Gabapentin
 

I've recently been prescribed gabapentin by my neuro which is supposed to help with a number of symptoms. I have started at 300mg but I'm nervous to continue taking it considering Ive read that their are many interactions with supplements such as magnesium and calcium and I believe supplementation to be more imporrtant. I did notice a calming effect to the medication but I'm confused what to do here.

Anyone with any insight into the interactions here? Doctors and pharmacists seem to be useless about these (important) types of things.

Take the magnesium at the opposite time of day. I take 600 mgs of gabapentin before bed. I take the supplements about 12 hours opposite to that. (between breakfast and lunch)

I've been taking gabapentin for 14 years. The way it helps my body and mind let go of tension is great. It allows me to sleep without muscle twitches. It has a short half-life of 8 hours so it does no effect me the next day.

Thanks for the quick reply. I was a little hesitant about starting this medication but I do feel there is some benefit. Do you know what kind of dangers are associated with taking the supplements at the same time as the gabapentin dose? It baffles me (even though it shouldn't at this point) that my neuro failed to mention this and the local pharmacist didn't even know the mechanism of action.

It decreased absorption. The interaction checker says to just have a 2 hour separation between gabapentin and magnesium. No big deal. The risk is not getting enough gabapentin if it is taken to prevent seizures.

Rather than deal with 2 hours, I just take them at different times of the day.

I was also prescribed gabapentin for constant headaches at the suggestion of a PT who likened my pain receptors to motion sensing lights that were tuned to turning on at ants as opposed to people. I haven't taken it yet, as I had just finished being prescribed a bunch of muscle relaxers and prednizone that didn't help, and am kind of sick of medication. Any insight into whether gabapentin might help? I've heard that it's a medication doctors often try to treat a number of things, but you often need to take it at very high doses.

Gabapentin works at low doses such as 300 to 600 mgs. High doses are 1200 to 3600 mgs. I was on 1200 mgs for a few years.

This drug is fantastic for a range of conditions. It's a great anticonvulsant. It's also very useful for chronic pain conditions:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146212/
http://www.ncbi.nlm.nih.gov/pubmed/15564948
http://www.researchgate.net/post/Whi...h_chronic_pain

I'm on Pregabalin which is the 2nd generation version:

http://www.ncbi.nlm.nih.gov/pubmed/23374941
http://www.ncbi.nlm.nih.gov/pubmed/22879908
http://www.ncbi.nlm.nih.gov/pubmed/19539427
http://www.ncbi.nlm.nih.gov/pubmed/20056767

The pregabalin stops my hypnic jerking while trying to get to sleep:

https://en.wikipedia.org/wiki/Hypnic_jerk

Both show similar results, at least in chronic pain:

http://www.nps.org.au/publications/h...013/pregabalin

As with all drugs, both Gabapentin and Pregabalin can have side effects:

http://www.drugs.com/answers/gabapen...hy-674995.html

If you get bad side effects with one I would suggest trying the other.

If you take them when you wake up, the cognitive side effects are going to be worse. My doctor has me take the pregabalin before bed and it makes falling off to sleep so easy.

I'm prescribed 300mg 3 times a day. The neurologist explained that it would help with my headaches at the original concussion site and perhaps aid in my anxiety and OCD symptoms. I originally tried taking it at night but it disrupted my sleep. I know that is a paradoxical effect.

That is why I take it during the day as well as at night. My brain seems to be getting used to it and it no longer disrupts my sleep as far as I can tell. I'm hesitant to dose 900 mg all at once, since I am rather sensitive to medications at this point. I've noticed some adverse effects but overall it seems to be helping. Perhaps, pregabalin would be better suited for me, but my neurologist is not very flexible.

Mark, have you ever had to discontinue your use of Gabapentin. I've been reading online and a lot of users report some terrible withdrawal symptoms similar to benzodiazapine withdrawal.

Any experience with the tapering or withdrawal of gabapentin? I'm currently taking your dose of 600 mg/night before bed.

I went cold turkey for a week when we forgot to take it on a trip. No problem. If you are only taking it once a day, very little stays (less than 1/2) past 8 hours. So, you taper off every day. Some need to take it 3 times a day for more serious conditions plus some take much stronger doses.

I cold turkeyed off Klonopin to gabapentin. I did not notice a problem with the benzo either.

