Doctor insights on:
Nortriptyline For Neuropathy
A complete nerve transection will leave an area totally numb. The distribution of the numbers depends upon where the nerve was cut. A partial nerve injury may leave the area tingly or incompletely numb. Finally even if the nerve is not cut the swelling and bruising to the tea can affect the nerve as well. Usually we consider sharp penetrating injuries as likely having nerve lacerations when sensation is lost. A hand surgeon can examine the hand and pinpoint the site or extent of nerve injury and recommend ...Read more
Neuropathy: They are different. Often they can used in combination. I tend to reserve Amitriptyline for use at night for patients who are also having trouble with insomnia. Gabapentin must be titrated to minimize side effects. The most common problem i see is practitioners titrating to a high enough dose to get a reduction in pain. ...Read more
Niether: Niether have strong evidence supporting their use in anxiety. Neurontin's effects on anxiety are thought to be mediated through its effects on the inhibitory neurotransmitter gaba (similar to, but much more subtly than, benzodiazepines). Lamictal is still being investigated for use in anxiety because it can reduce activity of the excitatory neurotransmitter glutamine. ...Read more
It depends: Every fibromyalgia patient is different and a medicine that works for one patient may not work for another. Cyclobenzaprine (flexeril) is a muscle relaxant that belongs to a class of drugs called the tricyclic antidepressants. Lyrica (pregabalin) is a seizure medicine that is also used to treat pain. While many patients benefit from these medicines, others don't tolerate them. You will have to try. ...Read moreSee 1 more doctor answer
I'm not responding to any meds given for sudden onset peripheral neuropathy of the feet. Can dilaten help.Tried gabapenten lyrica (pregabalin) Elavil cymbalta.
Dilantin: The use of Dilantin is unlikely to reduce the pain of peripheral neuropathy if the other anti-convulsant medications have failed to relieve the pain. Alternative treatments such as transcutaneous electrical nerve stimulation, capsaicin cream, Lidocaine patches and identifying and treating the cause of the neuropathy may help you feel better. ...Read moreSee 1 more doctor answer
Baclofen good medication for spasticity due to peripheral neuropathy? Cyclobenzaprine better choice??
Please describe efficacy difference in Lyrica (pregabalin) vs Gabapentin for migraine/headache of a very nervey type?
It depends: Efficacy refers to proven and clear superiority based on objective evidence. Hence, I doubt you'll find an answer for your efficacy question. Even the effectiveness question is problematic and in my clinical experience all I can say is that gabapentin is possibly preferable when nerve pain is associated with less rather than more anxiety. ...Read moreSee 1 more doctor answer
Fibromyalgia: Dear butterfly78765, nortriptyline is an older tricyclic antidepressants which has cardiac and anticholinergic side effects. It would be best to optimize one medication, either one would be fine, Cymbalta (duloxetine) would be preferred due to lesser side effects, major one being 10% patients can get high blood pressure. The answer is purely for educational purposes, please contact your md. ...Read moreSee 1 more doctor answer
Which tcas is more potent for sciatica pain relief, amitriptyline(or nortriptyline), imipramine(or desipramine)?
TCA: Tca are classic for neuropathic pain - sciatica for example. Any of the ones u mentioned may be quite eefective - and cheap. They are not without side effects - dry mouth, constipation, sedation. Any of the ones u mentioned can be effective. I personally like amytryptilline - 10mg at night - as mentioned all will work. Additionally other meds such as lyrica, (pregabalin) neurontin, Cymbalta are options. ...Read moreSee 1 more doctor answer
Classified as a tricyclic antidepressant, and considered of modest benefit these days due to significant anti-cholinergic side effects (drowsiness, dizziness, dryness of mouth, blurring, and perhaps effect on bladder). Confusion may occur in older folks. Had some value in migraine prevention at one point. Used rarely these days as ...Read more