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When I titrated down from my maximum gabapentin dose--
--which at one point had reached 2700/mg day (and yes, I had many of the common side effects in the ramping up process, though many of these, other than the weight gain/bloating, were fairly short-lived), I did it VERY slowly, in the hope of avoiding the uptick in symptoms that happens with almost all symptom-dampening drugs due to the body's upregulation processes in response to drugs.
In the case of gabapentin, which works by reducing the neural firing rate of the central nervous system (it was originally developed as an anti-seizure med), the body naturally upregulates the neural firing rate in response, so titrating down too quickly brings that upregulating process to the fore before the body can recompensate, and one gets "withdrawl sysmptoms". (This is not unique to gabapentin; it happens with most drugs.) In my case, I did get a supply of 300 and 100mg pills from my doctors, who I had told I was going to try to titrate down VERY slowly. I dropped the dosage, on average, 100mg per WEEK, subtracting it from individual dosages in a round-robin manner. Yes, it did take nearly half a year for me to get off completely, but I managed to avoid most of the upregulation compensation rebound symptoms. |
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