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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Larry Hoover on May 1, 2005, at 16:18:59
Gabapentin (Morontin....errr....Neurontin) has got to be the most bizarre med I've ever used. It is beyond bizarre.
Thursday I just wasn't able to focus my mind. Friday, I was at the office, and I had a good day, but when I got home.....total bizarro city....
My eyesight was totally distorted. You know how they pixelate faces on the TV to distort identities....they kind of shimmer, sometimes? Well, all of my peripheral vision went kind of like that, and the closer it was to the center, the worse it became, until there was kind of a ring of intense shimmering distortion, surrounding clear central vision. It was like being in a hallucinatory tunnel. Total time, maybe 45 minutes to an hour. It faded in, and faded out.
Last week I was at the local variety store, and the proprietor (my landlady) asked me, "How are you today?" Standard fare, right? My answer, "I don't know." And I stood there, stunned, for the longest while, until she asked, "Are you OK?". And again I answered, "I don't know." Finally I said, "It must be this new med I'm on for pain", and I walked out without my purchase. When I got outside, the whole world was distorted, like the plane of the horizon was head height instead of feet height. (If you've seen representations of the gravitational distortion of space, it was like that.....I was in a gravity well.) I'm just glad I wasn't in my car at that moment.
I get this sort of "bubbles of the bizarre" ever since I went on this stuff. No two "episodes" are the same. Initially, my vision was pretty distorted, but that settled down soon enough. Yet, I still get these "bubbles". Sometimes they're emotional in content. I don't know what else to call them. Bubbles of the bizarre.
Right now I am totally emotionally flat. Out of nowhere. Another bubble? Who the hell knows.
Apart from that, this stuff makes me stupid. I am constantly amazed at the stupid things I say, write, and do. My short term memory is so defective, I've missed some very important appointments, including a meeting at which I was on the agenda......I'd worked the whole previous day on my presentation, and I simply forgot to go. Ergo, Morontin.
The stuff is miraculous for my neuropathic pain, though. I've only needed oxycodone three times (in six weeks) since I went on it, instead of three times a day prior to it.
Feedback?
Lar
Posted by Ritch on May 1, 2005, at 16:41:07
In reply to Morontin.....anybody using it? (gabapentin), posted by Larry Hoover on May 1, 2005, at 16:18:59
> Gabapentin (Morontin....errr....Neurontin) has got to be the most bizarre med I've ever used. It is beyond bizarre.
>
> Thursday I just wasn't able to focus my mind. Friday, I was at the office, and I had a good day, but when I got home.....total bizarro city....
>
> My eyesight was totally distorted. You know how they pixelate faces on the TV to distort identities....they kind of shimmer, sometimes? Well, all of my peripheral vision went kind of like that, and the closer it was to the center, the worse it became, until there was kind of a ring of intense shimmering distortion, surrounding clear central vision. It was like being in a hallucinatory tunnel. Total time, maybe 45 minutes to an hour. It faded in, and faded out.
>
> Last week I was at the local variety store, and the proprietor (my landlady) asked me, "How are you today?" Standard fare, right? My answer, "I don't know." And I stood there, stunned, for the longest while, until she asked, "Are you OK?". And again I answered, "I don't know." Finally I said, "It must be this new med I'm on for pain", and I walked out without my purchase. When I got outside, the whole world was distorted, like the plane of the horizon was head height instead of feet height. (If you've seen representations of the gravitational distortion of space, it was like that.....I was in a gravity well.) I'm just glad I wasn't in my car at that moment.
>
> I get this sort of "bubbles of the bizarre" ever since I went on this stuff. No two "episodes" are the same. Initially, my vision was pretty distorted, but that settled down soon enough. Yet, I still get these "bubbles". Sometimes they're emotional in content. I don't know what else to call them. Bubbles of the bizarre.
>
> Right now I am totally emotionally flat. Out of nowhere. Another bubble? Who the hell knows.
>
> Apart from that, this stuff makes me stupid. I am constantly amazed at the stupid things I say, write, and do. My short term memory is so defective, I've missed some very important appointments, including a meeting at which I was on the agenda......I'd worked the whole previous day on my presentation, and I simply forgot to go. Ergo, Morontin.
>
> The stuff is miraculous for my neuropathic pain, though. I've only needed oxycodone three times (in six weeks) since I went on it, instead of three times a day prior to it.
>
> Feedback?
