[aaronjaffe]

Hi all, I'm new to the forum and could use some input.

Here's the main question: I'm a 6'1, 205lbs male who has very mild reactions to medication -- what would be a sufficient daily dosage of neorontin to treat occipital neoralgia?

I've been suffering with headaches and constant, continuous muscles spams in the face, jaw, neck, and shoulders for more than a year.

I recently diagnosed the root cause as occipital neoralgia, and went looking for treatment options and found that neorontin popped up a lot. However, that's one of the many medications I've already tried. However, the dosage was 100mg once at night, and I stopped after a week of feeling absolutely zero effect from it one way or the other. Is the dosage too low and did I not give it enough time?

Diagnosis: Root cause-- occipital neuralgia. Secondary factors-- minor cervical disc issues (4 minor buldges confirmed by MRI), and TMJ.
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This started for me back in December 2012. I'm a college coach and made it through an entire some how in very bad shape. I have a pretty crazy pain tolerance, but it was rough. Constant spasm pain to the point that constructing complete sentence or even standing could be difficult.

Starting in June 2013 when I was like, "Ok this isn't going to just go away" I started attacking it. 11 doctors, a chiro, 3 months of PT, and no improvement.

Zanaflex, mobic, flexeril, soma, ativan, valium, skelaxin, neurontin... which little relief. Zanaflex helped a little at the start. Both valium and ativan provided significant relief until the effects wore off, and I didn't want to be on them for very long.

A month and a half ago I got fed up after going to another ineffectual doctor. I decided to start directing all this myself, proceeded to use a variety of treatments diagnostically and ended up with the above.

Treatment wise I had cortisone facet injections to see how much the cervical disks were in play (not much). Botox injections this Friday to at least temporarily neutralize and TMJ issues. I needed to get a treatment plan together fast for occipital issues.

Our season starts in a week. And I don't think I can physically or mentally make it through another one like last year.

Thanks,
Aaron

[glenntaj]

--though I'm sorry you haven't been able to get much relief.

For what it's worth, 100mg of Neurontin is a TINY dosage, especially for someone your size. Most doctors/neurologists will start at low dosages, due to the side effects (typically, as with many anti-seizure drugs, fogginess, lethargy, fluid retention, weight gain) and ramp up with time as one becomes acclimated to these--but I suspect that at your size you may not even be experiencing that on that dosage.

Neurontin is used for a variety of neurological pain and seizure conditions, but it may only be effective for somewhere around to a third of half of all patients. Still, you could try a dose gradually raised over days. I know of people with MS, peripheral neuropathy, etc., who have gone as high as 4800mg/day and still gotten some additional relief with each ramp-up, though the drug availability does tend to be reduced at higher levels (i.e., a jump from 300 to 600mg/day tends to be more noticeable in effect than one from 900 to 1200, and so on).

At my highest, I was up to 2700mg/day to control my very painful full-body small-fiber neuropathy. I started with 300mg/day, and I weighed about 190 at the time--I did notice an immediate effect but did not get 'full" effect until I was taking 800mg three times each day. Each ramp up did involve a bit of getting used to as side effects would ramp up as well, but fortunately these would subside back to more "baseline" levels in several days. (When I came down in dosage from the drug I did it VERY slowly, as one is supposed to with anti-seizure meds to prevent rebound effects--I would come down about 100mg each week; it took me several months to come off it completely.)

Often, meds such as neurontin are prescribed with an small dose of anti-depressant such as Elavil, in that for many these meds have a synergistic effect.

We do have a meds forum here where you can look for more info:

http://neurotalk.psychcentral.com/forum72.html