Meds For Neuropathic Pain?

[Aaron77]

I'm thinking that a lot of my pain may be neuropathic... can those of you that have had success with meds for neuropathic pain please let me know what has worked for you or what has'nt? Thanks

[Aaron77]

I'm thinking about Gabapentin... have heard that it has helped out some people.

Although my eyes get really red and painful when working on the computer for a while everybodies telling me that I don't have major signs of dry eye so I'm thinking that I may have a problem with the nerves sub surface.

[irish eyes]

Chemia

That is a horrible experience for you to have; I say that because it's something I've been through myself. Doctors didn't completely deny that there was something wrong with my eyes but they couldn't understand why I was making such a `big deal' out of it.

It didn't help that I had seen a lot of different people - so the argument always seemed to be along the lines of "Dr So & So couldn't find that much wrong either....". This had gone on for years and years.

Thankfully now, I'm seeing someone who has taken more of an interest. My visit to him yesterday was a positive one because the treatment seems to be helping. He is a nice enough chap but a little on the intense side so it was good to see a smile on his face when efforts on both sides seemed to be paying off. It can restore your faith.

Aaron
I was prescribed an antidepressant for neuropathic pain - I think it was something called Amitriptyline. Tricyclic antidepressants can cause drowsiness as a side-effect; this was something that I experienced quite badly so I had to abandon them. I felt generally much worse in myself and my eyes were not any better. Perhaps I should have given them longer but at the time I didn't feel that it was something I could cope with.

[ding]

neuro pain

Hi Aaron I had lasik on 1/29/2008 and for about 8 months I was unable to work due to severe eye pain the drs all thought it was just dryeye however I went to bfs and Dr Rosenthal said it was neuro pain he sent me to a neuro eye doc who put me on amitriptyline. It has helped me a lot I was able to return to work I still have some days my eyes bother me but not anything like the servere pain I had before. I wish you the best of luck hang in there it will get better this board helped me a lot. ding

[Aaron77]

Hi Aaron I had lasik on 1/29/2008 and for about 8 months I was unable to work due to severe eye pain the drs all thought it was just dryeye however I went to bfs and Dr Rosenthal said it was neuro pain he sent me to a neuro eye doc who put me on amitriptyline. It has helped me a lot I was able to return to work I still have some days my eyes bother me but not anything like the servere pain I had before. I wish you the best of luck hang in there it will get better this board helped me a lot. ding

Did you have problems with the appearance of your eyes or was it mainly just the pain?

I think the redness I get in my eyes is due to the dry eye, as the eyes get more red they get more painful so I think some of my problem is dry eye but that I probably also have some neuropathic pain.

[lboogie]

how do they tell if your pain is caused by neuropathic pain versus just dry eye? I wonder if it's something I might ask my doctor about.

[irish eyes]

Chemia

All this certainly caused big problems with me. Like you, things came to a sudden halt in many respects and I've never really got used to it - even though it's gone on for years.

I am by nature, someone who hates fuss but it was even suggested that my complaints about eye discomfort might be down to lack of the `proper attention' from my husband. I think they were trying to tell me that I was hysterical. (Hysteria earned its name because it comes from the Greek hustera, meaning uterus.) Being female, I was doomed from the start!

I rarely mention my eye condition to anyone at all because I usually get the same shocked response that I should even bother a doctor about it when they have poorly people to care for.

[mylittlem]

In addition to Lyrica as a possible solution for my eye problems, I was prescribed Valtrex. This drug fights the herpes virus and is suppose to be effective to treat shingles if in fact the eye pain may be neurological in this respect. Initially I thought there was a positive response, but ultimately I didn't think so and it was discontinued. Sorry I couldn't be more helpful but I also tried approaching the problem as if it were neurological, but never found anything that seemed to indicate this was the case.

[Aaron77]

how do they tell if your pain is caused by neuropathic pain versus just dry eye? I wonder if it's something I might ask my doctor about.

Maybe they can access the Post-Lasik nerve condition through the use of a confocal microscope excessively deformed nerve regeneration may mean nerve pain

[Sammy B.]

Aaron,

I am not 110% sure I can help in this discussion but I can say that I believe that anxiety adds to the effects/symptoms of dry eye.