>
> Lar
Larry, the weirdest visual effects that I notice when I take it are: 1) A mild case of "night blindness"... difficulty seeing in the dark... do you notice when you walk into a dark area out of the light and you "see" the optic nerve cells firing-creating a white noise of sorts? On Neurontin that is greatly diminished for me. 2) Daylight vision seems to be "windexed".. everything seems "cleaned" and "smoothed" and "sharpened" somehow. Hard to describe. I read something a long time ago about how gabapentin tinkers around with calcium and the optic nerve in some way. Sorry, can't be specific! -- Mitch
Posted by Phillipa on May 1, 2005, at 20:19:44
In reply to Re: Morontin.....anybody using it? (gabapentin) » Larry Hoover, posted by Ritch on May 1, 2005, at 16:41:07
Larry, If you can't figure it out the only two people I can think of are Chemist and maybe ED. You've probably already asked Scott. I'm sorry you're having such a hard time. My thoughts are with you. You have helped me so much and are always there for me. Fondly, Phillipa
Posted by SLS on May 2, 2005, at 7:47:21
In reply to Morontin.....anybody using it? (gabapentin), posted by Larry Hoover on May 1, 2005, at 16:18:59
> Gabapentin (Morontin....errr....Neurontin) has got to be the most
bizarre med I've ever used. It is beyond bizarre.It definitely can be.
I felt as if I were looking through a plastic film or cracked glass at dosages higher than 1200mg. Things seemed distant to me. My whole psyche felt distorted and blunted.
I wouldn't presume to explain the pharmacology behind these idiosyncratic reactions. If you discover that you cannot find an optimal dosage of gabapentin to exert a therapeutic effect without producing negative psychotropic effects, you might want to try Lyrica (pregabalin) if it becomes available or Cymbalta (duloxetine) in the meantime. I don't think waiting out Neurontin at higher dosages will yield a mitigation of side effects if they are similar to what mine were. I waited at least two weeks for them to dissipate at 1800mg without success. The appearance of side effects might actually be time-dependent as well as dosage dependant. You might not have had them when you first reached the higher dosages. Once initiated, a moderate dosage reduction might not relieve them at all. In my experience, 900mg was the ideal dosage to promote positive psychotropic effects without suffering negative cognitive side effects.
I'm sorry, Larry, that I can't provide anything more definitive. I even tried to use Google and Medline to see if gabapentin might actually promote absence seizures. I hope you can find a way to make it work for you.
- Scott
Posted by Larry Hoover on May 2, 2005, at 9:08:56
In reply to Re: Morontin.....anybody using it? (gabapentin), posted by SLS on May 2, 2005, at 7:47:21
> > Gabapentin (Morontin....errr....Neurontin) has got to be the most
> bizarre med I've ever used. It is beyond bizarre.
>
> It definitely can be.
>
> I felt as if I were looking through a plastic film or cracked glass at dosages higher than 1200mg. Things seemed distant to me. My whole psyche felt distorted and blunted.Ya, this is the stuff I need to hear about. Even crazymeds doesn't seem to cover this aspect in any detail, despite clear evidence from clinical trials that visual/perceptual problems were relatively common.
> I wouldn't presume to explain the pharmacology behind these idiosyncratic reactions. If you discover that you cannot find an optimal dosage of gabapentin to exert a therapeutic effect without producing negative psychotropic effects, you might want to try Lyrica (pregabalin) if it becomes available or Cymbalta (duloxetine) in the meantime.
I'm not taking it for mood effects.....I was kind of hoping for a bonus round drug. Take it for neuropathy, and obtain psych effects for free. It's always been on my list of "oughta try" drugs. I suspect it could be very useful for PTSD, based on how it affects me.
Pregabalin, maybe, but why did you suggest Cymbalta?
> I don't think waiting out Neurontin at higher dosages will yield a mitigation of side effects if they are similar to what mine were. I waited at least two weeks for them to dissipate at 1800mg without success. The appearance of side effects might actually be time-dependent as well as dosage dependant.
I started at 400 t.i.d. (1200 total), but I found that I couldn't sleep on it. So, I went to 400 b.i.d., with the last dose no later than around 2 p.m. I purposely went into daily withdrawal, so I could sleep. That seemed to work okay, but I got 300 mg caps from my doc, and I've been taking 300 b.i.d. We're not talking huge doses here. The first couple of weeks were bizarre, all right, but I'm weeks into this now (6?), and I'm on a declining dose, and these distorto bizarro things come out of the blue.
