Gabapentin is used to help control partial seizures (convulsions) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.
Gabapentin is also used to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles.
Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It is not used for routine pain caused by minor injuries or arthritis. Gabapentin is an anticonvulsant.
This medicine is available only with your doctor’s prescription.
This product is available in the following dosage forms:
Capsule
Tablet
Tablet, Extended Release, 24 HR
Solution
Suspension
Gabapentin Dosage for Children
Please remember that you are not allowed to buy Gabapentin Online if you are 19 years old and under. Please find a local doctor to prescribe you Gabapentin prescription and buy it in a local Gabapentin pharmacy.
Gabapentin is FDA-approved as a secondary treatment for partial seizures in children 3 years or older with epilepsy. The use of gabapentin in children for any other medical condition is not FDA-approved. Dosing will be determined by both the child’s age and weight.
Gabapentin dosage by age for children older than 3 years
Age (yr)
Recommended dosage
3-4 yrs
40 mg per kg (18.2 mg/lb) of body weight divided into three doses Maximum: 50 mg per kg (22.7 mg/lb) of body weight daily
5-11 yrs
20-35 mg per kg (9.1-15.9 mg/lb) of body weight divided into three doses Maximum: 50 mg per kg (22.7 mg/lb) of body weight daily
12 yrs or older
300-600 mg taken three times per day Maximum: 3600 mg per day
Gabapentin is a generic prescription drug that is FDA-approved as an add-on treatment with other medications for partial seizures in those with epilepsy.
It can also be used to treat nerve pain from postherpetic neuralgia (a complication of shingles). Gabapentin is frequently prescribed off-label for many other conditions, such as diabetic peripheral neuropathy, fibromyalgia, and alcohol dependence.
Gabapentin is typically prescribed as a generic, but the drug is also available under the brand names Neurontin and Gralise. Some patients may be prescribed drugs very similar to gabapentin—such as Horizant (gabapentin enacarbil) or Lyrica (pregabalin)—instead of gabapentin.
Gabapentin is taken as a tablet, capsule, or oral liquid. Dosing will depend on the condition being treated, age of the person being treated, and kidney function. The usual dose for epilepsy starts at 300 mg on the first day. The dose can then be increased until an effective dose is reached, which is usually 300 to 600mg taken three times per day.
Gabapentin dosage forms and strengths
Gabapentin is taken by mouth as a tablet, capsule, or oral solution.
Tablets: 600 or 800 mg per tablet
Capsules: 100, 300, or 400 mg per capsule
Liquid: 250 mg per 5 milliliters (ml) oral liquid
Gabapentin dosage for adults
For adults, the gabapentin dosage can vary widely depending on the condition being treated. Upon starting treatment with gabapentin, the starting dose may be 100 to 300 mg per day and steadily increase until an effective dose is reached. The maximum dosage will depend on the condition being treated.
Standard gabapentin dosage for adults: 300-600 mg taken three times per day.
Maximum gabapentin dosage for adults: 1200 mg taken three times per day for a maximum daily dose of 3600 mg.
Gabapentin dosage for children
Gabapentin is FDA approved as a secondary treatment for partial seizures in children 3 years or older with epilepsy. The use of gabapentin in children for any other medical condition is not FDA-approved. Dosing will be determined by both the child’s age and weight.
by both the child’s age and weight.
Gabapentin dosage by age for children older than 3 years
Age (yr)
Recommended dosage
3-4 yrs
40 mg per kg (18.2 mg/lb) of body weight divided into three dosesMaximum: 50 mg per kg (22.7 mg/lb) of body weight daily
5-11 yrs
20-35 mg per kg (9.1-15.9 mg/lb) of body weight divided into three dosesMaximum: 50 mg per kg (22.7 mg/lb) of body weight daily
12 yrs or older
300-600 mg taken three times per dayMaximum: 3600 mg per day
Gabapentin dosage chart
Indication
Age
Standard dosage
Maximum dosage
Partial seizures
12 years and older
300-600 mg three times per day
3600 mg per day
5-11 years
25-35 mg/kg (11.4-15.9 mg/lb) per day divided into three daily doses
50 mg/kg (22.7 mg/lb) per day
3-4 years
40 mg/kg (18.2 mg/lb) per day divided into three daily doses
50 mg/kg (22.7 mg/lb) per day
Postherpetic neuralgia
18 years and older
300 mg on day 1, 300 mg twice daily on day 2, then 300 mg three times daily on day 3; dosage may be further increased after day 3 to 600 mg three times per day
1800 mg per day
Diabetic peripheral neuropathy
18 years and older
300-1200 mg three times per day (off-label)
3600 mg per day
Fibromyalgia
18 years and older
600 mg twice daily and 1200 mg at bedtime (off-label)
2400 mg per day
Alcohol dependence
18 years and older
300-600 mg three times per day (off-label)
1800 mg per day
Gabapentin dosage for partial seizures
Gabapentin is FDA approved as adjunctive therapy for partial seizures in adults and children 3 years of age or older.
Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
Maximum gabapentin dosage for adults: 3600 mg daily in three divided doses.
Renally impaired patients (kidney disease)—dose amount and dose frequency adjustment:
Creatinine clearance of 30-59 ml/min: 200 to 700 mg twice per day
Creatinine clearance of 16-29 ml/min: 200 to 700 mg once per day
Creatinine clearance of 15 ml/min or less: 100 to 300 mg once per day decreased proportionately (1/15 per whole number value) for each decrease in creatinine clearance
Hemodialysis: dose is dependent on estimated creatinine clearance; a supplemental dose of 125 to 350 mg is given after dialysis
Gabapentin dosage for nerve pain due to shingles (postherpetic neuralgia)
Gabapentin is FDA approved to treat postherpetic neuralgia, that is, neuropathic pain due to shingles (herpes zoster).
Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
Maximum gabapentin dosage for adults: 1800 mg daily in three divided doses.
Renally impaired patients (kidney disease): See dosage for renal impaired patients above
Gabapentin dosage for neuropathic pain
Gabapentin is most frequently prescribed off-label to treat nerve pain (neuralgia) due to nerve damage (neuropathy), compression, or irritation.
Standard gabapentin dosage for adults: 300 to 1200 mg taken three times per day by mouth.
Maximum gabapentin dosage for adults: 3600 mg daily in three divided doses.
Renally impaired patients (kidney disease): See dosage for renal impaired patients above
Gabapentin dosage for fibromyalgia
Gabapentin is used off-label to reduce fatigue, provide pain relief, and improve sleep in patients with fibromyalgia.
Standard gabapentin dosage for adults: 600 mg twice daily and 1200 mg at bedtime.
Maximum gabapentin dosage for adults: 2400 mg daily.
Renally impaired patients (kidney disease): See dosage for renal impaired patients above
Gabapentin dosage for alcohol dependence
Gabapentin is widely used off-label to reduce insomnia and cravings in people with alcohol use disorder, particularly those in the maintenance phase of alcohol abstinence.
Standard gabapentin dosage for adults: 300 to 600 mg taken three times per day by mouth.
Maximum gabapentin dosage for adults: 1800 mg daily in three divided doses.
