feel. Other than the fatigue, I think Neurontin is great. I wouldn't hesitate to up the dosage again if the pain again became worse.
ive been on neurotin 300 mg 3 times a day find i can only take it at night because it makes me too sleepy this has not changed since i started it i cnnot afford to be sleeping all day long so i wait till the nigght time shower and then take it
To live my life to its fullest and to put all my trust in God.
Thanks for all the responses, all... they've been really helpful. I agree with all of you in some respects, but I think we often (at least, I know I do!) forget what Penny says... when the pain becomes managed, some of the fatigue might go away. It's just so frustrating... still needing crutches to get around, having to depend on other people, watching my brother take *my* car... and *still* being in pain! When you dwell on that, and the fact that the stuff that helps you feel better makes you exhausted, you do get down! I quickly threw out Elavil and Zoloft when my OS prescribed them, so I'm committed to trying the Neurontin for at least the rest of the summer. I was at my lowest point with this injury when I started the Elavil, and I'm thinking that maybe I didn't give it enough of a chance, so it's something down the road to try if the Neurontin still makes me drowsy.
I will also ask my doc about what Hatcher mentioned with taking all the doses at night. I know we feel this deep sense of fatigue all day, but it's definately more heightened an hour or so after taking a dose, so this could help those lows again... although I do know when it's time for the next dose, so I also wonder if this would be counterproductive.
Haven't tried the Vicodin mix yet; I'm scared to! Usually when the pain is bad I try and distract myself or go to bed.
I'm just worried about being on this drug forever. I am very concerned that the OS thinks "let's mask this pain", and I don't want that. I want the problem fixed, and in my case, we can remove another neuroma, so I think once he knows that, I will feel better. The nerve pain was worse at PT today, so we'll see what happens...
I never got over the side effects of neurontin and after being on it for more than a year it did not help the pain, seemed my pain was no worse when I did not take it but the side effects lessened when I quit taking it, my side effects got worse the more I took and I had to keep increasing the dose because each level quit helping the pain after a while. I did not find long term relief from neurontin but I did have long term side effects and am just getting my life back, but still have to deal with the pain. sorry
I have been taking 1200mg/day of Neurontin (300 mg every 6 hours) for about 6 weeks now. I am also taking 10 mg of Percocet every 6 hours and 200 mg of Celebrex twice/day. I really haven't noticed any of the side effects except it takes a while to wake in the a.m. and I sleep like I'm in a coma which is a blessing because prior to the meds I couldn't sleep at all due to the pain. The only other problem is apparently I have been snoring like a chain saw so in order for my wife to get some sleep. I moved into the spare room. My pain is now pretty much under control and after a week or so on this regimen I got used to it and don't fell any dopey'er (sp) than I used to.
Neurontin is not a narcotic drug and I know it is commonly Rx'd with narcotics so I don't think you have to worry to much about a multiplier effect. It is my understanding that Neurontin has a half life of approx. 5 to 6 hours so if you can get relief by just taking it at night, by all means try it. My Dr. has me taking it every 6 hours just for this reason and I find I do not have ups and downs with the pain.
We just got a new pharmacist (well, in about May when I had my surgery) at our pharmacy, and he was wonderful in explaining a lot about Neurontin. He convinced me to stay on the maintenance dose for at least 3 weeks before quitting on the drug, and it's been 2 weeks for me on maintenance and I'm feeling pretty good. I think that I'm a little more active, but I'm also getting used to the Neurontin in my system. He said I'm on a really middle of the road dose, which made me feel better. If I'm laying down soon after I take the Neurontin, I notice I do feel sleepy, so I try to take it when I'm in the middle of something. I'm not a huge drinker, but alcohol seems to exacerbate the effects of the drug... so I don't plan to do much drinking while I'm taking this
In terms of pain, I have more nerve pain as well as muscle pain, etc. I got the okay from my OS to take Vicodin prn with the Neurontin, but a lot of people have found they feel sleepy when mixing the two. Do you find this to be true?
Also, how have you done putting an anti-inflammatory into the mix? I don't like to take a million drugs, but my physical therapist is pushing for me to ask for Bextra. Would you recommend it?
And I do take the first dose of the day at night (300mg 3 times a day). From all I have read, it is better to keep the Neurontin at evenly spaced intervals, so I try my best to do that-- and it seems to help.
What did you do to have the lovely privilige of taking Neurontin? I had some fun surgery on my lateral plantar nerve
Bextra and Neurontin together were just fine with me. I take 800mg of neurontin 4 times a day. Xanax .5mg 4 times a day. 100mg Zoloft 1 time. Tramadol 50mg 3 times a day. Nortriptyline 20mg at night. Bextra 10 mg 3 times a day. I am also on the Duragesic Patch 25 mcg on for 72 hrs.
These are some big drugs and I should be a zombie BUT it is what I need to deal with the neuropathy that I have. I functon normally without drowsiness during the day. It seems when I have to deal with the pain is when the fatigue level goes up. It is exhausting to the body to deal with pain.
Each person is different so it seems to reason each of us will have a different reaction to different medications and/or combinations of medications. You just have to find the cocktail that works for you.
I hope everyone finds what they need to live painfree.
A question in never stupid if you don't know the answer.
I am awaiting fusion surgery on my C spine for bulging discs from C3 to C7 with bone spurs and some other problems at C5, C6 which are pinching off the nerves going to my arms. All of this is from complications of Ankylosing Spondylitis (AS) which is a type of arthritis.
Before surgery my NS wants me to go to a Neuro and have an EMG and a brain MRI (where they will find absolutely nothing, according to my wife). He is being extremely cautious (which I appreciate) before going right in to the surgery. Although this will delay things for a while and is very frustrating, I guess it's for the best.
Fatigue is a normal part of AS so I guess I just don't notice if Neurontin is causing fatigue because it doesn't seem to be any worse. I just want things to get moving because I am tired of the pills and tired of the pain. It seems like almost every day there is new pain. Yesterday I grabbed the side of a TV with my left hand, to move it about an inch and a half, and I got an electric shock pain in my thumb, index and middle fingers. Now, I can't put any pressure on those 3 fingers without getting that same pain.
All the best,
"Broke Down, Busted Up and Outta Gas"