Neurontin is it a narcotic
University of Kansas School of Medicine Historically, pain has been a neglected symptom in patients with gastroparesis, even though (and perhaps because) it is often the most problematic to manage. In the most extreme cases, pain can dominate the picture, resulting in considerable suffering and utilization of health care resources. While not dismissing them outright, some formulations come in rapid and short-acting preparations. Levsin/SL, for example, can be chewed or placed under the tongue and allowed to dissolve. The tricyclic anti-depressants (TCA) drugs have become one of the mainstays for treating chronic abdominal pain. Much of this problem stems from a complete lack of knowledge about the causes of pain in gastroparesis. There are no experimental studies or clinical trials on this subject. Therefore the approach to treatment is both arbitrary, subject to the biases of the treating physician, and empirical, without any biological rationale to guide therapy. Some examples are: diclofenac (Voltaren, Cataflam) diflunisal (Dolobid) ibuprofen (Motrin, Advil) indomethacin (Indocin) ketoprofen (Orudis, Oruvail) ketorolac (Toradol) naproxen (Naprosyn, Alleve) piroxicam (Feldene) These medications can be helpful but have the potential to cause stomach ulcers and bleeding. Nortriptyline may be the least likely to cause these unwanted problems. Working closely with your doctor and carefully adjusting dosages is essential. The selective serotonin reuptake inhibitors (SSRI s) have not been clearly proven to be effective tools against neuropathic pain. The TCA drug most studied and prescribed most commonly is amitriptyline (Elavil). Dosages are started at a very low level, lower than used for treating depression, and then slowly increased. It may take several weeks before benefits of pain reduction are experienced. ..
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