Hi there -
Gabapentin is an anti-
seizure drug which is also used as a nerve
pain blocker (especially for post-herpetic neuralgia, but basically for any sort of nerve
pain). Pamelor (nortryptaline) is a tricyclic
antidepressant used also as a nerve
pain blocker (primarily anymore -- rarely used for
anti-depressant purposes now).
Your question "...are these two drugs chemically related?" is unclear as to whether you're asking if gabapentin and Pamelor are related or if either of them are related to phenobarbital and dilantin. To clear this up, none of the four drugs are in any way related to one another. Neither gabapentin nor Pamelor are related to each other nor to dilantin nor phenobarbital.
That being said, I question the wisdom of prescribing both gabapentin and Pamelor simultaneously, as they both can have rather marked side effects, some of which may overlap. Your main complaint, however, seems to be this
headache "from the neck up", which sounds rather like a tension
headache. This could be due to rigor in the neck muscles or some other neurological response to one or both of the drugs you're currently taking. While gabapentin rarely results in
headache being reported, but Pamelor does carry "sudden
headache" as both a side effect and as a reported adverese event. It could very well be the cause of your unique
headache. You probably should report this to your doctor and inform him that you intend to discontinue to drug to see if the
headache abates. You should taper off the medication over the course of about a week's time to accomplish this.
The fact that the top of your head is sore to the touch suggests this is actually a nerve
pain, so may well be a paradoxical reaction to one or both of the medications you're currently taking, but since Pamelor is more notorious for reportedly causing
headache, while headace is rarely reported with gabapentin, I would remove the Pamelor first. You may well require one or the other (or possibly both) to manage your pelvic
pain, but if you have to trade that for a bad
headache, you may as well weigh your options. Just be sure you consult the prescribing doctor and let him know if you choose to try taking a break from the Pamelor. He can't force you to take it anyway, but he should be aware of whether or not you're taking it.
If stopping the Pamelor causes the
headache to resolve, you've solved your problem. If it doesn't, you might need to persue some other course to relieve it, or you may need to have your whole
pain management plan rethought. However, I'd be willing to bet Pamelor is the problem here, and possibly moreso because it's being used in combination with another nerve
pain blocker.
This is only a suggestion, and your conversation with your doctor, should you choose to persue this suggestion, should be what helps you make your final decision on the matter. However, I do feel use of the two drugs seems an unnecessarily risky and potentially very uncomfortable combination that a lot of people wouldn't be able to tolerate for a variety of reasons.
I hope this is helpful to you. Best of luck with all this and I hope you're feeling much better really soon. Please keep us updated.