Renally impaired patients (kidney disease): See dosage for renal impaired patients above
Gabapentin dosage for pets
You should not give gabapentin to animals unless a veterinarian has given the animal a prescription for gabapentin. Veterinarians frequently prescribe gabapentin to treat seizures or chronic nerve pain in pets and large animals. The recommended dose is 5-10 mg per kilogram of body weight (2.3-4.5 mg/lb) every 12 hours, but dosing will vary between veterinarians. Gabapentin dosages can vary from 3 to 11 mg per kilogram (1.4 to 5 mg per pound) as an analgesic to 10 to 30 mg mg per kilogram (4.5 to 13.6 per pound) as an anticonvulsant. As with people, the dose may start small and steadily increase until an effective dose is reached.
First, we must consider the different neuropathic pain types. Neuropathic pain can be diverse in nature, encompassing a wide range of pain types, including post-herpetic neuralgia (PHN), painful diabetic peripheral neuropathy (DPN), and painful cancer-related neuropathies.
Gabapentin has been shown to be beneficial in treating several types of neuropathic pain; however, the mechanism of action by which gabapentin exerts its analgesic effect is still unknown.
It is suggested that gabapentin may block the calcium channel alpha(2)delta (a2d)-1 receptor in the brain. This protein-modulated receptor is involved in excitatory synapse formation. Therefore, the therapeutic effects of gabapentin may be attributed to prevention of new synapse formations.
Gabapentin was shown to offer substantial improvement in neuropathic pain with side effects that were similar to those on placebo.
Even with sufficient data supporting the use of gabapentin in the treatment of various neuropathic pain conditions, gabapentin only has Food and Drug Administration (FDA) approval for PHN. Dosing recommendations for off-label use of gabapentin can be somewhat ambiguous, if a recommendation exists at all. Therefore, several studies further investigate dosing regimens specific to other neuropathic pain syndromes.
Gabapentin Dosing Considerations
Three gabapentin products are FDA approved to treat PHN. The different formulations cannot be interchanged and each has its own dosing schedule.
For immediate-release gabapentin (Neurontin), dosing may be initiated with 300 mg on day 1, doubled on day 2 (300 mg twice a day), and tripled on day 3 (300 mg 3 times a day). The dose can then be titrated up as needed for pain relief to a maximum dose of 1,800 mg daily (divided into 3 daily doses). Clinical studies referenced in the package insert state that efficacy for a range of doses from 1,800 mg/day to 3,600 mg/day were observed; however, there was no additional benefit seen with doses greater than 1,800 mg/d.
Gralise is an extended-release gabapentin formulation that also is FDA approved for PHN with a titration schedule that begins with 300 mg on day 1; 600 mg on day 2; 900 mg on days 3 to 6; 1,200 mg on days 7 to 10; 1,500 mg on days 11 to 14; and 1,800 mg on day 15 and thereafter.
The third gabapentin formulation for PHN treatment is another extended-release product, Horizant. The starting dose is 600 mg in the morning for 3 days, increased to 600 mg twice daily on day 4 and thereafter. A daily dose of Horizant greater than 1,200 mg provided no additional benefit at the expense of side effects.
Several studies have evaluated off-label use of gabapentin in the treatment of other neuropathic pain conditions. A randomized, double-blind trial compared gabapentin to placebo in 135 patients with DPN over 8 weeks. The results showed a statistical benefit of gabapentin compared to placebo, at all end points, for pain improvement.
The gabapentin dosing regimen used in this study was 900 mg/d for week 1; 1,800 mg/d for week 2; 2,400 mg/d for week 3; and 3,600 mg/d for week 4. All the patients were titrated up to a dose of 3,600 mg/d, regardless of efficacy at lower doses. Patients who could not tolerate this dose were titrated down to the greatest tolerable dose.
Of the 84 patients randomized to the gabapentin group, 56 (67%) were able to tolerate 3,600 mg/d.During the first week, gabapentin resulted in improvement in sleep interference compared to placebo.
By the second week, gabapentin resulted in improvement in all pain rating scales compared to placebo. Of the 84 patients in the gabapentin group, 70 completed the study, and 7 patients withdrew due to adverse drug events (ADEs). Most ADEs reported in the gabapentin group were of mild or moderate intensity, and the most frequently reported effects were dizziness (23.8%), somnolence (22.6%), headache (10.7%), diarrhea (10.7%), confusion (8.3%), and nausea (8.3%).
A double-blind crossover study (n=40) assessed gabapentin for the treatment of DPN. The dose of gabapentin used in this trial was much lower, with patients titrated up every 3 days to a maximum dose of 900 mg/d. The end points evaluated in this study included level of pain on a visual analog pain scale (VAS), and scores on the present pain intensity scale, the McGill pain questionnaire (MPQ), and the global assessment of pain relief.
Statistical improvement between gabapentin and placebo was noted in only 1 end point, the MPQ score, with a mean reduction of 8.9 points for gabapentin compared to 2.2 points with placebo (P=0.03). No serious ADEs were noted, and the most common ADEs of gabapentin were drowsiness, fatigue, and imbalance. The results of this study suggest that gabapentin is not effective or is only minimally effective in treating painful DPN at a dose of 900 mg/d.5
A search in the Cochrane Database of Systematic Reviews was conducted to further examine dosing regimens for neuropathic pain. In a review analyzing 37 studies for gabapentin treatment in chronic neuropathic pain, the main outcome was Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) definitions for moderate and substantial benefit in chronic pain studies.6 These were defined as follows:
30% reduction in pain over baseline (moderate)
50% reduction in pain over baseline (substantial)
Much or very much improved on Patient Global Impression of Change (PGIC) (moderate)
Very much improved on PGIC (substantial)
Gabapentin was shown to be better than placebo across all studies for IMMPACT outcomes. The review concentrated on gabapentin doses of 1,200 mg/d or greater and reported that doses at or above this threshold were reasonably effective for treatment of various neuropathic pain types.
The upper threshold for maximum effective gabapentin doses ranged from 2,400 mg/d to 3,600 mg/d in the majority of studies reviewed.
ADEs and withdrawal rates for patients taking gabapentin doses of 1,200 mg/d or greater were compared to those for patients taking placebo in 20 studies with 4,125 participants. Common ADEs seen were somnolence, drowsiness, and sedation.
These occurred in 14% of participants in the gabapentin group versus 5% of those taking placebo. Data also showed gabapentin was associated with a higher incidence of dizziness (19% vs 5%), peripheral edema (7% vs 2.2%), and ataxia or gait disturbances (8.8% vs 1.1%).
