slept 30 hours. not on any new meds..didn't take xanax or ambien
 

what the heck? just when I hought things couldn't get any weirder. woke up a few times for a minute and tried to take my meds but arms wouldn't do what they were told. what now

30 hours... wow! get hydrated is the first thing I would do!

You must have been exhausted.

Do you feel any better now after you've woken up more?

You stole sleep from me. I hardly slept at all last night. Forgot to take my gabapentin.

sorry Mark :). maybe the gabapentin really knocks you for a loop when you increase it and it builds up in your system. I felt better a little better but not 30 hours worth!!

I'm sure you get all the sleep from us and we are awake every night and you really knock down!!! Maybe you were exhausted and needed that sleep so bad.
I'm glad you are ok and hope you keep resting well,gentle hugs from jesika .
Please tell us the secret!!!:grouphug:

thanks Jesika..alas I increased the gabapentin because of insomnia, night terrors, nightmares, tremors, and broken sleep. sometimes I am up 30 hours and now sometimes I sleep 30 hours :) never a dull moment with a tbi/pcs. perhaps the gabapentin will keep building up and I will sleep like a normal human being for the first time in years. here' hoping we all find the supplement/regimen/medication that brings that to all of us

god i would love to just sleep and sleep til this f'ing thing is over. but i'm terrified to try a new drug after dropping amatryptaline and starting sertaline (zoloft) caused an anxiety attack...which ended when i reversed course.

i'm getting 8 hours w/ occasional ambien, and the amatryp makes my legs jumpy when i take more than 12mg at night, so haven't found an approved way to knock myself out for say, 6 weeks. then i'd hopefully wake up and feel like myself again.

any advice? or...is it: "there's no way out but through."

just fantasizing here, but wouldn't it be great if we could just check ourselves into a swanky hospital, some sorta drug would knock us out and another drug would fix our brain. then we'd wake up with no memory of the horrors of pcs, but we would still be able to walk away with the wisdom gained. or not. f' wisdom.

are you kidding? I would LOVE that. it actually exists now for drug addicts. it's called rapid detox, they put you under anesthesia and pump you with a drug that takes you out of withdrawal and you wake up ok. or something like that.

if it existed for brain injury I would pay anything. I actually felt good for two hours the other day and was ready to send you guys a dear john letter but then the feeling good went away :)

Mark. If you increased your gabapentin, yes, it can do that.

It's likely you'll get used to the sedation in a week or so, but it might calm some of the sleep issues.

How much were you taking before, and how much did you increase it by?

nine hudred to eighteen hundred. it has helped the waking up burning and trembling thing but not the chronic head neck pain. I know it is only good for certain pain. i'll take it

I dream about this often... I also have said that if I was knocked out right after for a few days then I would have faired better... I would have gotten proper "brain rest" and may be "healed" by now....

Holy guacamole, no wonder you slept 30 hours! :D Upping 900 at a time is pretty big increase.

Glad it helped with the burning/trembling at least. Sounds like that was keeping you awake and waking you up. Also, you know, gabapentin works only by chronic exposure you dont' see full effect until it stays in the system a while... give it a week and see. Who knows, perhaps it will reduce the head pain some as well.

Increasing above 1800 can be done safely with medical supervision, but it's less likely to be useful. (Response is non-linear above this dosage, i.e. the drug is less and less "efficient").

waves

wave,

Keep in mind that markneil is 350 pounds. It may be a part of why such a high dose is needed and well tolerated.

I am 150+ pounds and have taken up to 1200 mgs before bed. At first, I needed 1200 or at least 900. Now, I do fine with 600.

It is not know to help with normal pain (that's an off label use), such as skeletal pain but helps some with nerve pain similar to Lyrica.

I've been taking it for 14 years.

I take it to reduce the body jerks and to help my mind let go of thinking. Its half-life is only 8 hours so unless it is taken multiple times during the day, its benefit can be targeted at sleep issues.

markneil, If you are waking up still tired, did you keep your cpap mask on ? Apnea will negate the good sleep benefits.

Hi Mark! :)

Seems to me also that weight would be a factor in overall dosing as this med is heavily distributed in tissues (diffuses out of the blood). But I do know of people over 200 lbs and use only 600-900 successfully.

However, an increase of 900mg at a time is steep even if one is heavy, and could certainly bring on a potent sleepiness. ;)

The thing I was saying about dose is only about absorption. Higher than 1800 studies show that dose/response rate loses linearity. For instance, increases from 1200 to 1800mg, or from 1800 to 2400 mg, are both 600 mg. But in the latter case, a bit less of the med is going to get "delivered" and as you increase further, less and less of it gets "delivered". Not sure if that's clear I'll try to find you a link tomorrow. (I need to get to bed!)

I take gabapentin myself... have on and off for years -- 1200mg for migraine prevention. And sometimes other things.

Yes, it's good with the letting go of thinking... can be a little "too good" that way. :D:o (When I was on another med along with it, I couldn't handle it.... I couldn't think straight to do my job. :eek:)

Interesting. I used to keep it as a sleep aid, but it only worked if I didn't use it with any sort of regularity. In other words, I got used to the sedation quite quickly. I don't know, but I wouldn't want to take a really steep dose on an occasional basis... I'd be afraid of seizures when it leaves the system.