Any withdrawal would likely be at the most just some uncomfortable twitches or such. It would be easy to break up pills so you could taper off. 600 to 300 to 1/2 of a 300 would be an easy taper off.

My doctor prescribed gabapentin to help with sleep difficulties about a month after my concussion. After my first dose of only 300 mg, I woke up feeling worse than any time I've ever been intoxicated on alcohol. I was stumbling, I was dizzy, and my tongue was not working right. I had to stay home from work, obviously. Eventually, I felt better. I told my doctor how I reacted, and he thought it was odd, as some people take more than that dose during the day.

After a few weeks, he wanted me to try it again. I was worried about possible tardive dyskinesia, but he told me it shouldn't happen. He wanted me to pour out about 2/3 of the capsule and try it again before bedtime. Reluctantly, I did. I had nearly as strong of a reaction the 2nd time, but this time, the tongue reaction stayed. That was about a year ago. It is not noticeable to everyone else, but when I am extra tired or stressed, I have a bit of a lisp because my tongue is affected. I have to work extra hard to speak normally.

I was not someone who was med-sensitive before my concussion. But after that, and a rather strong reaction to a general anesthetic for an out-patient surgery after my concussion, I am very wary of trying new meds. What I'm finding out is that very few studies are done on how common meds affect persons with concussion or other acquired brain injury.

On top of that, a couple of months later, I saw a rather sensationalist-looking headline about neurontin (gabapentin) and Lyrica (related to neurontin) being a 'death sentence' for new synapses. Not something I want post-TBI! I followed the trail to the original study, and basically, yes, that's what it's saying. That's a good thing for preventing formation of synapses related to epilepsy (gabapentin is an anti-epileptic). Not a good thing elsewhere, IMO. I just don't want to take any chances.

I tried to post the links to the study and another article on gabapentin and presynaptic plasticity, but my post count isn't high enough. They are free on PubMed, so here are the titles:

Gabapentin receptor alpha2delta-1 is a neuronal thrombospondin receptor responsible for excitatory CNS synaptogenesis. Cell. 2009 Oct 16;139(2):380-92

Astrocyte-derived thrombospondins mediate the development of hippocampal presynaptic plasticity in vitro. J Neurosci. 2012 Sep 19;32(38)

I wish you responded earlier with this information. Im currently at 1200 mg/day. I'm looking to taper down. Can anyone help me? I'm afraid of seizures.

I've been on 600 mgs of gabapentin for 14 years. Was at 1200 mgs for the first few. I read the literature. The negatives are not at bad as they sound. First, they were only observed in rats. Second, the reduction in synapse genesis was just a reduction, not a stoppage. Third, the vast majority of synapse genesis happens in the first 5 years of life. There is very little happening in adults.

You will likely suffer much greater damage from seizures than from a reduced synapse genesis.

*administrative edit* There have been similar postings about SSRI's and just about every other med. There are negatives about Tylenol/acetaminophen, one of the most trusted meds on the planet. .

I will get back on here tomorrow (which is really today, [emoji4][emoji23][emoji23][emoji23]) I can't keep my [emoji102] open to write like normal. I keep messing Up.

I take 3600mg.


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Alma,

I had some out patient surgery at 6 months post head injury (unrelated).

You talk about a bad reaction! Oh my. I woke up from anesthesia a very different person than who walked in the hospital. One night my wife went shopping and when she came home I was frozen with terror. She was on her Ipad trying to find out info about the surgery. I was so convinced she was telling a boyfriend she couldn't come over...I fought for all I was worth to keep from choking her. Meds can be powerful stuff.

I found that until just recently I did not react to meds or supplements well during injury recovery ....some have had an opposite effect on me than intended.

Bud

I have not had any seizures to my knowledge and am not epileptic so I don't see any reason to be taking this medication. I wish I had known about its relative dangers before starting it. I want to discontinue it but I seem to be having withdrawal symptoms. Trying to hold steady at 1200mg/day and then taper down to 900.

Why do doctors insist on prescribing medications without explaining the downsides? I specifically asked my neuro before taking it if gabapentin was habit forming and he told me no.

Another failure of the United States medical system. I am going to write a book about this pathetic display eventually.