The rate of serious events was similar between gabapentin and placebo groups. Twenty-two studies involving 4,448 patients reported on participant withdrawals due to ADEs, which occurred in 11% of patients taking gabapentin compared to 7.9% of those taking placebo.6
Postmarketing Abuse
Postmarketing reports have described symptoms of agitation, confusion, and disorientation upon abrupt withdrawal of gabapentin. Cases usually involve other potentiating factors, such as the use of higher than recommended doses for unapproved indications, a history of poly-substance abuse, or the use of gabapentin to relieve symptoms of withdrawal from other substances.1 In a study of postmortem toxicology, cases that tested positive for gabapentin or pregabalin were included to determine if abuse of these drugs contributed to the fatalities. Of the 13,766 cases investigated, 0.31% were positive for gabapentin. Of the gabapentin cases, 18.6% were considered abuse, and 4.7% were poisonings. An overwhelming majority of abuse cases (87.5%) also involved opioid intoxication, and 100% involved alcohol and/or opioids. In addition, a greater number of pregabalin cases were designated as abuse cases than gabapentin cases (48.1% vs 18.6%, respectively).7
Conclusion
Gabapentin has sufficient evidence showing its efficacy and safety in treating neuropathic pain. Effective treatment doses of gabapentin for neuropathic pain tend to be higher compared to effective treatment doses for other conditions. Gabapentin is a relatively safe medication. The most prevalent effects seen are drowsiness, somnolence, and sedation. It is necessary to start at lower doses of gabapentin and titrate up to a therapeutic dose. Ataxia and somnolence appear to exhibit a positive dose-response relationship; therefore, titrating the dose of gabapentin may help manage possible ADEs.
Fibromyalgia is a muscular condition that affects many people. It refers to muscle fatigue and pain felt across different muscle groups in the body, not just on isolated areas. Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.
The term fibromyalgia directly means pain that is embedded in the tissues of the muscles, specifically the fibrous tissues. This very acute pain starts from the ligaments, the tendons, and other such connective muscle tissues that are present all over the muscular system of the body. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.
Fibromyalgia Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event.
Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.
There are however some controversial theories regarding Fibromyalgia that propose that this condition is a psychosomatic illness, that is, it is a disorder brought about by psychological factors and not necessarily physical factors. This reasoning is mainly brought about by the strong evidence available that relates Fibromyalgia to major depression.
An in-depth review regarding the association of major depression disorders with Fibromyalgia brought out significant similarities between the two in terms of psychological characteristics and neuroendoctrine abnormalities in the patients.
Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain’s pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Medications designed to treat epilepsy are often useful in reducing certain types of nerve pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms. Gabapentin is a medicine used to treat pain caused by nerves that are not working properly. Gabapentin changes the way that the nerves send messages to the brain. It can be taken in a tablet or a liquid, with or without food. Doses are usually 1200 mg to 2400 mg each day. At the start of treatment low doses are used to minimise side effects, but the dose is usually increased after a few weeks.
At the reviews of gabapentin for fibromyalgia in drugs.com , almost 70% Fibromyalgia Patients think Gabapentin can cure their fiobromyalgia disease. But almost 20% fiobromyalgia Patients think it doesnot work. ( Rating 1 -2 %), another 15% patients think it do work but the effect is not that good ( Rating 3 – 5 ).
One of the patient said:
“I have had fibro for 7 years, finally have a doctor that prescribed me Gabapentin. It’s amazing I feel like a normal person again. I sleep through the night, with no pain anymore. My anxiety is gone also, which is awesome. I know everyone is different, but it works for me. I have had little to no side effects yet. First few doses was a bit of an air head other than that no complaints. Being able to function pain free and agitation free is a blessing.”
Another Fiobro patient said:
“I had the best results, in relieving the pain, with gabapentin. I was able to work through the other symptoms. The etodolac helped with the inflammation. I was doing well, until the muscle spasms started, again. I suspect the mould allergies exasperated the symptoms. So, cyclobenzeprine was added. I don’t know what happened, but I was jobless, homeless, and very sick by the time a CVS pharmacist recognized the V.A. had put me on another toxic, prescription drug cocktail. When I brought it to the V.A.s attention, as usual, it was ignored. The medications that help, are the ones the V.A. will not prescribe to veterans like myself. They say speak up, if you do, expect to be classified as mentally ill, violent, aggressive, involuntarily committed”
NatalieW555 Said:
“I was suffering from fibromyalgia pain most of my adult life, I’m 52 by the way, not realizing there was this wonderful medication available to me…I started it about 2 years ago and it really makes a HUGE difference in how my body feels. I take 300 mg 3X daily. I hope it never quits working for me…you should give it a try….It has no side effects on me.”
Member Annabqnm Said:
“Pretty much saved my life. 13 years ago fibromyalgia symptoms (severe pain especially legs and shoulders), started. My father was taking high doses of gabapentin for chronic guillaune barre. He urged me to try it–and it was the first real sleep I had in months! My rheumatologist had me on 1600mg. 3x, gradually lowered to 1600 mg. 2x. Studies at Mayo Clinic and Johns Hopkins show very few (and very mild) side effects, even at high doses. The only problem I have is if I forget to take them. Then I get flu like symptoms. I was able to continue my career (elementary school teacher) with no problems. Retired this year age 66 and very active. BTW my memory seems better than most friends my age.”
But 30% Fibro customers think Gabapentin is not effective for their Fibro disease. I looked the reviews they have wrote, I found most of them are just back pain or leg pain but not Fiobromyalgia. But some Fibro patients do think it has some side effects, especially thought problems such as depression.
One of the Fibro patient said:
“I have “fibromyalgia,” severe muscle pain from a twisted spine/congenitally deformed vertebrae. I was getting better with yoga, but hurt my back/rib muscles overdoing. I developed depression on gabapentin after a few weeks. At first it dulled the pain and made me feel lightheaded, and I had memory problems. Then my anxiety increased and the pain continued, and hit a real low. I spent two weeks in a psych ward until a brilliant psych nurse who believed in treating muscle pain. I am now recovering on a mix of robaxin, a muscle relaxer, a low dose of valium for rib spasms, and prozac and remeron (for sleep) and hope to get off all of them once I can exercise again. Similar reaction to Lyrica four years ago.”
Gabapentin is effective for Fibro. But you need consider whether you can endure the side effects of gabapentin. Please check our website for the Gabapentin Side Effects.
Gabapentin is as an anti-epileptic drug and as an analgesic, particularly for pain of the neuropathic or neurogenic type. When used for controlling epilepsy, it is usually used in conjunction with another anti-epileptic drug. But Gabapentin is widely used to treat nerve pain or neuropathic pain than it is to treat epilepsy.
Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (”change of life”, the end of monthly menstrual periods). Talk to your doctor about the risks of using this medication for your condition.
It is also widely used to treat Anxiety and Migraine prevention.
One of Gabapentin “off-label” usage is for migraine prevention and treatment, including migraines with or without aura, vestibular migraines. It can reduce the frequency of headaches, pain intensity, and the use of symptomatic medications. Gabapentin is a good preventive therapy for migraines refractory to standard medications.
The chemical structure of gabapentin is related that of gamma-aminobutyric acid (GABA) which is a neurotransmitter in the brain. The exact mechanism as to how gabapentin controls epilepsy and relieves pain is unknown, but it probably acts like the neurotransmitter GABA.
The effective dose of gabapentin varies greatly. Some persons need only 200-300 mg a day whereas others may need 3000 mg or more a day. It may take several weeks to become effective, so it is important to stay on it for an adequate length of time.
The Efficacy of gabapentin in migraine prophylaxis experiment shows gabapentin is an effective prophylactic agent for patients with migraine.
In the Clinical trials, 143 patients evaluated gabapentin for migraine prophylaxis. After 3 months the patients taking gabapentin had a reduction of the migraine frequency by 1.5 migraines per month (or by 35.7%) compared with a reduction of 0.6 migraines per month for the placebo group. Also, gabapentin reduced the headache frequency by 50% or greater in 45% patients compared with only 16% patients on placebo. The most frequently reported adverse events were asthenia, dizziness, somnolence, and infection.
