Health Organization for Pudendal Education

Hi Bart,

I think Lyrica and gabapentin are really similar---in fact, I thought they were almost same drug---so I would not try Lyrica, given your experience with gabapentin. I was on three medications at once for almost all three years (tramadol or a slightly stronger opioid, gabapentin, and either amitriptyline or nortriptyline), so it was hard for me to know how much each was helping. But I was on amitriptyline for a while alone at the beginning, and I think I thought it helped a little.

So very sorry to hear that your pain returned after 14 years. This is such a difficult, confusing, and emotionally challenging problem. I still have fairly low level of pain that comes and goes (though I always have at least a little discomfort), and I do not know what creates the flares.

Take care,
April

Thank you so much for the feedback April. Wishing you comfort and healing

April wrote: ↑Mon Apr 07, 2025 6:58 am Hi Bart,

I think Lyrica and gabapentin are really similar---in fact, I thought they were almost same drug---so I would not try Lyrica, given your experience with gabapentin. I was on three medications at once for almost all three years (tramadol or a slightly stronger opioid, gabapentin, and either amitriptyline or nortriptyline), so it was hard for me to know how much each was helping. But I was on amitriptyline for a while alone at the beginning, and I think I thought it helped a little.

So very sorry to hear that your pain returned after 14 years. This is such a difficult, confusing, and emotionally challenging problem. I still have fairly low level of pain that comes and goes (though I always have at least a little discomfort), and I do not know what creates the flares.

Take care,
April

Many thanks, Bart. I wish the same for you!

April

Like some of you, I’ve been through the med roulette too. Gabapentin was a nightmare for me as well, terrible withdrawal and only marginal relief. Tramadol didn’t do much, and I had the same concerns as Bart with opioids in general.

The one thing that actually helped me noticeably was medical cannabis, specifically strains high in CBD with just enough THC to take the edge off. I didn’t expect much, but it gave me real relief without the zombified side effects I got from other meds. If you’re curious, I got mine through a medical cannabis prescription, the process was way smoother than I expected and the consultation was thorough.

I’ve also tried low-dose amitriptyline (10mg) and while it helped with sleep, it didn’t touch the pain unless I increased the dose, which came with more side effects than I could handle. Right now, cannabis combined with heat, light movement, and pacing has been the most sustainable combo for me.

Whatever you found to be the right blend of CBD to THC? Is there a product link you would be open to sharing?

Thanks,
Bart

onlysams wrote: ↑Thu Apr 17, 2025 9:50 pm Like some of you, I’ve been through the med roulette too. Gabapentin was a nightmare for me as well, terrible withdrawal and only marginal relief. Tramadol didn’t do much, and I had the same concerns as Bart with opioids in general.

The one thing that actually helped me noticeably was medical cannabis, specifically strains high in CBD with just enough THC to take the edge off. I didn’t expect much, but it gave me real relief without the zombified side effects I got from other meds.

I’ve also tried low-dose amitriptyline (10mg) and while it helped with sleep, it didn’t touch the pain unless I increased the dose, which came with more side effects than I could handle. Right now, cannabis combined with heat, light movement, and pacing has been the most sustainable combo for me.

By far gapanetin until it stopped working.only urethral symptoms horrible ones....had also pgad but it was prolly from Zoloft stopping so i am a unlucky guy.Pgad is gone but gabapentin stopped working and i am back at horrible urinary symptoms again in urethra

Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.

I'm so glad duloxetine is helping you! I have been talking to my doctor about trying it for my pain .May I ask what dosage you're taking?

missvicky wrote: ↑Sat Oct 04, 2025 9:51 pm Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.

bartland wrote: ↑Sat Oct 04, 2025 11:00 pm I'm so glad duloxetine is helping you! I have been talking to my doctor about trying it for my pain .May I ask what dosage you're taking?

missvicky wrote: ↑Sat Oct 04, 2025 9:51 pm Do not loose hope on this condition. My Primary Doctor recommended Cymbalta(Duloxitine). It works. Years ago they wanted to send us to a Phsyc Doc because it was all in our head! I suffered for years with this condition but primary Doc was on the ball.

All I'd say for these agents that are used to treat neuropathic pain, individuals respond very differently but it's certainly not a wonder drug!

This will answer your question: -

https://cks.nice.org.uk/topics/neuropat ... uloxetine/