Neurontin/Lyrica/Baclofen??

[jtroy]

Ok all...sorry about the constant topic I'm in love with. I'm curious to hear from anyone who perhaps was on Neurontin and then added Lyrica to the mix...perhaps being able to reduce the Neurontin. Also, those who started with Lyrica and then added Neurontin are also people I'd like to hear from.

I tried Neurontin in the past but I was on so many other meds...so so many that I titrated up for a while but when there was no benefit after the proverbial month I used to give meds I quit taking it because I didn't want to sedate myself even more (this was back in my narcolepsy days where I was untreated and we just thought it all was med sedation.)

Anyway...I've done alot of research as well as conversations with my doc about the mode of action of Lyrica, Neurontin, and Baclofen. Dr. Steve indicated that he thought my pain was highly neuropathic and this is something I've also been thinking...especially when I started taking Lyrica at dosages beyond the 600mg/day and getting increased benefit from it.

My doc is willing to continue increasing my Lyrica but I'm very reluctant to increase my dosage (1200mg/day) due to the idea that I could maybe either top out and not have the ability to increase later, or down/up regulate receptor mechanisms that might make other meds less effective or ruin a potential for great benefit from a med that comes out in the future.

My thought is that maybe adding either Neurontin or Baclofen to the mix would help. Neurontin would be similar to adding more Lyrica...maybe could allow me to reduce the Lyrica without losing the benefits. Baclofen has a similar mode of action but its end result is achieved in a different capacity...it would be less predictable for positive results than Neurontin.

Anyway...anyone with experience would greatly help me. If not, any ideas are always welcome...I'm hoping one day I will be able to function at a higher capacity, go back to practice, and be able to do so opioid free. I'm not asking the Lord to do away with this pain if it isn't his will, and seems not to be...but being able to live with it and practice taking meds that wouldn't make clients worry about me and their animals would be my miracle and make life completely different. Thanks again all...looking forward to your responses.

Regards,

T. Jones, DVM

[Kandra]

I emailed you about this...as it's not my own personal experience I didn't want to relate it here :)

[slipnslide]

T. Jones,

Let me start by saying that I have absolutely no experience with taking two of the same type of drugs. However, I can pass along to you what I was told by my PM. :)

I was having trouble with the side effects of Neurontin, so my PM put me on Keppra. He said it's an "old drug, and been around for years" and "people tend to tolerate it better, and it has less side effects". He said something about "calcium" and it "attaches to the receptors in the brain and blocks the pain signals"....or something to that effect:o;). Perhaps it might be something to look into to boost the Lyrica:confused:.

Sorry if I'm no help, it's just a thought.;)

Kim

[Peter B]

Doc,
As always, I wish you the best and hope you can return to doing what you're so passionate about. My only question is; Why would your patients know about any meds you might be taking? I'm upfront with anyone that wants to know what and how much I take of anything but I'm not a vet. Actually I don't work at all but if I did I certainly wouldn't be sharing any of my personal info regarding what I take with anyone at work nevermind your clients.

pete

[jtroy]

Hey there Pete:

You know, I guess this working while taking meds thing is more a personal issue than anything. You are correct...clients shouldn't know what you are taking, etc. My problem is that I've lived in this tiny town for so long and everyone knows me....so, if they knew I were still taking opioids for pain I think that my practice would suffer some...maybe not...I don't know.

I can tell you that my pm doc is very po'ed at me over the issue...he continually tells me that if I could work while on the meds then I shouldn't be so concerned about it....also, the veterinary boards are very old-fashioned when it comes to this issue. If they know that there is a vet practicing while on opioids they have no problem calling them in to explain...it shouldn't be something that they concern themselves with but they do...for the most part they are dealing with vets who are diverting and using the meds for reasons other than what they are made for....but then there are the handful who take them truly for pain.