In Famous medical websites, migraine patients also review the gabapentin as the migraine prevention medicine. They rate Gabapentin 8.1 stars out of ten stars. It is a high mark and means Gabapentin is a very effective medicine for migraine prevention.
I haven’t been taking this medication for long but it’s helped so much. Neuro started me off on 300mg at night and now I’m at 600mg at night. It doesn’t make me sleepy or drowsy. Before starting gabapentin, I was having migraines just about every day. I started having aphasia and vision changes with my migraines, so I decided to take action. I’ve only been on it for almost 2 weeks but I’ve been migraine free and my triggers are no longer triggers at this point, which is fantastic. I should note it has reduced my appetite but this is not a negative thing.” – Crystaldreams July 25, 2017
This medication is..interesting. I am 20 with what a few doctors think is Fibro and a chronic pain condition but was Rx’d this med by a psych doctor for tension migraines. While it does NOT really help with migraines, it has been making me awfully sleepy and drowsy, and helping with weird aches and pains throughout my body. It can be used as a mood stabilizer and I can see why- because it makes you so drowsy you can’t do or say anything, especially after taking the evening dose! I’ve been afraid to drive any car since starting this. It makes me more drowsy than my anxiety meds which don’t make me drowsy at all! Doctor is raising the dose because since writing that first part- I have become quite used to the med, where my dose does NOT work – Chelseabergstresser (taken for 1 to 6 months)May 11, 2017
“I have chronic Migraine called Glutamate Storm. First dose of 100mgs made me sleep 36 hours. Before I got the prescription I never slept more than 5 hours per night and often only got 2 hours of sleep per night. But I did not want to take a prescription every day, so I only took it when my ears were ringing really loud and I was sleep deprived. But then I noticed that my chronic cough was always gone the day after taking Gabapentin. So I started taking it every day for that. When I did, my headache and ear ringing got a lot better. I am now taking 400 mgs per day. I had bad breath at first, but it’s gone. Dr. says it might have detoxed something. I am all for that. Better out than in. This drug has helped me a lot. And I am not pro-pharma.” – Gylm April 26, 2017
Gabapentin is an anticonvulsive medication which first discovered in the 1970s in Japan.
Its original use was as a muscle relaxer and anti-spasmodic medication, but later, it was discovered the potential of the medication as anticonvulsive medication and as an adjunct to stronger anticonvulsants.
Gabapentin
Gabapentin is an anticonvulsant medication that got FDA approval for partial seizure therapy in 1993. Currently, gabapentin has FDA approval for:
Postherpetic neuralgia
Adjunctive therapy in the treatment of partial seizures with or without secondary generalization in patients over the age of 12 years old with epilepsy, and the pediatric population, 3 to 12 year-olds with a partial seizure
Moderate to severe restless leg syndrome (RLS) moderate to severe
It also has off-label use for neuropathic pain, fibromyalgia, bipolar disorder, postmenopausal hot flashes, essential tremors, anxiety, resistant depressant and mood disorders, irritable bowel syndrome (IBS), alcohol withdrawal, postoperative analgesia, nausea and vomiting, migraine prophylaxis, headache, interstitial cystitis, painful diabetic neuropathy, social phobia, generalized tonic-clonic seizures, pruritus (itching), insomnia, post-traumatic stress disorder (PTSD), and refractory chronic cough.
In one placebo-controlled, retrospective study that investigated the effects of gabapentin on about 700 patients with refractory partial seizure disorder, there was an improvement in overall well-being in patients. The effect prompted a controlled investigation of the drug in primary psychiatric conditions.
An important benefit of gabapentin is that there is no interaction with valproate, lithium, and carbamazepine. Also, gabapentin has minor side effects.
Gabapentin in the Treatment of Anxiety and Depression
Gabapentin is rarely prescribed for patients with only anxiety disorder but is commonly prescribed for patients with bipolar disorder to reduce anxiety levels. Clinicians can also use it for patients who have anxiety and depression. Since anxiety is a coping skill, there is no drug to treat anxiety, but the medications used for this purpose make it possible to live at the moment, giving patients a chance to undergo anxiety treatment with non-pharmaceuticals. Even though the studies show that gabapentin is ineffective in the treatment of bipolar disorder, a case-control study with 60 patients in an acute phase of mania had a significant reduction in symptoms of anxiety with lithium and 900 mg of gabapentin. In another study with 21, mixed-state patients refractory to mood stabilizers received gabapentin (up to 2000 mg per day) for eight weeks, and patients with depressive symptoms had significant improvement in their CGI-BP (Clinical Global Impression-Bipolar) scores.
A meta-analysis of 7 trials pointed to gabapentin’s greater efficacy versus placebo in generalized anxiety disorder (GAD), although the effect size was approximately 0.35 for mental anxiety symptoms. A study of 153 patients who responded to the initial treatment of 450 mg per day for maintenance treatment of social anxiety disorder.
There are no clinical studies on the effectiveness of gabapentin as monotherapy or adjunctive therapy in major depressive disorders. However, there are case reviews that show some patients with depression who are refractory to standard antidepressants but showed therapeutic improvement when using gabapentin as adjunctive therapy.
In a randomized, double-blind study, with 130 patients that had under eye surgery, a one-time dose of 600 mg gabapentin significantly reduced the perioperative anxiety compared to a placebo. However, there was no significant difference compared to melatonin.
The chemical structure of gabapentin (Neurontin) is derived by addition of a cyclohexyl group to the backbone of gamma-aminobutyric acid (GABA). Gabapentin prevents seizures in a wide variety of models in animals, including generalized tonic-clonic and partial seizures.
The exact mechanism of action with the GABA receptors is unknown; however, researchers know that gabapentin freely passes the blood-brain barrier and acts on neurotransmitters.
Gabapentin has a cyclohexyl group to the structure of neurotransmitter GABA as a chemical structure. Even though it has a similar structure to GABA, it does not bind to GABA receptors and does not influence the synthesis or uptake of GABA.
Gabapentin works by showing a high affinity for binding sites throughout the brain correspondent to the presence of the voltage-gated calcium channels, especially alpha-2-delta-1, which seems to inhibit the release of excitatory neurotransmitters in the presynaptic area which participate in epileptogenesis.
Even though there is no evidence for direct action at the serotonin, dopamine, benzodiazepine, or histamine receptors, research has shown gabapentin to increase total-blood levels of serotonin in healthy control subjects.
The elimination half-life of gabapentin is 5 to 7 hours, and it takes two days for the body to eliminate gabapentin from its system.
One benefit of gabapentin use is its mild side-effect profile. The most common side effects are fatigue, dizziness, and headache.
Gabapentin has no activity at GABAA or GABAB receptors of GABA uptake carriers of brain. Gabapentin interacts with a high-affinity binding site in brain membranes, which has recently been identified as an auxiliary subunit of voltage-sensitive Ca2+ channels. However, the functional correlate of gabapentin binding is unclear and remains under study.