DannyT,

I don't think you should be concerned. The research does not say gabapentin is dangerous. The warnings that came from the research pertain to infants and young children. *administrative edit*
The "Death Sentence" headline was not supported by the research. It is just alarmist hyperbole used to get people to read an article. We can't live our lives based on alarmist headlines. We must dig deeper if the headline is a concern.

As I have said before, I have been taking gabapentin for almost 15 years. I don't plan on changing. Without it, my body twitches when I sleep.

I totally agree Mark but I have been experiencing withdrawal symptoms between doses. With a half life of 5-8 hours this means I wake up every day over anxious and sore. I just want to limit my use of a drug that has little value to me at this point, now that I know a little more about it.

How likely do you think a seizure is from starting a taper or even cold turkeying it?

I've involuntarily cold-turkeyed for 7 days without a problem. Are you taking 1200 mgs once a day or splitting the dose ?

Some meds can cause symptoms when there is a change, both increasing and decreasing the dose after a steady state has been maintained for an extended period.

If you are going to wean off completely, please let your doctor know. Some people struggle with depression from changes.

The likelihood of a seizure is entirely dependent on your brain's condition. I don't think anybody can predict.

This is what I put my thumbs up to. I see a failure in the medical system when it comes to communication and patient education. Pharmacists are the ones who know, or SHOULD know the most about the medicines you're taking. After all, they are DOCTORS of pharmacy and went to school for the same if not longer length of time than a medical doctor. That's why their license, most of them in a hospital, and now changing in current retail settings too, say PharmD! They are Doctors of Pharmacy. There are MANY YEARS and THESIS writings behind that title badge. It's not all about just counting pills people.

And for the LOVE of GOD!! Stay at the same DAMN pharmacy!! Don't be bouncing around from pharmacy A to pharmacy B to pharmacy C because this makes it a hell of a lot harder to keep track of drug interactions!

I personally think Gabapentin is an excellent drug to use and have seen a lot patients do well with it. Before you ask, yes, pharmacy used to be my job. I was a CPhT for 20+ years. Not anymore since my crash [emoji33][emoji31][emoji22] I worked awhile after, but just can't. Anyway, back to it. So Gabapentin is an excellent drug for a lot of people, but every drug out there affects people differently. What works great for me, may not work for you, and vice versa.

I started off on the lower dose range on Gaba, but I don't recall what it was. Hence what part of what's part of my problem now [emoji15], and I can lol about it. I am now on the max dose, which is 3600mg a day. I take 1200mg: three times a day.

I thought a mention or two in here was about epilepsy or lack of. I do not have "true epilepsy" either. Least I don't think so? However, I do have seizures. They are not your typical seizures that everybody thinks of when people "hear" the word seizures. Seizures do not AUTOMATICALLY classify them as Grand Mal seizures, which ARE the Tonic-Clonic generalized ones. Muscle shaking, falling down, foaming at the mouth, very scary to see, etc.

There ARE several other types of seizures. I happen to suffer from another type. Courtesy of my severe TBI which I sustained in my crash. Yeah me. I just happen to be in the record books for coming back so good for having such horrific things happen to me. Called never give up. Although lately things catching up [emoji22] now

In the end here? Each individual is just that, an INDIVIDUAL


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I've been splitting the dose for a little over a month now. I was holding steady at 300 mg and then my brother died and I increased the dosage and started taking it during the day.

I currently need to take 300mg as soon as I wake up and right before I go to sleep to help stave off the withdrawals and even that is inadequate.

For example, I woke up an hour ago and have felt like crap since. I took the 300 mg but it takes so long to be metabolized. I just want to be free of this back and forth and move on. It's really not fun added to my whole situation. I'm a soldier now I guess. Damn what a couple mild TBIs can do. I'm keeping the faith it will get better. It's been over a year now.

Danny, I don't know much about this except for what I've read here on the forums. I've never taken it. When you say you're splitting it do you mean that you're prescribed 600mg tabs and taking 300mg twice a day? Or, are you taking the capsules?

You could run a search here for past posts too e.g. either Neurontin or Gabapentin taper or withdrawal

There are many recommendations online to treat it like a benzodiazepine taper. You've probably seen that already.

Half-life is only 5 to 7 hrs.

Personally, if I was doing this I'd do it very, very slowly and with supervision of your doctor.