Hi there my friends I am hoping for some medication advice to do with depression and burning. I was originally on sertraline for depression. When I saw my MS nurse I told her I didn’t think the sertraline was working. She suggested I try Duloxetine as has dual action for mood and pain.
So I have been prescribed Duloxetine 60mg twice a day. Still getting burning pain in my back and tummy. So I take Gabapentinf for this as required. I have previously been told 900mg there’s times daily is maximum dose for this. I am nowhere near this - maybe 1500mg is my maximum daily dose but usually less.
My GP has consulted with my neurologist who is not happy for me to take Duloxetine and Gapapentin together as can cause low sodium seizures and comma.
I,think the Duloxetine is a better antidepressant for me. BUT the burning needs to be adressed. I have a bucket load of spare Gabapentin which I will continue to take but this will eventually run out and GP won’t prescribe more when on Duloxetine.
What is the answer? I think I need a different antidepressant that I can take with Gabapentin. Not sertraline as didn’t work, not mirtrazapine as causes weight gain.
Does anyone have any ideas please.
Many thanks and sorry for th ramble
Min xx
Be careful with both Duloxetine and Gabapentin, either together or separately.
I had a bad reaction to Duloxetine - within 3 days I’d been turned into a dribbling zombie 
and was very sensitive to all but the lowest dosage of Gabapentin. Worth reading the package leaflets inserted into the boxes and check for known side effects and other incompatible medications. Also be careful if offered anything ending in -triptyline. They’re all powerful drugs and the side effects can be worse than the condition you’re trying to treat.
Hi
Yes I’ve had this conundrum with meds as well. Unfortunately drugs that say they are dual purpose often are only effective at vastly different doses. It is difficult to find one drug that treats both neuropathic pain and depression successfully. You may have to accept the fact that you will need to take two drugs rather than one, your GP should weigh up the risks of which combination will work best. It’s often trial and error unfortunately.
I hope you find something that works for you.
Hi there,
Thanks so much for your replies.
I really want to stay on Duloxetine as I feel more bouncy on this antidepressant
So looks like I will have to put up with the burning 
will this damage my health if I do this. Or is there another drug that can put the flames out???
Hugs
Min xx
Hi there. Here’s my contribution and you can see how different we all are in our reaction to different drugs and their combinations. Experimentation is the only way to go.
I’m fine on 1900mg of gabapentin daily and my GP tells me I’ve still got upwards flexibility there.
Most SSRIs don’t agree with me. There’s a new drug called Vortioxetine which is technically an SSRI but a psychiatrist had to prescribe this for me as the GP had never heard of it. I’m on max dose of 20mg daily but am just trying a low dosage of Amitriptyline (an old fashioned tricyclic antidepressant) alongside it at the end of the day that also helps me sleep.
Amitriptyline also has an analgesic effect and many GPs don’t think to use it because it’s so old-fashioned!
Mirtazipine is great for me BUT really sets off my arthritis! 
Don’t apologise! It wasn’t a ramble!
Thanks for this. I remember taking amitrityline decades ago pre ms diagnosis for really bad tooth pain. I had to take the next day off work as just so sedated.
Will certainly look vortioxetine up as a possible alternative anti depressant I can take with gabapentin???
I have a GP appointment next Tuesday with a GP I don’t really know - can’t chose nowadays in my practice and she knows Ja.k (removed by moderator)about MS!!! So not holding out much hope there
Thanks again much appreciated. Just riding the burn without Gabapentin.
Min xx
Don’t expect your GP to know about vortioxetine but at least with amitriptyline you can be pretty confident they know about that!
Good luck
Hi again thanks again for all of your replies
Saw a great GP on Friday. He did say that he knew of patients on both Dulaxatine and Gabapentin. Stupidly I didn’t ask if I could have both as had so many other things to talk about such as MRI and bladder Botox.
However if I get really fed up will get another appointment with him and ask.
Hugs
Min xx