AboutMary E Scott, RPh, CGP Expertise I am a certified geriatric pharmacist with over 23 years experience as a long-term care consultant to nursing homes. I also do community-based consulting on an individual basis. My facility-based monthly newsletter on pharmacy topics is read by nurses in over 200 long-term care facilities in 5 states.
Experience I received a BS in Pharmacy in 1980 with post-graduate work in public health. I have had a Consultant Pharmacist license since 1984.
Organizations American Society of Consultant Pharmacists .I received certification in geriatric pharmacy in 1998.
Question QUESTION: Hi;
I'm a 73 yr. woman with major spine surgery 4 yrs. ago, which resulted in neuropathy. One yr. ago diabetes was also dfiagnosed, take Glyburide/Metformin 5/500 2x daily for that. The neuropathy worsend considerably and the original Neurontin scrip was replaced with Gabapentin 300mg and just upped to 3x daily, when I had told the Dr. I could not even take it 2x!! Only at bedtime can I take it, because it allows me some sleep, but if I take it in the daytime it knocks me out in an hr. and I'm non-functional for hours! I can't even think what 3 would do! I'm very sensitive to all allopathic medicine. So my question is - is there anything from any field that would give me relief, while staying alert during daytime hours, when I often have to drive also??? My Dr.is fairly open to my requests.
Thank you very much!
Ms. Jutta
ANSWER: Hi,Jutta,
There are 2 other medications you could try that may not knock you out as much as Neurontin (gabapentin), Lyrica and Cymbalta. Are you taking any other medication that may be contributing to the drowsiness? Other meds such as muscle relaxants,antidepressants,other pain meds taken together with gabapentin can cause a 2 +2= 5 kind of reaction. If you would like to list all the meds you are on, I could take a look at them and make suggestions. Hope this helps, Mary
---------- FOLLOW-UP ----------
QUESTION: Hi Mary;
Thank you for answering so swiftly and concise, I'll try and match that. Have tried Lyrica, Dr. gave me sample, it made me very dizzy shortly after taking. Have not tried Cymbalta,that is advertised for depression and on checking Gabapentin that's in the same family, so wouldn't it act the same way? That bothers me, since I have no psychiatric problems, depression or anxiety etc. I just have nerve pain in my feet and hands,specially laying down!! My heart is good, my bp 125/80, cholesterol 121. Have a growth in thyroid which has just been biopsied the 2nd x, since first gave no definite result. Am getting results next week, in meantime there has not been thyroid medication - another worry how that will cross reference...
The meds I'm on are as mentioned for diabetes
Glyburide/Metformin 5/500mg - 2x
Celebrex 200mg 1x
Gabapentin 200 (3x) take only 1x
Nexium 40mg 1x (reflux from hiatal hernia)
Folic acid 1mg. 1x
Darvocet 600 only occasionally for back pain (spine has major titanium reinforcement)
Baclofen 20mg only for bad leg cramps occasionally
Boniva monthly for Osteoporosis
This might give you a better picture and thank you very much
Ms. Jutta
Answer Hi, Ms Jutta
Sorry it took so long for me to answer-was away for the weekend. Cymbalta is not exactly like gabapentin. Although it is an antidepressant, it is a serotonin and noradrenaline reuptake inhibitor which means that it increases the levels of serotonin and noradrenaline in the brain which sends out signals to various receptors in the body. Gabapentin works on a different brain chemical (GABA). Cymbalta (duloxetine) can work in the brain as an antidepressant,but also blocks pain receptors which cause neuropathy,and also works on the receptors which cause stress incontinence (bladder leakage when one coughs or sneezes). Sounds kind of strange,but true! It is probably being advertised for depression because the manufacturer thinks it will get more market share than saying it's for neuropathy or incontinence.I have an journal article about this if you would like me to send it to you or your doctor.
As far as your other meds are concerned, there are no interactions with Cymbalta.Hope this helps, Mary
