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Re: gabapentin [Neurontin] comments-advice dove

Posted by Snowie on October 29, 2000, at 17:14:57

In reply to Re: gabapentin [Neurontin] comments-advice, posted by dove on October 25, 2000, at 11:43:51

Dove,

Thanks for a very informative post! So far I've increased Neurontin very slowly and have had none of the side effects you mentioned. I'm afraid to break open a 300 mg. capsule for fear that I might either take too much or not enough, so I have a prescription for 600 mg. (200 mg. x 3) per day. I don't understand why they don't make 200 mg. capsules.

Do you ever find that sometimes Neurontin works very well, and other times it doesn't seem to work at all? It's a very unpredictable medication for me.

Snowie


> Just a few quick comments concerning gabapentin: When gabapentin (Neurontin) is ramped too quickly, it can and will cause initial sedation, which from my experience, passes very quickly (commonly by week two). When the dosage is ramped up too quickly, or is too high at the onset, there appears to be a dermatological reaction. *Every* single time I have a dose increase I end up with itchy dry irritated skin, which magically disappears within ten days, *every* single time.
>
> What Scott said about Neurontin bypassing the liver is absolutely correct! This is a HUGE advantage over most mood-stabilizers and anti-anxiety meds. Although, this key feature does present a mild drawback (I think it's of no consequence, while others may find it a great annoyance.) as there are limits to how much your body can use at a given time. Neurontin readily passes through the "blood/brain-barrier?" (I hope I understand this correctly?) and is excreted in the urine completely unchanged. But... There seems to exist a limit to how much the brain (?) can *use* at any one given time (in one single dose). The upper limit is 300 mgs I believe, with any single dosage going above and beyond this limit losing an ever-increasing percentage of usable mgs.
>
> Many doc's seem to be *uninformed* as to Neurontin's ideal dosing schedule and ramping requirements. I had to print off a truckload of stats/abstracts/Op-Eds for my p-doc, as well as informing him that I had been experimenting with Neurontin's dosage increases, timing, and single dosage amounts. I found the med to be absolutely worthless if taken all in one dose right before bed, whether or not I was taking 300 mgs or 900 mgs. I ramped up much slower than the "norm", preventing the bone-weary heavy-lidded sedation others sometimes complain of. I also space my total daily dosage (1,500 mgs.) throughout my waking hours. My flexible Neurontin schedule is 300 mgs taken every 3-4 hours, with absolutely none taken at bedtime.
>
> Ramping:
> I started by splitting 300 mgs capsules in approximately half, either pouring half into one of those empty capsules you can get at health food stores, or just mixing it food or juice. It is incontrovertibly stable in liquid, food, and oxygen, and will not deteriorate. Therefore, your first line of defense against the sedation would be the "low and slow" methodology. Should irritated skin or rash appear, remain at that dosage level until skin irritation and/or rash disappear. Prudently, move to the next level with the expectation of possible (and temporary) dermatological reactions, and sedation.
>
> Timing:
> The same "low and slow" methodology and capsule splitting applies to the med schedule/timing. Take the halved (or quartered--whichever works best for you) dosage spaced out during the day to prevent excessive sedation and to increase med availability for when you need it most. As your body responds to the med, it is fairly easy to figure out how fast--or slow--the med is being consumed. My Neurontin consumption has an upper limit of 4.5 hours, and a lower limit of 2 hours. That is Neurontin's "window" of effectiveness for my individual body.
>
> I'm taking Neurontin primarily for mood-stabilization and its anti-anxiety effects.
>
> Hope this helps,
>
> ~dove


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poster:Snowie thread:47055
URL: http://www.dr-bob.org/babble/20001022/msgs/47707.html