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Re: The uses of Neurontin » Cass

Posted by Elizabeth on July 19, 2001, at 10:41:03

In reply to The uses of Neurontin, posted by Cass on July 18, 2001, at 15:38:45

> I'm pretty puzzled because I am on Neurontin for neuropathic pain only.

That's a good reason. Another anticonvulsant drug, Tegretol, has a long and glorious history of being used for neuropathic pain, but Neurontin is much safer and more convenient in a lot of ways.

> My doctor didn't say that it was psychopharmaceutical drug. Yet I've been reading threads here about Neurontin being a mood stabilizer and anti-anxiety medication. Are we talking about the same drug?

Yup. It seems to be somewhat helpful to people with some kinds of anxiety such as social phobia and panic disorder, as well as mania or hypomania in bipolar disorder; IMO, it's particularly well suited for patients who have "soft" bipolar-spectrum disorders (BP II, cyclothymia, "borderline personality") with associated anxiety and agitation. It's used to treat a wide variety of other symptoms, diseases, and disorders, including restless legs syndrome, myoclonus, aggression (related to mental retardation, head trauma, and various psych disorders), nystagmus, bruxism, various movement disorders, headache, and spasticity, as well as neuropathic pain of various origins (and some types of non-neuropathic pain) and some types of epilepsy.

The mechanism of action is not entirely clear; it's a GABA analog, but it's not a GABA-A agonist or a benzodiazepine receptor agonist. I think, based on a few stories I've heard, that there's a real possibility that it might help relieve benzodiazepine or alcohol withdrawal symptoms, though. It does activate GABA-B receptors under some conditions, I think. (That doesn't explain its anxiolytic effect, though. FWIW, I tried taking the GABA-B agonist baclofen for muscle spasm and it was utterly useless.) Neurontin may have some effect on voltage-gated calcium channels which may be responsible for observed effects on the N-methyl-D-aspartate system. (NMDA receptors are a subtype of glutamate receptors; like many other receptor subtypes (e.g., the muscarinic and nicotinic subtypes of acetylcholine receptors), they were named for the first selective agonist that was discovered.)

Like many drugs that have central as well as peripheral actions, Neurontin is psychoactive.

-elizabeth


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