Posted by Rick on August 26, 2000, at 16:06:54
In reply to Re: Neurontin for GAD, posted by Robaire on August 26, 2000, at 11:24:08
Yes, Neurontin (gabapentin) is often given in doses up to 3,600 mg/day, somtimes higher. E.g. see abstract below testing gabapentin for Social Anxiety -- manufacturer-funded, but with highly-regarded researchers. The dosages there ranged from 900-3600/day.
I once took Neurontin for awhile at 3,600, but quit before giving it a fair trial because my blood sugar unexpectedly started shooting up. (My pdoc had never heard of this effect, but I noted that the latest monographs do list this as one of three anecdotally-reported side effects.)
It does seem odd, though, that such a high-end dosage would be suggested while you're still taking a substantial amount of Valium. Conversely, 400 mg. sounds pretty low; I would expect something more like 800, 1000 or 1200, but I'm not an expert.
Rick
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J Clin Psychopharmacol 1999 Aug;19(4):341-8
Treatment of social phobia with gabapentin: a placebo-controlled study.Pande AC, Davidson JR, Jefferson JW, Janney CA, Katzelnick DJ, Weisler RH, Greist JH, Sutherland SM
Parke-Davis Pharmaceutical Research, Division of Warner-Lambert Company, Ann Arbor, Michigan 48105, USA. atul.pande@wl.com
A randomized, double-blind, placebo-controlled, parallel-group study was conducted to evaluate the efficacy and safety of gabapentin in relieving the symptoms of social phobia. Sixty-nine patients were randomly assigned to receive double-blind treatment with either gabapentin (dosed flexibly between 900 and 3,600 mg daily in three divided doses) or placebo for 14 weeks. A significant reduction (p < 0.05) in the symptoms of social phobia was observed among patients on gabapentin compared with those on placebo as evaluated by clinician- and patient-rated scales. Results were similar for the intent-to-treat and week-2 completer populations. Adverse events were consistent with the known side effect profile of gabapentin. Dizziness (p = 0.05), dry mouth (p = 0.05), somnolence, nausea, flatulence, and decreased libido occurred at a higher frequency among patients receiving gabapentin than among those receiving placebo. No serious adverse events or deaths were reported. On the basis of these limited data, it seems that gabapentin offers a favorable risk-benefit ratio for the treatment of patients with social phobia. Further studies are required to confirm this effect and to determine whether a dose-response relationship exists.
Publication Types:
Clinical trial
Multicenter study
Randomized controlled trial
PMID: 10440462, UI: 99367074
poster:Rick
thread:60
URL: http://www.dr-bob.org/babble/20000822/msgs/43793.html