Some persons with a spinal cord injury develop a chronic burning, numbness or stabbing pain below the level of injury. This type of pain often does not respond to the usual analgesics such as acetaminophen, NSAIDS or narcotics. This pain often develops 3 to 6 months after injury. Movement, spasms and emotional states may make the pain worse. Drugs used to treat depression and seizures are often helpful for this type of pain.
Amitriptyline (Elavil) / Nortriptyline (Aventyl)
Dosage
Dose must be individualized for each person. Dose can vary from once daily up to 3 times daily.
Side effects
Drowsiness, dizziness, dry mouth, constipation, urinary retention, lowered blood pressure
Precautions
Take exactly as prescribed by your doctor. Should be taken regularly (every day) not just occasionally. Do not mix with alcohol.
Carbamazepine (Tegretol)
Dosage
Dose should be individualized—200 to 600 mg daily in 2 or 3 divided doses.
Side effects
Drowsiness, dizziness, headache, nausea, vomiting, skin rashes.
Precautions
Carbamazepine can cause severe reactions including liver, heart, blood and kidney damage. If you are prescribed carbamazepine, your doctor will order periodic blood and urine tests. Make sure you do not miss any of your appointments for tests and follow up with your doctor.
Do not mix with alcohol.
Gabapentin/Neurontin
Dosage
Individualized dose from 300 mg/day to 3600 mg/day.
Side effects
The incidence of intolerable side effects is low: drowsiness, GI (gastro-intestinal) upset, fluid retention. More common side effects include drowsiness, dizziness and blurred vision.