Antidepression vs. Anticonvulsants

[southerngirl]

I am back in full force pain, with the creppy crawling feeling, my face in hot, my atn is back, it was really great for awhile but I knew I was in remission and now the monster is back. My question is what should I ask my doctor for? I was on elival that was the first med that really helped me, but I hated the dreams it brought along with it. Is there anything else out there that is better with less side effects. And what does Tracy mean by ACD's, does the klonopin really help? I know Ultram will not even dent my pain as I have been taking perocet and that's not working. Hopefully will see my md tomorrow and try and find a pain doc here that knows what he's doing.
thanks for all your thoughts and prayers
Catherine

[Mom2boys]

Hi Catherine,

As we all know TN is so difficult to treat during flare up and I believe ATN is even being harder to treat. I was on 5 different types of Anticonvulsants with some relief but it wasn’t until I went off them completely and started taking Nortriptyline (only 50 mg daily) that I started to see a significant reduction in pain. My ATN is on the right side and is more of a constant, deep boring pain, not stabbing but painful all the same. The end of my nose, lip, ear, eye, and cheek, top of my head, neck so on and so forth would be deep bone crippling pain. Trileptal, tegretol, lyrica all made my symptoms almost worse. I had loads of pins and needles associated when I was on the anticonvulsants. My specialist took my off of them and Im soooooooooooooooooooo glad I finally listened to him. I also go to acupuncture twice a week and deep massage two times a week. I am loads better. I’ve been Dx going on 5 years. I have my moments where I wonder “is it really the Rx or am I in remission?” you know the drill. All I know is my pain is at a far better management level and I am not on the the "stupid pills". All I know is Im happy to have a reduction in pain, its going on 4 months since I change medications (the longest stretch in years). Ill take it, enjoy it and gather strength.....

[EE03]

Catherine, I'm sorry your in so much pain. ACD's are anticonvulsants, also referred to as AED's or antiepileptic drugs. Klonopin is a weird drug on its own, considered a tranquilizer that has anti-seizure properties. Studies indicate that approximately 2/3 of the people who have used it for TN found it effective but it is one of the more sedating face-pain drugs. As for Ultram, I'm taking the extended release form and I'm at 200mg's a day. It didn't help a lot at first, but after continued use, it really has helped me. I think its also one of those drugs that has to build up in the system to reach maximum benefit, or at least in my case thats how it seems. It doesn't cover 100% of the pain, but its a trade off I'm willing to live with. When the pain gets too bad, I add klonopin. The typical ACD's and antidepressants used for face pain have yeilded a ton of bad side effects for me and this is where I'm at and where I hope to stay. Although I still feel some of the pain, its not like it was before I started using meds and it did take about a month for me to notice a difference in the pain. And, it appears to work on chronic pain and not immediate pain. I'm probably not explaining this clearly, but if you stub your toe real bad, you still feel it.

I hope you get in to see your doc really soon and get this under control before the holiday. Hugs, Ellena

[allih]

I use Neurontin for ATN. I also get that crawly feeling plus pins & needles and aches throughout all three branches. Neurontin seems to be the drug of choice for ATN as the pain is different than the stabbing shocks of regular TN. I started at 600mgs 3 times a day and am now on 800mgs 4 times a day. I'm almost to the point of seeking something different if this dosage wears through.

Neurtonin is a short acting ACD so needs to be taken about every 4 hours as it only lasts about that long for TN. I'm also on Effexor XR, an anti-depressant, for depression, fibromyalgia and chronic migraines. I haven't noticed any decrease in the ATN pain but that may just mean Effexor isn't one that works well on that type of pain reduction.

It may be that you have to try a few different things before you find what works best for you. I WISH that there was a magic pill we could take that would definitely work on TN, but that seems to be a pipe dream.

As with all pain disorders, trial and error seems to be the only way to go.

Good luck
Alli

[TP56]

Catherine, I'm having good results on a combination of Lexapro and Klonopin. I originally started taking them both for different reasons, anxiety/panic attacks and depression, but the Klonopin especially does seem to help..

A magic pill for all pain disorders sure would be nice wouldn't it...

The Neurologist wanted to put me on Nortriptyline, but I wasn't ready to take that route yet. Will see when and if...

Good luck to you in finding something that will help ease your pain as well.

I wish you well.

Regrads,
Tamara

[EE03]

Catherine,

I checked back through my notes and wanted to post this to you as I messed up my previous response. When I first started taking Ultram, I was taking 50mg twice a day, and that was what I was referencing when I indicated that it didn't help right away. But, when I started on the extended release at 200mgs, I got immediate relief from the pain I was experiencing at that time. I do get some breakthrough and I assume the breakthrough is the worst of the TN pains, and thats when I supplement with klonopin. I hope your doing better. Please post when you can.

Hugs, Ellena

[southerngirl]

My friends, that you for all the info, I printed it and took it with me to my doc. We decided to try elival(nortripline) since I had been on it before and had some relief. He wants to try one pill at a time so if this doesn't take all the pain away we will add another. I took 2 last night and allthough I am very droggy today the pain has been cut by 65% allready. That gives me hope, it makes me sad because I was in remission for over a yr, and I really thought it was gone but with this illness you can never say never. I'm hoping the stress and cold weather is at fault, and when spring comes my pain will get better. Until then I will continue with the pills.
Again I love you all for your concern and your posts they really helped me alot.
Catherine

[grace.mackay]

Catherine,

While I wasn't in a position to contribute to this discussion, I'm glad your pain has reduced, and with a bit of luck it will be under control again now for a long time, but I agree, the love, support,advice and information offered here is incredible, and it helps no end, so I wish you all the best and hope you have a fabulous christmas and a pain free new year.

Grace.***

[EE03]

Catherine,

Thats wonderful news. I hope you get it completely knocked back by the holiday. Best wishes for a pain-free Christmas.

Hugs, Ellena

[allih]

That's great! Christmas will be much more enjoyable now that you are getting some relief.

Merry Christmas!
Alli

[Mom2boys]

That is great! Like I posted prior, I have had great results with Nortrptyline. I have everything crossed that you too will have the same. Keep us posted.