Stay with me on this one: When I was at my "post-LASIK BONKERS" worst, I was watching a yoga program and I was shocked when the instructor, during a relaxation period, said to "calm the inner corners of your eyes....the ones that are nearest to your nose..." And when I tried to just relax my face and that particular area, it kinda worked to alleviate some of the dryness symptoms or rather symptoms I had perceived to be dryness. It wasn't some magical cure, more like an "Aha!" moment, where I realized I was holding a lot of tension in my face.

I guess what I am saying is that those of us who are walking around stressed to the max are tense in all sorts of places - not just the classic "band around the chest" tightness that we expect to feel. Because you have to be aware of your eyes and how they feel all day, I would wager that you are a walking stressball as well. Do you think you are walking around majorly stressed?

So whatever you take for the pain or dryness, let it be something that calms your nerves. Have you tried a low-dose anti-anxiety med?

I am always surprised at the amount of people who are ON something for nerves - whatever their situation is. It shouldn't be considered a failure in my opinion. It can be necessary for us to return our lives to some sort of normalcy during periods of great strife.

- Rose

[Aaron77]

Do you think you are walking around majorly stressed?

Yes.

So whatever you take for the pain or dryness, let it be something that calms your nerves. Have you tried a low-dose anti-anxiety med?

No.

You make some good points, I think I get stressed out because of the eyes... I think I've been grinding my teeth as well as of late, the pain gets me really tensed up sometimes.

[odydnas]

Chemia and Irish eyes, doctors not understanding our pain is a HUGE problem. Luckily, we have this site (for which I am SO thankful for), and Plug A Doc where we can find docs that actually are interested and keep up with the research. It took me a while, but I found a great doc who told me that he has never yet seen a person who's symptoms matched their clinical signs. So keep looking Chemia, and I hope you will find a good doc...chances are he/she might not be in your area and you will have to travel several hours for your appt, but it's worth it. Good luck!

Aaron, I haven't taken pain meds, but my doc did mention he would send me to a pain clinic if we exhaust all options. Have you tried that? Make sure its a very good clinic that may have had some experience with dry eye pain (altho I am sure that would be rare).

[irish eyes]

I do so agree with you Odydnas

At times, I have become so absorbed by pain that little else in life has managed to penetrate the misery. To have medics undermine it has been so insulting - and who wouldn't feel bewildered at their attitude.

Being able to deal with the experiences of pain can equip us with an important attribute -empathy. I have found too many doctors tend to judge rather than to understand.

In the poet Toni Morrison's words:

When there is pain, there are no words. All pain is the same

[rosye]

One of my last eye doctors insisted that I suffered from neuropathic pain and wanted me to take tricyclic antidepressants, but my psychiatrist only prescribed me Gabapentin, since tricyclics would worsen the dryness. I took it at night for some time, and it seemed to help reducing the pain at first, but after a while it stopped working, so I discontinued. Then one day I was talking to some friends and the subject "headache" came by, and one of then said their doctor prescribed Ketorolac Trometamine pills for it. This is an non-steroidal anti-inflamatory drug (as common headache pills often are) and since in Brazil is easy to buy a sort of non-prescription drugs over the counter, I decided to try that for my occasional headaches. For my surprise, it didn't stop my headache so effectively as my friend told me so, but it did reduce my ocular pain!! When researching more about this drug, I discovered that it's the same principle of the Acular drops (indicated for allergic conjunctivitis)... of course it was not prescribed for me and I'm conscious that NSAIDS can cause nasty gastrointestinal problems, so I do NOT overuse it. But I thought it would be worth to mention it, maybe you can talk to your doctors about it. It's not a neuropathic pain management drug, but at least for me, it reduces the eye disconfort if I need it...

[willwork4tears]

Gabapentin (Neurontin) is often prescribed for neuropathic pain. It is also off-labeled for migraines among other conditions.

Lyrica is FDA approved for fibromyalgia pain and is also thought to work through nerves.

Cymbalta is an antidepressant (serotonin and norepinephrine blocker) that is FDA approved for depression and fibromyalgia.

TCAs can cause more dryness b/c the drugs are "promiscuous". This means that in addition to binding to serotonin transporters, they also bind to lots of other receptors, including histamine, so they essentially act as anti-histamines as well. This is why they cause drowsiness and dryness as side effects. The newer SSRIs are more specific, resulting in fewer side effects.

If anyone has any antidepressant-specific questions, I'd by happy to help. I wrote my dissertation on antidepressants and the serotonin transporter.