Gabapentin crosses several lipid membrane barriers via system L amino acid transporters. In vitro, gabapentin modulates the action of the GABA synthetic enzyme, glutamic acid decarboxylase (GAD) and the glutamate synthesizing enzyme, branched-chain amino acid transaminase.
Results with human and rat brain NMR spectroscopy indicate that gabapentin increases GABA synthesis. Gabapentin increases non-synaptic GABA responses from neuronal tissues in vitro. In vitro, gabapentin reduces the release of several mono-amine neurotransmitters.
Gabapentin prevents pain responses in several animal models of hyperalgesia and prevents neuronal death in vitro and in vivo with models of the neurodegenerative disease amyotrophic lateral sclerosis (ALS). Gabapentin is also active in models that detect anxiolytic activity.
Although gabapentin may have several different pharmacological actions, it appears that modulation of GABA synthesis and glutamate synthesis may be important.
Is Gabapentin Addictive ?
Asking about the signs someone is addicted to gabapentin first begs the question: What is gabapentin?
To answer that question requires putting gabapentin in perspective as a pharmaceutical drug that, while providing relief to thousands of people for nerve pain, also has the potential for abuse. It isn’t an opioid, but it has found a niche audience among those who take it recreationally, and for doctors who began to seek alternatives to narcotics as the opioid epidemic reached its apex, it seemed like a safer alternative.
In 2016, gabapentin was the 10th most prescribed drug in the United States, with 64 million prescriptions written that year . That was up from 39 million prescriptions written only four years earlier, in large part because “gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary,” according to a 2018 article in the journal Psychology of Addictive Behaviors.
In that particular article, researchers analyzed data from a study of drug users in Kentucky who reported using gabapentin for non-medical purposes. Their findings? “Overall, the sample reported having initiated gabapentin more than 10 years earlier after having it prescribed for a legitimate, though generally off-label, medical indication (e.g., pain, anxiety, opioid detoxification). Participants reported use of gabapentin in combination with buprenorphine, other opioids, cocaine, and caffeine to produce sought-after central nervous system effects (e.g., muscle relaxation, pain reduction, sleep induction, feeling drunk, and feeling ‘high’).”
Gabapentin, such studies reveal, can be problematic. Whether used in conjunction with other drugs or on its own, it can be abused, which makes it a substance of concern. To understand the signs someone is addicted to gabapentin, however, requires some knowledge of what it is, where it comes from, how it works and how it can be addictive.
Comparative Studies
Gabapentin and lamotrigine have been compared in an open, parallel-group, add-on, randomized study in 109 patients with uncontrolled partial epilepsy and learning disabilities. The two drugs were similarly efficacious, with similar incidences of adverse events and serious adverse events. Neither lamotrigine nor gabapentin exacerbated any of the challenging behaviors observed in these patients.
The most common adverse reaction to gabapentin was somnolence, which was mostly reported during the initial titration phase.
In a double-blind comparison of gabapentin and lamotrigine in 309 patients with new-onset partial or generalized seizures, the target doses were gabapentin 1800 mg/day and lamotrigine 150 mg/day.
Severe adverse events were reported in 11% of patients taking gabapentin and 9.3% of patients taking lamotrigine. Two patients had serious adverse events thought to be related to the study drug; one took an overdose of gabapentin and the other had convulsions with lamotrigine. The most frequent treatment-related adverse events in both treatment groups were dizziness, weakness, and headache; 11% of patients taking gabapentin and 15% of those taking lamotrigine withdrew because of adverse events. There was an increase of over 7% in body weight from baseline in 14% of the patients taking gabapentin and 6.6% of those taking lamotrigine. There were benign rashes in 4.4% of those taking gabapentin and 11% of those taking lamotrigine.
The hypothesis that both amitriptyline and gabapentin are more effective in relieving neuropathic pain than diphenhydramine has been tested in a randomized, double-blind, triple crossover, 8-week trial in 38 adults with spinal cord injuries [18]. Maximum daily doses were 2600 mg for gabapentin and 150 mg for amitriptyline.
Amitriptyline was more efficacious in relieving neuropathic pain than diphenhydramine. Withdrawal because of possible adverse reactions occurred five times during gabapentin treatment:
(1) shortness of breath;
(2) dizziness, fatigue, and nausea;
(3) increased spasticity and pain;
(4) fatigue, drowsiness, constipation, and dry mouth; and
(5) severe itching.
The four most frequent adverse events were dry mouth, drowsiness, fatigue, and constipation, which were all more common with amitriptyline.
Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.
Gabapentin, also known by the brand name Neurontin, is a prescription painkiller belonging to its own drug class, Gabapentinoids. It is considered an anti-convulsant, and is most commonly used to treat epilepsy, restless leg syndrome, hot flashes, and neuropathic pain. It is often used as a less-addictive alternative to opioids; however, Gabapentin addiction and abuse still occur in many patients.
Gabapentin has a similar chemical structure to Gamma-aminobutyric acid (GABA), the brain chemical which affects the body’s nervous system. It can produce feelings of relaxation and calmness, which can help with nerve pain, anxiety, and even poor sleep.
Gabapentin is prescribed to treat nerve pain, alcohol and cocaine withdrawals, restless leg syndrome, diabetic neuropathy, fibromyalgia, and seizures. It works by altering one’s calcium channels to reduce seizures and ease nerve pain. Some brand names of Gabapentin are Neurontin and Gralise. The drug’s known street names are “gabbies” or “johnnies.”
Dosages of Gabapentin
Adult and pediatric dosages:
Capsule
100 mg
300 mg
400 mg
Tablet
300 mg (Gralise)
600 mg (Gralise, Neurontin)
800 mg (Neurontin)
Dosage Considerations – Should be Given as Follows:
Reducing the dose, discontinuing the drug, or substituting an alternative medication should be done gradually over a minimum of 1 week or longer.
Geritric dosing considerations:
Renal impairment is present, gabapentin dose reduction may be required, depending on renal function.
Partial Seizures
Neurontin
Adjunctive therapy for partial seizures with or without secondary generalization.
Initial: 300 mg orally every 8 hours.
May increase up to 600 mg orally every 8 hours; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated
Post herpetic Neuralgia
Neurontin
Day 1: 300 mg orally once per day.
Day 2: 300 mg orally every 12 hours.
Day 3: 300 mg orally every 8 hours.
Maintenance: Subsequently titrate as needed up to 600 mg orally every 8 hours; doses greater than 1800 mg/day have demonstrated no additional benefit.
Gralise
Dose gradually to 1800 mg/day orally; take once a day with evening meal.
Day 1: 300 mg orally once a day.
Day 2: 600 mg orally once a day.
Days 3-6: 900 mg orally once a day.
Days 7-10: 1200 mg orally once a day.
Days 11-14: 1500 mg orally once a day.
Day 15 and after (maintenance): 1800 mg orally once a day.
Dosing considerations:
Gralise tablets swell in gastric fluid and gradually release gabapentin. Swallow Gralise tablets whole; do not cut, crush, or chew them.