My boss tried to make me feel more comfortable about missing that meeting, but you gotta know it's going to make a negative impact if something similar happens with any regularity.
> You might not have had them when you first reached the higher dosages. Once initiated, a moderate dosage reduction might not relieve them at all. In my experience, 900mg was the ideal dosage to promote positive psychotropic effects without suffering negative cognitive side effects.
I'm not giving up on it yet. I just had hoped that getting relieved of the neuropathic pain would have provided me with a substantial lift in productivity. In fact, I'd have to say my productivity has declined. And, moreover, I have to spend far more time on edit and rewrite etc. than I am accustomed to having to do. <sigh>
I appreciate your sharing your experience with me.
> I'm sorry, Larry, that I can't provide anything more definitive. I even tried to use Google and Medline to see if gabapentin might actually promote absence seizures.
Thanks, buddy. I looked at absence seizure conceptually, and it does not apply. I had full awareness during the episodes. I could respond to spoken words. It was just bizarro.
And the other thing, the visual field thing, is reminiscent of an effect of vigabatrin, but it is only very rarely described with respect to gabapentin. I seem to have a knack for rare side effects.
> I hope you can find a way to make it work for you.
>
>
> - ScottThanks. I'm just going to keep dropping the dose, slowly, and see if things don't smoothe out. I'm about at the limit of dose, though. The pain is obviously waiting for me, on the other side of 600 mg.
Lar
Posted by ed_uk on May 2, 2005, at 11:15:29
In reply to Re: Morontin.....anybody using it? (gabapentin) » SLS, posted by Larry Hoover on May 2, 2005, at 9:08:56
Hi Lar,
It looks like you're gonna need to get a prescription for the 100mg capsules.
Quite a few visual disturbances have been reported with gabapentin in the UK.........
Click on gabapentin at this website........
http://www.yellowcard.gov.uk/daps.html
(sorry about the lack of detail)
Regards,
Ed.
Posted by Larry Hoover on May 2, 2005, at 12:03:13
In reply to Re: Morontin.....anybody using it? (gabapentin) » Larry Hoover, posted by ed_uk on May 2, 2005, at 11:15:29
> Hi Lar,
>
> It looks like you're gonna need to get a prescription for the 100mg capsules.Ya, looks like it. I pretty much had concluded that already. I'm going to have to use this stuff almost PRN. I use the opiate PRN, but absent the gabapentin, PRN still led to routine daily use.....as needed can still be pretty consistent over time.
> Quite a few visual disturbances have been reported with gabapentin in the UK.........
Ya.
> Click on gabapentin at this website........
>
> http://www.yellowcard.gov.uk/daps.htmlThanks very much. That is a very useful summary. Weight gain, noted. Sheesh.
Re: visual disturbance. I had a visual field disturbance, and there is not one single case noted. There was, however, a fairly frequently reported symptom, hallucination. If one is to be pedantic (and I can be), I'd suspect that a goodly number of those hallucinations have been misreported.
<pedantic mode on>
Vision is processed in three concentric fields. In the center, you've got foveal vision. You use that for reading, as an example. It doesn't even cover whole words, despite your brain's ability to make you think that it does. Surrounding foveal vision is macular vision....these together are sometimes called the central visual field, or central vision. That's where you store and process all the detail....things like recognizing faces, and so on. As you're reading, the macular vision retains the beginning of the word, while you read the next individual letter groupings with the foveal field, for example. The processing is so seemless, you don't even know how much eye movement is involved during reading. (Saccades....yet another potential realm of visual disturbance.)
Outside the central field is peripheral vision, which really is only sensitive to changes. Light intensity, colour change, movement....those register in peripheral processing. In low light intensities, you lose central vision altogether. Night vision is peripheral vision (in effect), with very low central sensitivity. That's why we need flashlights/streetlights at night. Depth perception is a central field function, exclusively.
The amazing thing about the brain's processing of visual data is that it blends the fields seemlessly. You have no idea that vision is processed in three separate streams, and integrated after the fact.
Hold your finger in front of one eye, to block out a part of the computer screen. If you look only with the blocked eye (just close the other), there is a lot of data missing from the computer screen behind. Open the other eye, and look past the finger to the screen, and the blocked information is pasted in behind your finger.....it almost disappears. Your brain does that, all the time. Missing details are filled in. What exactly gets pasted into the visual gaps is a matter of some intellectual interest. Differences in eye-witness accounts? You can't verify detail from visual memories, despite our legal reliance on that. Your brain does not record pasting events. Visual memories are probably rewritten with each recall. But I digress.