I don't know....maybe I shouldn't be so friggin concerned with it. My pm doc beats this issue into my head and probably is doing so b/c I've told all my docs that I have a goal to be back to work by the end of this year....who knows. Anyway...feel free to email me at: tjandfon@hotmail.com I'd love to discuss it further....I don't know....if you were my client would you feel comfortable with me performing major abdominal surgery on your pooch knowing that I had a fentanyl patch on? I'd be interested to know....thanks...Troy

[Leeaelle]

Hi ~ If you have neuropathy, I sure wouldn't add NEURONTIN! There are too many nasty side effects. I'd add Topamax, which works FAR BETTER and with fewer side effects.

Neurontin makes you gain weight thru water retention; Topamax generally has you lose a few pounds. Neurontin makes you feel 'loopy'; Topamax has NO side effect like that. It seems with Neurontin you have to up the dosage everytime you turn around; I've been on the same dosage of Topamax for 8 years and it STILL works.

I've taken Neurontin before and will NEVER take it again. That stuff is awful. I really like Topamax ~ it works far better for me. Best of luck! Hugs, Lee

[Mark N]

Troy, If I were a client I would only be concerned with the way your performed not worried about the meds you are taking. I am sure there might be a person or two that would have conerns but I would think most of them wouldn't think twice about it as long as your performance wasn't effected.

[Maggie]

I've know professionals who are on prescription drugs, also worked with them. From listening to talk around town, patients generally don't care as long as they don't see visible symptoms, or the person appears to be under the influence of something.

Maggie

[Nana4&cntn]

I have also taken Neurontin, gained weight w/o benefit from the Neurontin. My coctail includes Keppra, Lyrica, Baclofen and robaxin. I have received awesome results with the nerve pain but not much results with the spasms. I have a specific dosing scedule, I am not sure if that matters or not.

As for you practicing while on meds, I don't think it should matter, as others have said as long as there are no visual clues and you feel comfortable. I also have worked with professional who have taken large amounts of opoids. I spend a lot of time working with the court system here and no one has ever suspected me of taking meds.

I hope this helps,
Kathy

[cindybear]

Hi Troy,
You could work on any of my adored pets,,I have been on pain meds for 8 years,,not addicted..2 different things, Now if you said, I have a addiction and I am out of control.....That may be a different , and I would have a different answer..But I know you, and what you suffer from..And I know, what narcotics have done to me..The only side effects that I can tell I have, are constipation ..But when I was tirating my doses.....that was a different story..Anyway, Good luck !! I will be sending you and yours good vibes and a couple of prayers your way..I hope you accomplish your goals..It would make me do the happy dance, To see a chronic painer push pass his pain and be able to go back at doing what are his passions..I wish (hope ) that one day I will be able to have a goal with my passion to go back to nursing..But,,I doubt it,,cause with my last stroke, I had severe short term memory loss..and I can not be a nurse with short term memory..Anyway...I am behind you 100%..You Go...Hugs, Cindy

[anwise67]

I take Lyrica with nortriptyline for the nerve pain and trileptal for the severe spasms. The spasms were so bad that it felt like someone was pulling on the muscle from each side with enormous amounts of weight. I have been on trileptal for about 8 months and it has decreased the spasms by about 90%. There were some side effects to work through at first but the results have been very good.

[jtroy]

Thanks all for the replies...I just don't hear alot of good stories anymore about Neurontin....my doc called in some Baclofen and so far no problems...is it helping is the question...right now the answer is that weather changes (ie frozen in here) make it impossible for me to tell....he said to give it a while.

As for the other comments about practicing that is encouraging to hear. I know that when I get back in the saddle I'll be taking some medications...I'm just trying to see how far I can lower the opioids. I was once on such a humongous amount of them it is literally taking years to wean down while also combining other methods. I am going to a brand new pain specialist/therapist soon and am going to start really diving into this whole imagery and mind over matter stuff. What I've done thus far has made it possible for me to live on far less opioid intake although it is still quite high.

Anyway....thanks all...anything else is always welcome...hope you all are well.

Regards,

T. Jones, DVM