Gabapentin, Synthroid and Nortriptyline

[Idiopathic PN]

As you may have read my previous posts, I am on Gabapentin and Synthroid.

I had my follow-up consultation today with the neurologist who did the skin biopsy. I did not want to expect too much today but you must understand that in my heart, I was hoping that he would say something encouraging or worth pursuing.

Well, it was a let down, he just emphasized the negative result of my skin biopsy and he did not want to pursue any further tests. He said that whether my result was normal or abnormal, I will still hve to treat my symptoms.

He gave me another medicine - Nortriptyline. I know this is an anti-depressant medicine. This is supposed to be taken as complementary to the Gabapentin.

I am so hesitant to take this combination because of adverse side-effects. As it is, Gabapentine alone makes me so drowsy and sleepy. To add Nortriptyline will maybe makes me a zombie .

To add to all this, I have my unstable thyroid function. My last thyroid result was normal after 6 months of being low, but even then, the normal was still "below normal" level. And I read that Nortriptyline may result to exogenous thyroid.

I am stressed because I found out today that the Gabapentin and the Synthroid
I am taking all this time are with Gluten. I have been on gluten-free diet for a month now and yet all this time, I am ingesting gluten!!!

Does anyone have (had) a good experience with the combination of Gabapentin and Nortriptyline? Or is it better to be taken only either one of them. I was given with the lowest dosage for Nortriptyline. Doctor said that if the combination works, we will slowly taper down the Gabapentin.

Will appreciate your inputs.

[mrsD]

Interaction with thyroid is considered a minor type:

http://www.drugs.com/interactions-ch...=1463-0,1734-0

I think it is worth considering, as it may be more useful than
the gabapentin. But that decision is yours and your doctor's.
Used in a low dose, may not be problematic.

[Idiopathic PN]

Originally Posted by mrsD

Interaction with thyroid is considered a minor type:

http://www.drugs.com/interactions-ch...=1463-0,1734-0

I think it is worth considering, as it may be more useful than
the gabapentin. But that decision is yours and your doctor's.
Used in a low dose, may not be problematic.

Thank you Mrs.D.
You mean Nortriptyline may be more useful as a "stand-alone" treatment than being combined with Gabapentin?

It just makes me so concerned about the effect of all the medications that affect the central nervous system.

What could be the long term side effects of Nortriptyline in our body?

Thank you.

[mrsD]

I am only saying that the nortriptyline may be more effective than the gabapentin. (new meta analysis of gabapentin found it only effective in about 30% of cases).

For that reason it is worth trying it. If it works well, you could consider tapering off gabapentin to see which is doing more for you. People all vary in responses to drugs, so one has to try them to see.

More on nortriptyline:
http://en.wikipedia.org/wiki/Nortriptyline

Usually low doses of this drug work for PN.

[Idiopathic PN]

Originally Posted by mrsD

I am only saying that the nortriptyline may be more effective than the gabapentin. (new meta analysis of gabapentin found it only effective in about 30% of cases).

For that reason it is worth trying it. If it works well, you could consider tapering off gabapentin to see which is doing more for you. People all vary in responses to drugs, so one has to try them to see.

More on nortriptyline:
http://en.wikipedia.org/wiki/Nortriptyline

Usually low doses of this drug work for PN.

Thank you so much Mrs.D!

As you know, I am open to every medication available in the market, just to help me with the pain. I just have to get more information from experts like you - and for people who have actually used it.

Thanks for your time.

[mrsD]

When you first start, there may be some sedation. That usually wears off in a week or so. The doctors give it at night for that reason.