Central vision data is pasted into the peripheral field, too, to blend the edges. The peripheral field takes on some of the characteristics of the central field, towards the boundary, to promote that blending effect. That accounts for the accentuated ring of disturbance that I reported.
Anyway, I had a peripheral visual field disturbance, which could have been interpreted as an hallucination. I know better than to call it that, though. I didn't see something that wasn't there, a definitional requirement for the term hallucination. I saw true visual data, in an impaired way.
<pedantic mode off>
I wonder if my reinterpretation of the reports of hallucination is valid.
> (sorry about the lack of detail)
>
> Regards,
> Ed.Thanks very much for the link. It's exactly what I needed to see.
Lar
Posted by ed_uk on May 2, 2005, at 12:51:00
In reply to Re: Morontin.....anybody using it? (gabapentin) » ed_uk, posted by Larry Hoover on May 2, 2005, at 12:03:13
Hi Lar,
>I had a visual field disturbance, and there is not one single case noted.
There actually was but it wasn't listed with the other visual disturbances! It was listed under 'neurological visual disorder' in the neurological section........ (how annoying)
Visual field defect NOS 1 case
> Open the other eye, and look past the finger to the screen, and the blocked information is pasted in behind your finger.....it almost disappears.
You're absolutely right, how interesting.......
Ed.
Posted by Larry Hoover on May 2, 2005, at 13:17:45
In reply to To Prof Lar » Larry Hoover, posted by ed_uk on May 2, 2005, at 12:51:00
> Hi Lar,
>
> >I had a visual field disturbance, and there is not one single case noted.
>
> There actually was but it wasn't listed with the other visual disturbances! It was listed under 'neurological visual disorder' in the neurological section........ (how annoying)Ah, merci, mon ami. C'est vrais.
> Visual field defect NOS 1 case
>
> > Open the other eye, and look past the finger to the screen, and the blocked information is pasted in behind your finger.....it almost disappears.
>
> You're absolutely right, how interesting.......
>
> Ed.Vision is an amazing feat of processing.
I have an unusual degree, apart from the chem stuff..... B.Sc. Psych. How the brain works, how to test how the brain works.
Lar
Posted by ed_uk on May 2, 2005, at 15:29:16
In reply to Re: To Prof Lar » ed_uk, posted by Larry Hoover on May 2, 2005, at 13:17:45
Hi Lar,
I hope the 100mg caps give you the pain relief you need without the side effects :-)
Kind regards,
Ed.
Posted by Mr.Scott on May 2, 2005, at 21:03:23
In reply to Morontin.....anybody using it? (gabapentin), posted by Larry Hoover on May 1, 2005, at 16:18:59
I can only tolerate it in the 100mg capsules. A heavy day might be 4-600mg. Beyond that I'm useless. And yes it basically causes ADD..
Posted by SLS on May 3, 2005, at 9:19:00
In reply to Re: Morontin.....anybody using it? (gabapentin) » SLS, posted by Larry Hoover on May 2, 2005, at 9:08:56
> Pregabalin, maybe, but why did you suggest Cymbalta?
http://www.loftusmd.com/Articles/Pain/cymbalta.html
Also:
FDA Grants Priority Approval to Antidepressant Cymbalta (Duloxetine) to Treat Diabetic Peripheral Neuropathic Pain
INDIANAPOLIS, IN -- September 7, 2004 -- The U.S. Food and Drug Administration (FDA) has approved the antidepressant Cymbaltaź (duloxetine HCl; pronounced SIM-BALL-TA), judging it safe and effective for the management of diabetic peripheral neuropathic pain, a symptom of nerve damage that affects up to 5 million Americans, Eli Lilly and Company (NYSE: LLY) announced today.
Cymbalta, a balanced and potent serotonin and norepinephrine reuptake inhibitor, is the first and only FDA-approved treatment for pain caused by diabetic peripheral neuropathy. This approval came after a six-month priority review. More than 18 million Americans have diabetes and are at risk for developing persistent pain -- often described as burning, stabbing or shooting pain -- as a result of nerve damage believed to be caused by high blood sugar.
