My mom came to visit last weekend and forced me to go see a Psychiatrist. She still doesn't have a clue. He actually turned out to be an okay guy, though he said he thought I had bipolar disorder because I seemed manically "up" from the nervousness/agitation caused by my TMJ symptoms. I was like, "I wish I was manic, wouldn't I be really happy now then too?"
One good thing that came out of the appointment was a prescription for neurontin. I had wanted to try this when I went to Tufts but they said the "research" didn't prove it did anything for chronic pain. So much for the research, I think it is great and it definitely helps take the edge off and calm me down.
Gabapentin, I believe it was originally used for seizure control. It helps calm the mind and no one says it is too incredibly habit forming or loses its effect like flexeril or valium.
I consider amitriptyline to be the best long term medicine for pain control. However, neurontin wins a close second.
I have heard others here say neurontin is good for this (tmj) type of pain. I take triavil (perphanizine/amitriptyline combo ) which was prescribe by a dr at NYU's tmj pain mgmt clinic - and recently Luvtocamp pointed out that triavil can cause permament tardive dsykinesia (especially for woman) - which is a muscle movement disorder - which seems conflicting as then why would the pain mgmt specialist prescribe it to someone already experiencing muscle spasms, jerking, tics and twitches. In any event be cautious with use of the neurontin and should you notice any adverse reactions or anything out of the norm - even if they don't seem related to your taking the drug or the tmj - then either wean off of it or stop it - depending on the dosage you are taking. Please let me know if you continue to find it helpful going forward.
TL - I'm still trying to figure out exactly what perphenazine (or perphanazine) is. Internet searches don't turn up much but say it used to be used to treat schizophrenia as a general antipsychotic... ? Is it a painkiller? Do you find yourself building up a tolerance (as one study suggested)?
Yes - its an antidepressant - right? the specialist said it works well with tmj b/c the center of the brain that receives pain signals is located right next the mood center the drug actually affects - so by dulling the mood center of the brain , the receptors of the pain center are also affected and therefore pain signals are not perceived to be as "strong" and the body does not over respond to them. Supposedly it lessens the potential for developing a pain cycle or pattern as well where pain sensors start misfiring as a result of being chronically over stimulated - which perpetuates more pain.
I wanted to try the neurontin - one dr was willing to give it to me although others were hesitant - and now that I was informed about the potential of tardive dyskinesia with the triavil (which was not mentioned in the pamphlet the pharmacy gave me) I may ask my dr about it again.
The only thing I found was - not a build up of tolerance of it - but of it becoming addictive - after a few months I noticed I couldn't wait to take it at night (it makes me drowsy so I limited to night use only) - a few nights I found myself pacing the floor waiting for the "magical" hour. Plus it does cause weight gain. I eventually weaned myself off and now I have been going on and off of it every few months which I am sure my dr would not be thrilled to hear I am sure - it supposedly is most effective after several weeks as it builds up in the system.
Perphenazine is a highly potent typical neuroleptic for the treatment of psychotic patients (e.g. patients with schizophrenia) and for patients presenting with manic phases of bipolar disorder.
In low doses it may be used to treat agitated depressive patients (together with an antidepressant). Fixed combinations of perphenazine and the tricyclic antidepressant amitriptyline in different proportions of weight exist (see Etrafon below). Such combinations should never be used indiscriminately. When treating depression, perphenazine should be discontinued as fast as the clinical situation allows. Perphenazine has no intrinsic antidepressive activity.
Perphenazine also has sedating and anxiolytic properties making the drug particularly useful for the treatment of agitated psychotic patients and, in high doses (up to 100 mg per day), for patients with life-threatening (febrile) catatonia, a state in which the patient is extremely agitated, but is not able to express him-/herself. In this situation perphenazine may be used together with electroconvulsive therapy and correction of electrolytes/fluids in the body.
Side effects of Phenothiazines - These drugs have antipsychotic and, often, antiemetic properties, although they may also cause severe side effects such as akathisia, tardive dyskinesia, extrapyramidal symptoms, and the rare but potentially fatal neuroleptic malignant syndrome as well as substantial weight gain.
My neuro always wants me to take neurontin but I decline, it would just mask things, and you need to keep upping the dose usually. I prefere muscle relaxers, advil or if necessary ultran, meds that I can take on my own and still allivate some symptoms when needed. I also have Ms but I feel its my bite, occlusion, neck and cranial that are giving me my problems right now not the ms as much.
PS: I did try neurontin for a couple days and it made me feel drunk, but I imagine if worst comes to worst I would try it again, if I come to the realization that this may never go away.