Hi Adamo,
I am sorry that the drug is not working for you. I think that your doctor might actually know what he is talking about. After taking amitriptyline at a dose of 17.5 mg nightly, admittedly for some time, I had to reduce the dosage very very gradually. I would reduce by only 2.5 mg at a time and keep it like that for several weeks or months sometimes or I would get withdrawal symptoms (pain mainly). It has taken me over 2 years to get down to almost nothing. It might be the same story with gabapentin, in which case just go with it. If you withdraw gradually you might find that you no longer need it.
Good luck.
CS

I've gone down now only 200mg off the 2400mg gabapentin across one week and I am in just as much in trouble as after a one day reduction of as much. The disturbing part about this is the total lack of sleep and daytime akathisia. During the day it doesn't work for more than 1 hour. Day and night I am in agony. I need help from anyone on this forum who knows about this gabapentin devil. Can you suggest what forum I should turn to? Many thanks!

Welcome!

Let your doctor know that you have tried his suggestion, and tell him the things you experienced when you you removed 400 mg. He wasn't kidding because that is a fairly reasonable taper schedule but it clearly isn't working for you. There is an alternative...

In the US, gabapentin also comes in 100 mg capsules. If your doctor does not offer these, ask him to prescribe them for taper purposes. I might try taking off 200 mg every few days -- if that is still too steep, go with 100 mg.

Please do not try the cold turkey route from 2400 mg of gabapentin -- that's like begging to have seizures. It isn't worth the risk and there's no need. If you want off of it fast, your doctor will probably want to prescribe another antiseizure medication as a temporary safety measure. But normally, gradual reduction is the preferred route with seizure meds.

Best wishes! Glad the Valley Fever seems to be under control!

waves

The valley fever titer came back as 1:2 and the lung x-ray is normal so that is good. I appreciate your advice. I've done 100mg less for 3 days and just started on another 100mg less today. The hit was almost immediate — runaway agitation, chest pains and hyperventilating, anxiety, pacing. Is there something I can take to lessen the withdrawal? Or would taking some other drug just be replacing one addiction for another?

Hi Adamo,

The effects you describe all sound like symptoms of anxiety to me. The good news is it does not sound as though you are seizing. If you should have symptoms like acute nausea, visual disturbances (things looking real big, real small, tilted), strong foul smells, or anything else you cannot explain, please call your doctor right away. It is clear that you are very sensitive to this medication.

Gabapentin and anticonvulsants in general are not considered addicitive in the usual sense. However, these and other "non-addictive" drugs do induce neurochemical changes that do not reverse spontaneously, so a slow suspension is required to avoid seizures. The rate of dose reduction depends on individual sensitivity. Anxiety and agitation are possible adverse effects during reduction.

However, I'd be very, very, leary of trying to "lessen" symptoms by introducing another drug. The only drugs I can think of that might help would be:

1. a different anticonvulsant, which might not help with the anxiety, however
2. a benzodiazepine like Klonopin -- VERY addictive, even in the "standard" sense

So basically, yes, I see a high risk of trading one "addiction" for another in your case. Your doctor might have other suggestions, however.

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Personally, I think your best bet is to go more slowly, just as Glenntaj described. Reducing every 3 days is apparently still too fast for you. You probably need a week, perhaps more, between decreases.

You might try this -- after each dosage decrease:

1. See how long it takes you to get comfortable at the new dosage
2. Once comfortable, wait the the same amount of time again, symptom free, before going down again.

The idea is to hold still at each new dose for twice the amount of time it took you to feel ok.

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That is super that the objective exams confirmed that the Valley Fever remitted!

Good luck with this discontinuation quest. I'll check back on you.

waves

p.s. You might want to see a different doctor. You said this guy prescribed gabapentin for your "mental state"? To my knowledge, it is not a first-line medication (or even approved!) for any "mental" state. Was there also a pain management situation involved?

Your advice is super helpful. It is very kind of you to take an interest in my perhaps, in the scheme of things, quite trifling situation. As you say this may be purely an anxiety issue. There was no pain issue except for Vally Fever (which is not a pain issue — its a fungal infection). I was prescribed Gabapentin because of anxiety that began over the serious nature of my Valley Fever. And again, the reduction of this may be aggravating the underlying (post-traumatic) anxiety with the GABAs already having been altered by the drug in the last month. When I take 800mg in the morning I feel sick and confused. Within an hour or two I am in a stoned haze and am incapable of working at my job — even if I drink coffee. By early afternoon I am exhausted and by latter afternoon I am agitated and anxious (when I have to take another dose). Are the Gabas permanently altered by this drug or does it take a long time to recover normal functioning after cessation? Won't any prolonged taper increase the difficulty of reinstating normal function?

I think you are right about reducing it more slowly but if I remain as dysfunctional as I have become I am afraid of losing my livelihood. It is dismaying to me to have lost my mental acuity and I want it back. In any case, everywhere I've turned I have been rejected for any medically supervised withdrawal of this. I even went to a Narcotics Anonymous meeting and ended up asking the speaker about this drug. He told me its withdrawal is a common problem among addicts who are given it for other withdrawals. I have never been addicted to anything so I am scared and at a loss by such an experience. He said increased physical exercise is the only way to counteract the withdrawal symptoms. But really: When your are working how much can you possibly exercise?

Again, grateful for your help!

