"i was given 25 mg nortryptyline for shingles pain, along with gabapentin, and tramadol for shingles and back pain. i now have phn, i have had this pain for 6 months now. i had pretty severe  burning pain. within 3 days the burning stopped. most of the pain went away except at night. i went up on the gabapentin several times. i didn&#039;t want to go up on nortryptyline due to side effects ( extreme dry mouth, and it was hard to wake up in the morning). occasionally i miss a dose on accident, i go to sleep without it. i will hurt so much that i can&#039;t do anything but sit and use ice packs all day. also my pain will be much worse for 3 whole days following a missed pill. this has happened 5-6 times. nortryptyline is the most effective medicine i ta"