After discovering that suffering from a fever and chronic fatigue for the past two weeks was down to my medication left me feeling alarmed. So is it a case of the drugs don’t work – they just make you worse?
It is common for people with peripheral neuropathy to experience different degrees of pain. Hence it’s important to identify the type of pain medication that will work best for managing painful peripheral neuropathy symptoms, that also works with your body chemistry, and compliments other treatments.
Disclaimer: Please check with your doctor or practitioner before taking new medicines. Make sure you’re not allergic.
Differences between pain
Acute pain usually comes on suddenly and is caused by something specific. It is sharp in quality. Acute pain usually does not last longer than six months. It goes away when there is no longer an underlying cause for the pain.
Chronic pain is pain that is ongoing and usually lasts longer than six months. This type of pain can continue even after the injury or illness that caused it has healed or gone away. Pain signals remain active in the nervous system for weeks, months, or years. Some people suffer chronic pain even when there is no past injury or apparent body damage.
The following are the main types of medication that HNPP sufferers tend to use.
Amitriptyline is used for headaches and depression, as well as neuropathic pain. It reportedly provides pain relief in about 1 in 4 (25%) more people than does a placebo, and about 1 in 4 (25%) more people than placebo report having at least one adverse event, which may be troublesome, but probably not serious. The most common side effects, experienced by 5-15 per cent of people, include dizziness, drowsiness, dry mouth, nausea, sometimes insomnia and constipation. Apparently it is slow-acting so it can take around six to eight weeks to show any effect.
Otherwise known as Cymbalta, is commonly used to treat bladder problems, depression as well as neuropathic pain. According to a study for the Cochrane Database of Systematic Reviews, most people taking duloxetine however will have at least one side effect. These are mostly minor and the most common are feeling sick, being too awake or too sleepy, headache, dry mouth, constipation or dizziness. About one in six people stop duloxetine because of side effects. Serious problems caused by duloxetine are very rare though some HNPP sufferers have reported muscle spasms with this medication.
Branded under the name Lyrica is among the most commonly used to treat peripheral neuropathy and specifically HNPP. It can be used to treat epilepsy, headaches or anxiety. It is said to slow nerve impulses that may cause seizures and blocks nerve related pain. While most can take it with it no problems, some of the side effects include dizziness, extreme drowsiness, headache, dry mouth, peripheral oedema (accumulation of fluid causing swelling), weight gain, blurred vision, motor in coordination and ataxia (tremor or lack of muscle control) occurring in 1-10 per cent patients at lower doses.
Commonly known by its brand name Neurontin, it falls into a class of drugs known as anti-convulsants – or drugs used to treat epileptic seizures as well as relieve nerve pain. Only 14 per cent of patients taking gabapentin for chronic neuropathic pain report meaningful relief, according to another report by the Cochrane Database of Systematic Reviews. In a recent study by an independent organisation looking at the effectiveness of gabapentin and other drugs for treatment of nerve pain, as few as one in ten patients experienced a reduction in pain.
Two of the most common side effects of gabapentin are fatigue and weight gain. Many report excessive sleepiness and difficulty functioning while taking gabapentin. Significant weight gain has also been reported among some taking the drug – although the risk is generally low.
A study by the University of Miami Department of Neurology found that weight gain is more common among high dose users. In their study of 28 patients taking over 3000 mg/day, 10 patients experienced weight gain of 10 per cent of their baseline weight. That being said, some HNPP’ers have found relief from it, so it’s important not to knock anything until you try it.
When dealing with pain, it is worth giving whatever you can a chance and working with your doctor to try different approaches so that you find the particular approach that is right for you, which brings you the benefits of pain relief, allows you to do more, and gives you the quality of life that you want.