Creatinine clearance 30-60 mL/min: 200-700 mg every 12 hours
Creatinine clearance 15-29 mL/min: 200-700 mg once per day
Creatinine clearance less than 15 mL/min: 100-300 mg once per day
Hemodialysis (Creatinine clearance less than 15 mL/min):
Administer supplemental dose (range 125-350 mg) post hemodialysis, after each 4 hour dialysis interval; further dose reduction should be in proportion to Creatinine clearance (a Creatinine clearance of 7.5 mL/min should receive one-half daily post hemodialysis dose)
Renal impairment (Gralise):
Creatinine clearance is greater than or equal to 60 mL/min: 1800 mg daily with evening meal
Creatinine clearance 30-59 mL/min: 600-1800 mg daily with evening meal
Creatinine clearance greater than 30 mL/min or hemodialysis: Do not administer
In addition its potentially addictive nature, Gabapentin can cause suicidal thoughts, moods swings, and abrupt changes in a user’s behavior. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.
Gabapentin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
drowsiness
tiredness or weakness
dizziness
headache
uncontrollable shaking of a part of your body
double or blurred vision
unsteadiness
anxiety
memory problems
strange or unusual thoughts
unwanted eye movements
nausea
vomiting
heartburn
diarrhea
dry mouth
constipation
increased appetite
weight gain
swelling of the hands, feet, ankles, or lower legs
back or joint pain
fever
runny nose, sneezing, cough, sore throat, or flu-like symptoms
ear pain
red, itchy eyes (sometimes with swelling or discharge)
Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:
rash
itching
swelling of the face, throat, tongue, lips, or eyes
hoarseness
difficulty swallowing or breathing
seizures
difficulty breathing; bluish-tinged skin, lips, or fingernails; confusion; or extreme sleepiness
Gabapentin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Gabapentin Abuse
Gabapentin abuse tends to occur in people who already have an addiction to opioids or other drugs. The effects of Gabapentin intoxication have been described as a sense of calm, euphoria, and a high similar to marijuana.
A 2013 study in Kentucky found that of the 503 participants reporting illegal drug use, 15% reported using Gabapentin in addition to other drugs to get high in the previous six months. Another study, working with a sample of participants meant to represent the national population, found almost a quarter of patients with co-prescriptions of opioids and Gabapentin were getting more than three times their prescribed amount to supply their addiction. People using the drug without a prescription is a growing problem in many areas. Due to the drug’s legal status, this is difficult to address from a policing standpoint. States where Gabapentin abuse is becoming more common are beginning to classify the drug as a more strictly controlled substance.
Signs of a Gabapentin Overdose
Effects of excessive Gabapentin use include:
Drowsiness
Coordination problems
Tremors
Dizziness
Depression
Suicidal thoughts/behaviors
Changes in mood
Dizziness
Poor coordination
Forgetfulness
Anxiety
Difficulty speaking
Inability to feel pleasure
It is important to try to recognize these symptoms and to be wary of other red flags, such as the presence or abundance of pill bottles. These effects can be detrimental to one’s health, livelihood, and overall safety.
Many Gabapentin users in early recovery abuse Gabapentin because at high doses (800mg or more), they may experience a euphoric-like high that does not show up on drug screens. Gabapentin abusers typically take the drug in addition to opioids to produce their desired high, a dangerous and potentially deadly combination. It is possible to fatally overdose on Gabapentin, both on its own or in conjunction with other drugs. However, there is currently no antidote that can be administered to someone in the case of a Gabapentin overdose as there is with opioid overdoses. If you find a loved one showing signs of an overdose–drowsiness, muscle weakness, lethargy and drooping eyelids, diarrhea, and sedation—seek medical attention immediately.
Signs of Gabapentin Addiction
Lying about or exaggerating symptoms to doctors
Seeking out multiple doctors to get extra doses
Switching doctors after the original doctor refuses to continue prescribing the medication
Changes in social habits and/or circles
Changes in personal hygiene and grooming habits
Constant preoccupation with the drug
Unease at the thought of the drug being unavailable
Refusal to quit despite social, financial, or legal consequences
Failed attempts to quit
Treating a Gabapentin Addiction
Frequent and excessive use of Gabapentin can lead to a physical and psychological dependence on the drug. This is when someone becomes so accustomed to taking a drug that they need it to feel and function normally. Quitting a drug like Gabapentin cold turkey can be dangerous and induce several withdrawal symptoms of varying severity.
These include anxiety, insomnia, nausea, pain, and sweating. Quitting also increases one’s likelihood of having a seizure which can lead to personal injury or the development of medical problems and life-threatening emergencies. Trying to quit should be done at a rehab facility or with the guidance and supervision of a professional during a medical detox.
Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain, but exactly how it does this is not fully understood. Gabapentin is also used to treat certain types of long-lasting pain caused by damage to nerves.
Gabapentin belongs to a group of medicines known as anti-epileptic medicines, although it is prescribed for the treatment of several different conditions. You may have been prescribed it for the treatment of partial seizures, which are a type of epilepsy. A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. With a partial seizure, the burst of electrical activity stays in one part of the brain. Therefore, you tend to have localised or ‘focal’ symptoms. Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain. Exactly how it does this is not fully understood.
Gabapentin is also prescribed to treat certain types of long-lasting pain caused by damage to nerves. This type of pain, called neuropathic pain, can be caused by a number of different diseases. These include diabetes (where it is called diabetic neuropathy) and shingles (where it is called postherpetic neuralgia).
Although gabapentin is only licensed for use in epilepsy and neuropathic pain, it is also prescribed to help to prevent attacks of migraine. If you have been given it for this reason then you should speak with your doctor if you have any questions about your treatment.
Before taking gabapentin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking gabapentin it is important that your doctor knows:
If you are pregnant, trying for a baby or breast-feeding.
If you have any problems with the way your kidneys work.
If you have diabetes.
If you have ever had a mental health problem known as psychosis.
If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
If you have ever had an allergic reaction to a medicine.
Gabapentin Mechanism of action
The mechanism of the anticonvulsant action of gabapentin has not been fully described. Several possible mechanisms for pain improvement have been discussed. Though similar in structure to the endogenous neurotransmitter GABA, gabapentin has not been shown to bind to GABA receptors at concentrations at or below 1 mM. Gabapentin modulates the action of glutamate decarboxylase (GAD) and branched chain aminotransferase (BCAT), two enzymes involved in GABA biosynthesis. In human and rat studies, gabapentin was found to increase GABA biosynthesis, and to increase non-synaptic GABA neurotransmission in vitro.
Gabapentin has been shown to bind to the α2δ-1 subunit of voltage gated calcium ion channels, which contributes to its pain attenuation effects in diabetic neuropathy and post-herpetic neuralgia. Other neurophysiological findings indicate that gabapentin also interacts with NMDA receptors, protein kinase C, and inflammatory cytokines
What is gabapentin mostly used for?
Gabapentin is an antiepileptic or anticonvulsant treatment originally designed to prevent seizures, but which is now also used to manage certain types of pain and in a variety of other uses.
The medication is also used in veterinary medicine. Note that tablets, capsules or oral solutions designed for human consumption often contain sweeteners which may be poisonous to some species; be sure to buy Gabapentin in veterinary formulations for use in animals.
The medication comes in capsules, which may be opened and mixed into a beverage or soft foods that do not require chewing, though it is difficult to mask its bitter taste.
Preventing Seizures
Gabapentin is most commonly prescribed to prevent certain types of seizures:
Focal seizures
Mixed Seizures
Generalized Seizures
As a preventive treatment, Gabapentin may be used in children as young as 3, but is most often prescribed to people 12 years old and up.
