Clonazepepam

[Guest]

The pain in one leg is keeping me awake at night again despite Morphine patches and Oromorph at night after 3 to 4 hours sleep. Gp came in this lunchtimes and other than increasing my Amitriptyline does to 20 ml at night he left me a list of alternatives I could try.
Clonazepam
pregabatin /Gabapentin
Doctors spelling not mine

My pain is not cramps but a shooting pain from the ankle to the hip which repeats itself many times in an hour.During the day I get tingling if the leg is touched
Any pros and cons please
AM
X

[Ellie]

Hi AM,

The pain you describe sounds like neuropathic pain (nerve pain) Both Pregabalin and Gabapentin work on neuropathic pain. Both may cause you to feel sleepy, which may be no harm as you're in bed anyway.

Clonazepam is more of an anti-anxiety med; it's a benzodiazepine, a tranquiliser, which will help you sleep and not necessarily affect your pain. I'm not sure how your breathing is, so a combo of morphine, oramorph and a benzo may not be advisable. Bear in mind too that your body builds a tolerance to morphine or any opioids, so the dose may be ineffective now.

Did you see a Physiotherapist to see if they could offer advice? (I seem to remember you had spinal issues?)

Love Ellie.

[Terry]

Hi AM,

You could try a air massage sleave on that leg. Like Ellie says, it does sound like it is a nerve pain.

Cc,s friend has some sort of leg massager, I don't know if you could ware it all night or if OT,s will provide you with them.

They cost about 300 and I don't know how long they will last or if they fit.

Love Terry

[alfies mum]

Hi Ellie
I thought I would get an answer from you as you have a wealth of knowledge.Since I have been onMorphine the neck pain has been greatly reduced.The GP did think the Pregabalin Gabapretin was the best choice but wanted me to do some research on all of them.my breathing is fine at the moment my next test is November
Teeny thanks I will look into the air massage sleeve
AM
X

[Ellie]

Hi AM,

How kind of your GP to tell you to go off and do research!!! They've the info at their fingertips - literally.

If I had to choose, I'd try Pregabalin (Lyrica) first. It's absorbed better by the body so is more effective and is given at lower doses than Gabapentin, so there tends to be fewer adverse side effects. It may take a day or two to get meaningful pain relief.

Good luck with it if you decide to try it.

Ellie x.

[njm]

Absolutely support Dr. Ellie's sage advice.
One other thing: I also support the advice that you get the physio to 'diagnose' the origin of the nerve pain. it is possible it is sciatica or another pinched nerve that can be alleviated by physio. The fact that it occurs whn lying down and not in the day may be an important diagnostic indicator for the physio.
Charles