I agree with waves Klonopin can be a dangerous drug as well. However when you are withdrawing from medication, it is a good tool for a short duration under your doctors care. I took it only as long as it took to withdraw from my medications. I had no trouble stopping klonopin after that. ginnie

It is not at all trifling. Even if this is "just" anxiety, that is a real problem which needs to be medically addressed.

Time to see another doctor, IMHO. I can't understand prescribing this for anxiety... there are a couple of possible reasons standard meds were not chosen, but then... 2400 mg??? That is a phenomenal amount!

Oh dear! I know the stoned haze thing but I only get that when I first start treatment... you are still having that, and then later get withdrawal? Yuck!! It sounds as though you do not even tolerate the drug peaks at this dosage. So 800 in the morning means you've been taking it 3 times a day? What if you tried splitting your daily amount into 4 doses, spaced evenly. That's how I usually take it. It is a bit of a pain, but it might help with the nasty grogginess at the "peaks" and also reduce the feeling antsy before the next dose. Your blood level will remain more even.

Absolutely not.
That depends on the individual -- you see that in the degree to which you can taper comfortably.
Well, generally speaking, the longer one is on a drug, the harder it is to get off it. So yes, the faster you could get off it, the better. However, you must do it safely (slowly enough to avoid seizures). The other question is, how much discomfort can you put up with? When you removed 400mg, you reported immediate restlessness (pacing), hyperventilation and chest pain -- these are severe anxious symptoms. Enduring that level of anxiety for any length of time is just not healthy. A small amount of anxiety might be ok, but I'd not make the next reduction immediately the first day your anxiety resolves. You need breathers from it.

I hear you. I can think of a few things you can try. This will be safe, but you have to see what works. Try these one at a time, not all together:

-- alter your doses just slightly so you take slightly less during the daytime. This will be safe, and it should buy you some daytime acutity even at the current higher dosage. (I'd suggest no more than 300 mg difference between one time of day and another, at any given time. Later in the reduction, you'll want to make that difference smaller).

-- If you find you are more comfortable (less post-dose grog, less pre-dose agitation) with a 4 times a day schedule, you might find you can tolerate reductions of 200mg in a single shot.

-- Whether you stay with 3 daily doses or go with 4, make dose reductions on rotation, always starting with the morning dose.

What kinds of doctors have you seen? I'd choose a neurologist or a psychiatrist, not a GP, for help, as you need someone who is knowledgeable about this drugs. A neuro will be more used to dealing with gabapentin, but a psychiatrist might be more sensitive to your situation, and evaluate some alternatives with you regarding the anxiety and agitation. (Having these symptoms and choosing to see psychiatrist does not mean you are "crazy". )

Beware of the vocabulary you use with doctors. Sometimes we have to fence around with what we say to them. Asking to be "treated" can be interpreted by some doctors as "I need pills" and saying you are in "withdrawal" can mean "I am addicted", concept which many will reject when it comes to gabapentin. Also, when they see someone who feels they are "addicted" and asking for "treatment" or "substitution", they might interpret that as drug seeking behavior and refuse service accordingly. This is totally not your case, so pick your words accordingly.

You need: assistance and supervision with gabapentin discontinuation, because you experience severe side effects when you remove even small amounts.

The NA folks don't relate because they are in a different boat than you are. Your desire is to get off the drug, you don't like it, it is not a drug of abuse for you, you don't engage in drug-seeking behavior.

LOL, yeah. Don't take it too badly... just, any little bit of activity you can add in great. I know personally I'm not real safe to go out and run or similar, when I'm all goofy on gabapentin, but an exercise you can work into your day will help you with anxiety in general. Barring that, try 5 mins of meditation, relaxation, breathing, or mindfulness exercises. Or try 2 mins at a time, two or three times a day.

No problem at all. I'd really like to see you get help from a doc on this. I can at most try to talk you through some things, but I do know anxiety is a bad beastie (personal experience) and I hate to think of you dealing with that without medical support.

waves

Peripheral Neuropathy (PN) and Medications & Treatments.

You posted to the PN forum once, but I don't know if you followed up. Many members here take/have taken gabapentin for neuropathic pain of PN, and the med has been discussed exhaustively on that forum, so I would check the archives (Search function) for threads that contain gabapentin or Neurontin in their titles.

There is some anecdotal evidence that magnesium and/or calcium supplementation may attenuate withdrawal symptoms of gabapentin, but I've found nothing definitive/documented.

lessening gabapentin withdrawal

IMO it's important to understand the difference between addiction and physical dependence; they are not the same. Your are dependent on gabapentin, but not addicted to it.

Doc

I have some of the ReMag drops as well as those JNK and NeuroEdure tablets from The Road Back people. I'm not sure those things are working at all. If I take epsom salts baths I tend to feel MUCH MORE withdrawal symptoms rather than less which is kinda weird based upon what people say anecdotally.

I understand that I have a dependence rather than an addiction. I guess since I've never had an addiction I'm simply ignorant. Nevertheless, what I experience in between doses of Gabapentin is so intense it feels my body is craving the drug and I have to contain myself from taking it too soon. Of course, I do feel kind of high from taking it — but it is a nasty disorienting sensation that clouds my mind and certainly my judgment. The only thing I know is I am facing withdrawal symptoms by trying to reduce it and this is what some of my drug-addicted friends say is what is at issue anyway....

I appreciate your comment.