Amitriptyline and Lyrica memory effects

[alphalithio]

Hi Everyone -

I am fortunate to be able to say that my pain is controlled pretty well by Ami and Lyrica. However, since I have been taking the stuff (about 2.5 years) I have noticed a significant dropoff in my ability to remember all kinds of things. Mostly dumb stuff, like what happened on last week's episode of "The Bridge," but I work in a highly technical field, and I feel it's starting to affect my work a little. Another manifestation of the problem is that I get sidetracked more easily than I used to. I used to be quite good at concentration, but now my mind wanders. I'm compensating as best I can, by carrying notebooks around with me all the time, but that doesn't always work since you can't always know what you're going to be asked.

Anyway, I'll be interested to hear what you have to say about the topic. I see there have been various discussions over the past years. I started with amitriptyline first, so that's the one I feel had the biggest effect. Lyrica was added later (and I'm not sure it helps my pain much). I think I'm going to have to figure out how to balance my pain and my brain.

[Violet M]

Well, that's definitely a problem that happens with some of these drugs. I didn't take either of those drugs but I took enough other ones to know the side effects can be unpleasant.

I see that you had your nerve blocks from Antolak. He must be planning to retire in the near future -- he wasn't particularly young when I saw him 9 years ago. How did your nerve blocks go?

Violet

[janetm2]

I feel for you. The drugs are certainly needed to help with the pain but the brain does take a hit. I had issues with Gabapentin the switched to lyrica and it continued. Once off them the effects stopped. I also take amitriptylene but did not have problems until they tried increasing it. The only help I can say is that I had trouble finding an appropriate word one day and getting up for a sort break to walk around helped to clear my brain and a better word surfaced. Fortunately the surgery and acupuncture allowed me to get off the problems drugs. Hope you find a balance or other ways to work around the effects.

[HerMajesty]

I was on amitriptyline alone and don't recall the memory effect...but Lyrica is essentially the same as gabapentin (Neurontin), and that seems to universally cause effects similar to early senile dementia. I have friends who are on the same thing and we have all started calling it "Morontin". The good news is, I am pretty sure it is fully reversible by getting off the med. I should know in a year as I will start weaning down when I reach my 2 year post-op mark. But when I was 1st on the stuff, I went on and off a few times before finally committing to take it regulary, and I always got my brain power and multitasking ability back as soon as I was off it. Meanwhile keep a good pocket calendar, make lots of lists, write stuff in sharpie on the side of your hand, etc. I've been on morontin for 4 years so have pretty well adapted my lifestyle to not being able to rely on my own memory. It can be frustrating though.

[alphalithio]

I have been thinking that I'd try to come off of Lyrica and see how it goes. (I keep forgetting to talk to my doctor about it - haha). I went on ami first, and it had a big effect on my pain. Lyrica had a smaller effect, so I'm thinking that might be the place to start. I've been doing fairly well pain-wise in the last few weeks, as I've had a pretty good response to some chiropractic work with active release techniques. Nothing seems to rid me of the pain completely, but it has helped some.

It's funny...One doctor I saw said that ami was the one messing with my memory, and others have said it's the pregabalin. I guess I'd say that adding the pregabalin had a bigger effect on my memory. Anyway, I think I'll try to cycle the Lyrica down and see if it helps. I have to try to strike the right balance: I've got a family to provide for so I don't want to be fuzzy headed, AND I've got a family to provide for so I don't want to be in pain. (However you slice it I don't want to be in pain).

Violet, the people at Antolak's office told me that he tried to retire a few years ago, but that he came back out of retirement because there had been so many requests for his help. The blocks did seem to help for a few months, but as seems to be the case for so many of us, the pain came back. I'm probably going to go back for some more blocks - we have discussed it - but I want to give the chiropractic approach a good try before I do so I don't confuse myself about what is working.

[Violet M]

A, I guess I would caution you to be careful about too many nerve blocks. I know people who got worse from them. The fact that they made you temporarily better though, does point toward a diagnosis of PN.

Well, with Dr. Antolak certainly in retirement age and Dr. Ansell discontinuing PNE surgery, we will have to hope for new people coming on board to help PNE'ers.

Best,

Violet

[alphalithio]

Thanks for the information, Violet. You summed up my ambivalent feelings about the blocks well. They did help for a while, but I'm concerned about damaging the nerve or build up of scar tissue or worsening the problem somehow or another. It doesn't seem as if anyone gets "cured" from the blocks. My pain is generally in the 0-2 range as long as I take my meds. Last summer, we tried to knock down my amitriptyline dosage, but the pain came roaring back in about 2 days (decreased from 50 mg/d to 25 mg/day). As long as I get that ami, I am able to sit through meetings at work, and 2+ hour drives with no significant problem. That's why I think I'll try to cut back on Lyrica first.

[helenlegs 11]

I take lyrica and duloxetine/cymbalta and definitely have memory and other brain fog issues although definitely not as bad as when on gabapentin. I couldn't say exactly which drug is responsible, maybe some % of both? but seems like the lyrica is coming out tops so far, doesn't it.
I'm glad that you find the drugs combo effective but agree that stopping lyrica (as maybe it's got nothing to do with 'combo' or even lyrica alone) sounds the best plan, you can always reinstate it but definitely worth while giving it a go.
Let us know how it goes, hopefully any lack of lyrica effect is massively outweighed by memory power and you can ditch the lists etc.
take care,
Helen

[alphalithio]

Update: I've been doing very well pain-wise over the past few months, and so I thought I'd try ramping the Lyrica down (with my doctor). My previous dosage was 2 x 150 mg per day, so we cut that down to 2 x 75 mg per day. After about 24 hours the pain returned. Not too bad, like a 3 or 4, but bad enough to give me pause. Last summer I had a good response to ART (Active Release Therapy - seems to be similar in concept to physio to relax the pelvic floor) that I got from a chiropractor in town, so I decided to give that another try before I give up and return to 2 x 150 mg. I'm just back from my first ART treatment, and I'm still feeling some pain. I still think I'm going to hold off for a few days before I decide the Lyrica cutback experiment is a failure, but the difference in quality of life is significant....even with the effects on my memory.

I'll also mention that I've had a couple of strange symptoms (withdrawal?) since I cut Lyrica back...I've had a metallic/bitter taste in my mouth, and my sleep has been disturbed in two cases because I had an itch I couldn't seem to scratch. These aren't bad enough to make me give up, but the return of the pain is. So we'll see.

[rick]

Hello,

I am on both lyrica (600 mg) and Cymbalta (180 mg).

Memory deficits are a problem constantly. Often, I have difficulty saying a word that I know is part of my vocabulary.

Embarassing, if in company of a person who in unaware of my condition.

I am considering increasing lyrica back to 900 mg. Effectiveness seems to wax and wane.

Has anyone who takes lyrica/cymbalta combination noticed this up and down effectiveness?

Thanks,

Rick