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Treating Nueropathy
Jul 1, 2001

I am currently on Nuerontin, 400mg, 4 times a day and MSContin 15mg, 3 times a day, with 2mg Dilaudid for breakthrough pain. Is this the best way to stop the painful tingling and soreness I feel in my feet and lower legs? What other treatments are out? And What are the possible side effects fro these meds?

Response from Dr. Feinberg

In additon to gabapentin (Neurontin), an older class of drugs called tricyclics can be very useful for chronic pain. They must be started at a low dose and increased gradually, so it can take a while to know whether they will work. In your case, I would add a tricyclic to what you're already taking. If a tricyclic like nortriptyline or amitriptyline isn't helpful, you can try one of the seizure medications that have also been used for chronic pain, like carbamazepine (Tegretol). Pain relief can be more predictable if you switch from narcotic pills to a fentanyl patch-- it transfers the painkiller across your skin and needs to be replaced every 3 days.


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