Can my chronic tooth pain (stomatopyrosis) be increased by stopping Elavil or decreasing Rivotril? Should I take Elavil again?

Question

I have been taking the drug Elavil (10 mg per day) for chronic tooth pain (stomatopyrosis) for about 7 years. I stopped in early May and it seems like the pain is increasing. It's been 2 months now. I have to say that I have been tapering off the Rivotril since January 2018. I was taking one and a half (0.5) tablets a day, so 0.75 mg a day. I am down to one Rivotril tablet (0.5 mg) per day. I forgot to mention that I have been taking Rivotril for 26 years. As for Elavil, my family doctor has been renewing it for all these years, but she doesn't really believe in it. It was prescribed to me the first time by doctors in the Department of Stomatology at Notre-Dame Hospital.

Philippe De Grandpré · Accepted Answer

Hello, chronic pain is a complex problem, which is influenced by various components. There is of course the physical component of the pain, that is to say the presence or not of a lesion. Then there is the motivational component that influences the perception of pain. You may have noticed that the pain is often worse when you are sad, tired, stressed, etc. It is therefore possible that the return of pain is influenced by the decrease in rivotril, but also by the stopping of amitriptyline. I'm going to answer you with a question. If elavil is effective and well tolerated, should you take it again? I think so. Elavil seems to me to be a good choice for the kind of pain you are presenting with and if it helps why not continue it, you are taking a low dose in an appropriate setting. I don't have your full file and I haven't evaluated you, but I think it would be wise to go back on the elavil to see if the relief comes back, that's the way to see if the pain related to stopping this medication. If you have any other questions about pain, please feel free to write me again, this is my main focus in pharmacy Have a nice evening