Gabapentin
Definition
Gabapentin is an anti-seizure medication. It is sold in the United States under the trade name Neurontin.
Purpose
Gabapentin is used in combination with other antiseizure (anticonvulsant) drugs to manage partial seizures with or without generalization in individuals over the age of 12. Gabapentin can also be used to treat partial seizures in children between the ages of three and 12. Off-label uses (legal uses not specifically approved by the United States Food and Drug Administration [FDA]) include treatment of severe, chronic pain caused by nerve damage (such as occurs in shingles, diabetic neuropathy, multiple sclerosis, or post-herpetic neuralgia). Studies are also looking at using gabapentin to treat bipolar disorder (also known as manic-depressive disorder).
Description
Brain cells normally transmit nerve impulses from one cell to another by secreting chemicals known as neurotransmitters .
Gabapentin is chemically related to a naturally occurring neurotransmitter called GABA (gamma-amino butyric acid). The actual mechanism of action by which gabapentin acts in the brain to control seizures and treat pain is not known, although it appears to alter the action of nerve cells.
Gabapentin was approved for use in the United States in 1993. A liquid formulation was approved for use in 2000. Use in children ages three to 12 was also approved by the FDA in 2000.
Gabapentin is available in 100-, 300-, and 400-mg capsules; in 600- and 800-mg tablets; and in a liquid solution containing 250 mg per 5 ml.
Recommended dosage
People over the age of 12 should be started on 300 mg gabapentin taken three times a day. The dose can be increased up to a total of 1,800 mg per day. In some instances, doses of up to 3,600 mg per day have been tolerated.
Children should receive a dosage of 10–15 mg per kg of body weight per day, divided into three equal doses.
Chronic pain may be treated with 300–3,600 mg per day, divided into three equal doses.
When gabapentin is used for bipolar disorder, the starting dose is usually 300 mg taken at bedtime. Depending on the patient's response, the dose can be increased every four to seven days. Many people receive maximum therapeutic benefit at 600 mg per day, although some people have required up to 4,800 mg per day.
Precautions
Women who are breast-feeding and people who have decreased kidney functioning should discuss the risks and benefits of this drug with their physician. Women who are or wish to become pregnant will also require a careful assessment of the risks and benefits of gabapentin.
Patients should not suddenly discontinue gabapentin, as this can result in an increased risk of seizures. If the medication needs to be discontinued, the dosage should be reduced gradually over a week.
Until an individual understands the effects that gabapentin may have, he or she should avoid driving, operating dangerous machinery, or participating in hazardous activities. Alcohol should be avoided while taking gabapentin.
Side effects
Patients who experience the following side effects of gabapentin should check with their doctor immediately. These include more common side effects, such as unsteadiness, clumsiness, and uncontrollable back-and-forth eye movements or eye rolling. Less common side effects include depression, irritability, other mood changes or changes in thinking, and decreased memory. Rare side effects include pain in the lower back or side, difficulty urinating, fever and/or chills, cough, or hoarseness.
Children under age 12 who have the following more common side effects should also check with their doctor immediately: aggressive behavior, irritability, anxiety, difficulty concentrating and paying attention, crying, depression, mood swings, increased emotionality, hyperactivity, suspiciousness or distrust.
Multiple side effects often occur when a patient starts taking gabapentin. While these side effects usually go away on their own, if they last or are particularly troublesome, the patient should consult a doctor. More common side effects that occur when first starting to take gabapentin include blurred or double vision, muscle weakness or pain, swollen hand, feet, or legs, trembling or shaking, and increased fatigue or weakness. Less common side effects that occur when initiating gabapentin treatment include back pain, constipation, decreased sexual drive, diarrhea, dry mouth and eyes, frequent urination, headache, indigestion, low blood pressure, nausea, ringing in the ears, runny nose, slurred speech, difficulty thinking and sleeping, weight gain, twitching, nausea and/or vomiting, weakness.
Interactions
Antacids can decrease gabapentin levels in the blood. They should be taken at least two hours before taking gabapentin.
Resources
BOOKS
Ellsworth, Allan J. Mosby's Medical Drug Reference. St. Louis, MO: Mosby, Incorporated, 1999.
Mosby's Drug Consult. St. Louis, MO: Mosby, Incorporated, 2002.
Rosalyn Carson-DeWitt, M.D.
Initially I went 4 days without a single migrane (remarkable for me, a chronic migraine sufferer). On the 5th day I got a moderate migraine, however after taking my gabapentin, the migraine subsided.
From what I see, the medication is taken every 8 hours, however I believe it to be more effective every 6 hours (4x daily). Rather than increase the amount per dose, I am trying to increase the daily intake by taking it 4 times instead of 3.
Hopefully just 1600mg will be sufficient to rid the pain for good!
pain medicine---while she is suffering. My M..D. gives
me what I need to function. Did you ever read: Fibromyalia Advocate by Devin Staranyl,M.D. He says if you M.D.
feels that way---get another doctor.
As long as I take it regularly, its wonderful for pain.
But my main questions are has anyone had increased pain and I've been on it for 4 months and this month I got my script and I've been nauseated, walk unsteady. Why would that start now? My pharmacist said it sounds unrelated to her. Thanks.
I was unable to function for 24 hrs. Gabapentin did take away my pain and will knock a horse out.
So basically any side effects anyone has had please post :) thank you
I think personally if you give it a go and it doesnt work fine, but at least give it a go. Here in Australia, I have to go to the hospital to get the prescription made up as the local Pharmacy would charge me a lot for it.
I suffer compression of disks, left leg pain that keeps me awake all night along with tingling in the left leg and pain going right down the left side of me which can be debilitating most of the time. All medications have some side effects, I did try the larger dose but dont think it is for me. After only being on 2 tablets a day morning and night 300mgs I did notice a small amount of relief, not huge but a small amount. Please if you are in pain and not sure, we are all different I have only ever have had the lethargy from this medication, too much though as I need to have a license and dont want to fall asleep behind the wheel of my car.
Just give the medication a go, it cannot hurt and some of the side effects people are talking about dont even come up on the actual site for the product so am not sure where people are getting their information from.
Enjoy a small amount of relief if you can from one chronic pain sufferer to another