The half-life is misleading becausee this thing has crazy pharmacokinetics.
It takes several hours just to be absorbed (3-5 hours). I notice this when I start taking it... start feeling brainfuzz and sleepiness at about 5 hours after each dose.)

And then, it doesn't stay in the blood it migrates into tissues... body fat.

All in all, the slow absorption means plasma concentration risees very slowly, and then the tissue distribution means it falls off somewhat more rapidly than the half-life suggests as it permeates into body fat.

waves... who will check back tomorrow and try to find you some links that maybe explain better if you like. Or maybe I misunderstood you and you already knew these things. :o Nite nite for now.

Waves,
I thought I was a big shot because I read so much about Neurontin and how it works. I didn't know anything you mentioned :) very interesting. would love the website for further information and to kill time :)

I start to get effect from my before bed dose within 90 minutes. It could be that I never take it except before bed.

I don't get any cognitive decrease when I take it. It just sets me up so I can relax my thinking if I want/need to. I still need to practice good sleep hygiene to get to sleep. It does not put me to sleep.

btw, Time for my bedtime dose. I want to sleep tonight.

sources -- and amendments -- re: gabapentin pharmacokinetics
 

Hi again, Mark & Mark. :)

Ok, so most of my bookmarks on gabapentin were defunct or too specific and not about dosage considerations... so I had to go to google .... took me a bit.

AND, what turned up this time is little different than what I remember or perhaps found before. Not entirely surprising because every time I google this med something different comes up.

Anyway, I will post a few of the sources/articles.

1. http://www.ncbi.nlm.nih.gov/pubmed/8022536


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2. http://onlinelibrary.wiley.com/doi/1...01.02399.x/pdf

This tells us something a little more specific... not only the daily dose is significant, but the size of an individual dose is significant in absorption, becausee the transport mechanism (you can research this if you want) gets saturated... only a limited supply of "gabapentin taxi-cabs", lol. This suggests to me that taking a certain daily dosage split into a greater number of smaller doses can deliver slightly more gabapentin than taking fewer larger doses.

So, although it distributes outside the blood, it does not accumulate much in adipose tissue. This means weight is unlikely to have much impact on dosing considerations. (Perhaps a little, but would perhaps need more specifics on the albeit low concentration of drug in adipose tissue to believe that.)

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3. http://www.rxmed.com/b.main/b2.pharm...NEURONTIN.html

3 hrs is faster than what I remember/stated... might have been "tainted" by my own experience.

300-400 mg q8h is 900 to 1200 mg a day -- plasma conc. is dose-proportional.
">600 mg q8h" would be more than 1800/day -- over 1800mg a da plasma conc. is less than dose-proportional.

In other worsds, some people may respond with only a little in their blood, while others need a lot.

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4. http://www.rxlist.com/neurontin-drug...armacology.htm

This source states something slightly different -- that availability decreases as the dose goes up, even starting at 900 mg/day. These numbers still show a progressive decrease in availability with increasing dose. I do find very interesting though that the rate of decrease slows down as the dose goes up.

waves

What I know on its mechanism of action is murky... the only stuff I could find was either murky or too difficult for me to grasp completely. Many sources still report the mechanism of action as unknown, so if you know how it works you are doing way better than most! :D

If they are measuring plasma concentrations, the more plasma in a body, the lower the concentration for the same dose. Blood volume is directly proportional to weight.

All this data aside, what matters is how the person reacts to a specific dose of gabapentin. All the theory in the world will not over-rule how an individual responds.

If plasma concentration peaks at 3 hours, I must be responding to a lower concentration. Maybe the higher concentration achieved later is what helps me sleep so soundly.

That sounds right when you're considering the difference between a child and and adult, or even between a 5.3 woman and a 7.2 man, say.

However, if considering two adults of about the same height and build, where one is skinny and one is rotund, I don't see it.

Are you saying that if I, who weigh 140lb, were to put on another 140lbs, my plasma volume would double?

[edited to add that I sort of answered my own question in the next post.]

Right, and not only, the data itself shows that response to this particular drug is highly individual -- response doesn't correlate to plasma concentration.
Remember that 3 hours is the statistical mean. You might peak sooenr, and I might peak later.
Also remember that we can feel effects sooner than peak -- might be your case.

The helping to sleep is really individual. What helps whom depends a lot on why one is having difficulty sleeping. When I go to a sleep aid it's because I basically need a boulder dropped on my head. ;):D

take care

waves.

I'm guessing there would have to be a constant so it wouldn't increase by the same proportion as weight, but still in a linear fashion. I found an interesting article that brings up *all kinds* of considerations in the case of obese patients... not just blood volume. Apparently med absorption can increase or decrease depending on the specific characteristics of the med.... I am not going to hazard a guess with gapapentin, lol:

http://www.healio.com/orthopedics/jo...ons-in-obesity

(The article discusses mostly drugs associated with orthopedic surgery, but it talks about the whys and the wherefores... and these are quite interesting, and diverse! :eek:)

Happy reading to anyone interested.

Yeah I keep thinking about this as well. If they could just put me in a coma for 6 months to let my brain rest, I wouldn't mind that at all. You go to sleep, and wake up all good 6 months later.