The medication is typically taken 3 times per day, and treatment is usually long-term. Patients are usually started on smaller doses which are then increased if needed. The average dose for adults is 900 to 1800 mg per day.
Daily doses are usually divided into 3 smaller doses, taken morning, afternoon, and at bedtime. Doses should be taken at least 4 hours apart, but not more than 12 hours apart.
It may take several weeks for the medication to become noticeably effective. When working, seizures should occur with significantly less frequency or be eliminated entirely. It does not work on all seizures and is not effective for all patients; if effects are not significant after several weeks of use, speak with doctor about alternative options rather than continuing to buy Gabapentin.
Ending treatment abruptly may cause an increase in seizures; speak with a doctor about tapering off the medication.
Pain Relief
Patients planning to buy Gabapentin for pain relief should understand that it only works on very specific types of pain; namely neuropathic pain, or pain caused by damage to the somatosensory system, including:
Postherpetic neuralgia
Central neuropathic pain
Diabetic neuropathy
Fibromyalgia
Spinal injuries
Cancer
When given for pain, treatment may last just a few days for flare-ups or weeks or months in cases of chronic pain. Dosage rarely exceeds 1800 mg a day; greater amounts may be taken, but rarely produce additional relief.
Some individuals notice effects within the first day or two of treatment, but it may take several weeks to provide consistent pain relief in chronic conditions.
While some patients find Gabapentin tremendously helpful, others find it has little effect, even when treating the same condition. Speak with a doctor about other options if it is not providing significant relief.
Other Uses
Gabapentin is used in a wide range of other conditions, though it is not always the most effective option for certain ailments:
Menopausal symptoms
Uremic pruritus in liver failure
Restless leg syndrome
Insomnia
Anxiety disorders
Migraines
Many of this product’s off-label uses are somewhat controversial, as some claim there is no evidence the medication provides any benefit in some of the above conditions, while others claim it produces good results for some individuals.
In other cases the medication is recognized as being effective, but is not typically the preferred treatment; in these situations Gabapentin may be given when first-line treatments are ill-advised for some reason.
Patients are not advised to buy Gabapentin for off-label use without doctor collaboration, particularly if there are any preexisting major medical conditions.
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What is Gabapentin Off label Usage
Use only the brand and form of gabapentin that your doctor has prescribed. Check your medicine each time you get a refill at the pharmacy, to make sure you have received the correct form of this medication. Do not stop taking Gabapentin unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week. If you stop taking gabapentin suddenly or before your doctor tells you, there is an increased risk of seizures.
How to take gabapentin
Before starting this treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about gabapentin and will provide you with a full list of the side-effects which you may experience from taking it.
Take gabapentin exactly as your doctor tells you to. There are several different strengths of gabapentin tablets and capsules available, and you could be prescribed more than one strength.
You will be advised to take a low dose when you first start taking gabapentin, and then to increase the dose over a few days. This is to allow your body to get used to it. Most people take three doses a day once they are on a regular maintenance dose. Your doctor will explain all this to you, and the dosing directions will be printed on the label of the pack. If you are still unsure about how to take your doses, ask your pharmacist to advise you.
You can take gabapentin before or after food. Swallow the tablets/capsules with a drink of water. If you have been supplied with oral liquid medicine, see the instructions below for using the oral dosing syringe.
Once you are taking a regular amount of gabapentin, try to take your doses at the same times each day. This will help you avoid missing doses.
If you do forget to take a dose, take one as soon as you remember. Try to take the correct number of doses each day, but do not take two doses at the same time.
If you need to take an antacid or indigestion remedy, do not take it during the two hours before or the two hours after you take gabapentin. This is because antacids reduce the amount of gabapentin that your body absorbs.
Instructions for using the dosing syringe with Gabapentin Rosemont Oral Solution
Remove the bottle cap, and push the syringe adaptor into the top of the open bottle.
Insert the syringe into the adapter.
Turn the bottle (with the syringe connected to it) upside down.
Gently pull out the plunger of the syringe so that the solution fills the syringe to the mark which corresponds to your dose.
Turn the bottle the correct way up again, and remove the syringe from the bottle.
Put the tip of the syringe into your mouth, and gently push the plunger so that the liquid is released into your mouth.
Replace the bottle cap. Wash the syringe with water after each use.
Getting the most from your treatment
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this. If you are a woman and want to have a family, make sure that you discuss this with your doctor before you become pregnant. This is so that you can be given advice about your treatment from a specialist.
People with epilepsy must stop driving. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
A small number of people have developed mood changes or thoughts about suicide whilst being treated with anti-epileptics. If this happens to you, you must tell your doctor about it straightaway.
If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines.
You must take gabapentin regularly every day. Stopping treatment suddenly can cause problems. If it becomes necessary for the treatment to stop, your doctor will want you to reduce your dose over a few days.
Can gabapentin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with gabapentin. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common gabapentin side-effects
What can I do if I experience this?
Feeling sleepy, tired, unsteady or dizzy; blurred vision and other eyesight problems
Do not drive or use tools or machines
Headache
Ask your pharmacist to recommend a suitable painkiller
Feeling or being sick, indigestion, stomach ache
Stick to simple foods – avoid rich or spicy meals
Diarrhoea
Drink plenty of water to replace the lost fluids
Constipation
Try to eat a well-balanced diet and drink several glasses of water each day
Dry mouth
Try chewing sugar-free gum or sucking sugar-free sweets
Infections, flu-like symptoms, increased appetite, flushing,
increased blood pressure, changes in weight, changes in emotions or mood, fits, movement difficulties, feeling shaky, difficulties sleeping, breathing difficulties, cough, gum changes, bruises, muscle or joint pains, impotence, and swollen feet or ankles
If any of these become troublesome, speak with your doctor for advice
Important: gabapentin has been associated with a number of unwanted effects which affect the blood, pancreas and liver. Although these occur less commonly than the side-effects listed above, you must let your doctor know straightaway if you notice any of the following as they could be serious:
Persistent stomach pain with sickness (these could be symptoms of an inflamed pancreas).
A skin rash, or any swelling of your mouth or face (these could be symptoms of an allergic reaction).
Any yellowing of your skin or of the whites of your eyes (these could be symptoms of jaundice).
Any unusual bruising or bleeding (these could be symptoms of a blood disorder).
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to Store gabapentin
Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Once a bottle of Gabapentin Rosemont Oral Solution has been opened it will keep for one month. Do not use it after this time, and make sure you have a fresh supply.
Gabapentin Side Effects
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
increased seizures;
severe weakness or tiredness;
upper stomach pain;
chest pain, new or worsening cough with fever, trouble breathing;
severe tingling or numbness;
rapid back and forth movement of your eyes;
kidney problems–little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or
severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Gabapentin is an Addiction Treatment Medication
Gabapentin is used to treat cases of addiction in an off-label manner. Different companies, including Parke-Davis, Greenstone, and Teva, manufacture several varieties of the generic drug. Other drugs that have been used to treat the symptoms of addiction withdrawal, for specific substances, include:
Clondine
Other anticonvulsants, such as Tegretol and Depakote
Methadone and buprenorphine
Naltrexone
Typical Application
Available in capsules, tablets, and as an oral liquid, dosages range from 100 mg to 800 mg. The frequency with which a dose is repeated depends on the specific dose, which is usually based on the severity of withdrawal and the client’s weight. The drug’s half-life is around 5-7 hours.