Posted by Phillipa on May 3, 2005, at 17:01:35
In reply to Re: Morontin.....anybody using it? (gabapentin) » Larry Hoover, posted by SLS on May 3, 2005, at 9:19:00
Guess what? I knew that! Now I don't feel so stupid. Fondly, Phillipa
Posted by Maxime on May 3, 2005, at 22:57:40
In reply to Morontin.....anybody using it? (gabapentin), posted by Larry Hoover on May 1, 2005, at 16:18:59
Yeah, Morontin is a good name. Didn't make me as impaired as Topo-stupid. But I felt like I was walking on air and I was "floaty". My manager at the time took me aside and asked me if I was using recreational drugs. I told her the truth. Anyhow in about 3-4 days it caused such a bad case of edema I ended up in hospital. My legs were like balloons. So I guess my whole experience can be summed up as "floaty". :-)
I'm glad to hear it's working on the pain though. I was trying it as a mood stabiliser. Plus at least you paid for your purchase ... you didn't just walk out with it. :-)
maxime
> Gabapentin (Morontin....errr....Neurontin) has got to be the most bizarre med I've ever used. It is beyond bizarre.
>
> Thursday I just wasn't able to focus my mind. Friday, I was at the office, and I had a good day, but when I got home.....total bizarro city....
>
> My eyesight was totally distorted. You know how they pixelate faces on the TV to distort identities....they kind of shimmer, sometimes? Well, all of my peripheral vision went kind of like that, and the closer it was to the center, the worse it became, until there was kind of a ring of intense shimmering distortion, surrounding clear central vision. It was like being in a hallucinatory tunnel. Total time, maybe 45 minutes to an hour. It faded in, and faded out.
>
> Last week I was at the local variety store, and the proprietor (my landlady) asked me, "How are you today?" Standard fare, right? My answer, "I don't know." And I stood there, stunned, for the longest while, until she asked, "Are you OK?". And again I answered, "I don't know." Finally I said, "It must be this new med I'm on for pain", and I walked out without my purchase. When I got outside, the whole world was distorted, like the plane of the horizon was head height instead of feet height. (If you've seen representations of the gravitational distortion of space, it was like that.....I was in a gravity well.) I'm just glad I wasn't in my car at that moment.
>
> I get this sort of "bubbles of the bizarre" ever since I went on this stuff. No two "episodes" are the same. Initially, my vision was pretty distorted, but that settled down soon enough. Yet, I still get these "bubbles". Sometimes they're emotional in content. I don't know what else to call them. Bubbles of the bizarre.
>
> Right now I am totally emotionally flat. Out of nowhere. Another bubble? Who the hell knows.
>
> Apart from that, this stuff makes me stupid. I am constantly amazed at the stupid things I say, write, and do. My short term memory is so defective, I've missed some very important appointments, including a meeting at which I was on the agenda......I'd worked the whole previous day on my presentation, and I simply forgot to go. Ergo, Morontin.
>
> The stuff is miraculous for my neuropathic pain, though. I've only needed oxycodone three times (in six weeks) since I went on it, instead of three times a day prior to it.
>
> Feedback?
>
> Lar
Posted by Cairo on May 4, 2005, at 19:17:43
In reply to Morontin.....anybody using it? (gabapentin), posted by Larry Hoover on May 1, 2005, at 16:18:59
I just had my yearly eye exam with a personal friend who is an opthalmologist. I've been on Topamax for 6 weeks and have a family history of glaucoma and retinal detachment and all sorts of eye problems. He said there's nothing in the literature about visual field problems BUT he'd do a visual field test on me as he would if it were his wife and he hears things....hmmmm. Why don't you have it checked and be sure especially if Neurontin works for pain and you're going to be on it long term. You'd would want a baseline anyway if you're going to switch to Lyrica anytime soon and who knows what visual side effects what will have. Don't mess with the eyes.
Topamax has been doing funky things to my eyes, too. Wavy peripheral vision, though that could be attributed to dry eyes which is caused by my meds as well as part and parcel of my Fibromyalgia/Chronic Fatigue. Also, shimmering lights at times. Almost similar to an ocular migraine I had one time. Since Topamax causes headaches, maybe that's it. The worst is my slowed cognition and writing (I now write like I have dysgraphia.)
I'm going off the Stupimax anyway since it is causing increasing anxiety, crying spells, insomnia and not helping pain.
Cairo
This is the end of the thread.
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