Generally, it is used during medical detox and throughout subsequent treatment modalities to support relapse prevention while clients adjust to their new sober lifestyles.
Treating Substance Abuse
According to Medscape, gabapentin can inflict users with suicidal thoughts and abrupt changes in behavior. For this reason, it should only be used under medical supervision. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.
While it has been used to treat addictions to other substances, gabapentin is most often used to treat alcoholism — an addiction some 16.6 million adults suffered from in 2013, per the National Institute on Alcohol Abuse and Alcoholism.
During withdrawal from alcohol abuse or dependency, clients may experience anxiety, tremors, agitation, and irritability. In order to understand how gabapentin works, there must be a basic understanding of how the brain works first. Nervous system activity is partially controlled by GABA neurotransmitters. Gabapentin works by reducing activity among GABA. As a result, signals for pain, agitation, and anxiety are reduced, too.
An American Journal of Psychiatry study showed impressive results during the 16-week treatment of 150 people who were dependent on alcohol, noting better results among those who were treated with both gabapentin and naltrexone than the latter alone. TheJournal of Clinical Psychiatry reported on another study in which individuals treated for alcoholism with gabapentin showed a significant reduction in how much they drank and a greater rate of abstinence than those in the placebo group.
Gabapentin has the same calming effect on individuals who are detoxing from marijuana and benzodiazepines. Despite claims from fans of the plant-based drug, marijuana is indeed addictive. In 2012, 305,560 people checked into rehab citing cannabis as their primary drug of abuse, per the Substance Abuse and Mental Health Services Administration. One Neuropsychopharmacology study that analyzed the use of gabapentin in the treatment of marijuana addiction and withdrawal noted individuals in the gabapentin treatment group used less marijuana, had fewer withdrawal symptoms, and experienced improvements in cognitive functioning, compared to the placebo group.
Gabapentin is also used to treat Alcohol Withdrawal
I am still on gabapentin. Dose is 600mg three times a day – total 1800mg in a 24 hour period. I had not had a drink “craving” since August 11, 2014 when I quit. (I did this within one week of starting gabapentin). I did have a glass of wine at Christmas, one beer on my birthday, and one glass of wine at Easter. That’s it. I use to have 10 beers a day, and three glasses of wine or gin for bad panic attacks and generalized anxiety. So for me (not everyone) I can have that occasional drink with friends, at party or any social event – then come home and not touch the stuff and WITHOUT ANY CRAVINGS AT ALL – as I had during my 40-year binge. Still, this drug is amazing. AA never worked for me.
“I went on gabapentin for alcoholism that troubled me for 10 years when nothing including Alcoholics Anonymous barely worked. I read anecdotal information that it helped with alcoholism, went on 600mg twice daily and it was the first thing that helped me. Now I take 1200mg twice daily and find it works great! Afterwards I read a study in the Journal of American Medicine, Gabapentin in Alcohol Dependance, 2014 that confirmed it works well in many people for cravings and binge drinking. This medicine should be further studied to confirm it works well. On this site it is obvious it helps a lot of people struggling with alcoholism which I have, along with Bipolar Disorder. I call Gabapentin my” happy pills” that also takes away my anxiety
I’ve detoxed several times. The last one was really bad. This time My Dr. put me gabapentin 300 mg. 3 times a day and Lithium. I usually suffer withdrawals for 5-7 days. I did have anxiety for two days, but I’m on day 3, no anxiety and no cravings
Important information about all medicines
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty, so the doctor knows what has been taken.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.
Causes of Restless Legs Syndrome
In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.
Other factors associated with the development or worsening of restless legs syndrome include:
Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure,diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergymedications containing sedating antihistamines, may worsen symptoms.
Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.
Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.
Treatment for Restless Legs Syndrome
Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms.
Other non-drug RLS treatments may include:
Leg massages
Hot baths or heating pads or ice packs applied to the legs
Good sleep habits
A vibrating pad called Relaxis
Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.
Drugs used to treat RLS include:
Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain.
Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain.
Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Gabapentin ( Neurontin ), and Horizant.
Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.
Usual Adult Dose for Restless Legs Syndrome
Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM
There are several non-pharmacological approaches that may help alleviate the symptoms of restless legs syndrome (RLS), including:
Regular exercise: Engaging in moderate exercise, such as walking or yoga, on a regular basis may help reduce symptoms of RLS.
Hot or cold compresses: Applying a hot or cold compress to the legs may help alleviate discomfort and reduce the urge to move the legs.
Massage: Gentle massage or self-massage of the legs may help relax muscles and improve circulation.
Compression stockings: Wearing compression stockings or socks may help improve blood flow and reduce symptoms of RLS.
Relaxation techniques: Practicing relaxation techniques, such as deep breathing, meditation, or progressive muscle relaxation, may help reduce stress and tension in the body, which can exacerbate symptoms of RLS.
Maintaining a regular sleep schedule: Establishing a regular sleep schedule, including a consistent bedtime and wake-up time, may help improve sleep quality and reduce symptoms of RLS.
Avoiding triggers: Avoiding triggers such as caffeine, alcohol, and nicotine, as well as certain medications, may help reduce symptoms of RLS.
It is important to note that these approaches may not work for everyone with RLS, and individuals should talk to their healthcare provider before starting any new treatment regimen.
There are several medications that may be prescribed to alleviate the symptoms of restless legs syndrome (RLS), including:
Dopamine agonists: These medications increase the levels of dopamine, a neurotransmitter that helps regulate movement and sensation, in the brain. Examples include pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro).
Iron supplements: Iron deficiency can contribute to RLS symptoms, so taking iron supplements may help alleviate symptoms in some individuals.
Anticonvulsants: Certain anticonvulsant medications, such as gabapentin (Neurontin) and pregabalin (Lyrica), may help alleviate symptoms of RLS by modulating the levels of certain neurotransmitters in the brain.
Opioids: In some cases, opioids such as oxycodone or hydrocodone may be prescribed to alleviate severe symptoms of RLS, although their use is generally reserved for individuals with severe symptoms who have not responded to other treatments.
It is important to note that all medications carry some risks, and individuals should talk to their healthcare provider about the potential benefits and risks of any medication before starting treatment. In addition, treatment for RLS may need to be adjusted over time, as the effectiveness of certain medications may diminish or side effects may become problematic.
I am still on gabapentin. Dose is 600mg three times a day – total 1800mg in a 24 hour period. I had not had a drink “craving” since August 11, 2014 when I quit. (I did this within one week of starting gabapentin). I did have a glass of wine at Christmas, one beer on my birthday, and one glass of wine at Easter. That’s it. I use to have 10 beers a day, and three glasses of wine or gin for bad panic attacks and generalized anxiety. So for me (not everyone) I can have that occasional drink with friends, at party or any social event – then come home and not touch the stuff and WITHOUT ANY CRAVINGS AT ALL – as I had during my 40-year binge. Still, this drug is amazing. AA never worked for me.