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Gabapentin (Neurontin)
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Gabapentin (Neurontin)

For those of you who take Gabapentin (Neurontin):  Just curious what side effects you have experienced (and at what dosage), and how long they lasted?  I just started this last weekend, 300mg once a day at bedtime.  I am having a really hard time waking up in the morning and for the first half of the day I feel a little "loopy" or my head feels "swimmy"....if that makes any sense.....

My Internist warned me that I may feel tired/groggy in the morning, but that it should go away after a week or so.

Thanks for any input...

Chrisy
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Avatar_f_tn
Hi Chrisy,

I started out at 100 mg 3X/day and had relatively minor tiredness with that.  I slowly went up to a level where I was getting more relief (400 mg 3x/day, with an extra 100 mg if I need it).  Unfortunately, now I'm having definite dizziness associated with the medicine.  I'm getting used to it, but it doesn't seem to be going away.

Also, my acohol tolerance, while never high, is miniscule.  If I have a drink, I need to have it with a meal or sip it VERY slowly if I don't want to end up tipsy.  Quite honestly, that's kindof what the side effects feel like--being mildly drunk.  It's really no fun.

I'm taking it for trigeminal neuralgia, so the pain is really worse than the side effects.  I'm wondering if I'd be better off with tegretol?

Stephanie
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620877_tn?1282767697
Thanks for your input.  The way you describe the side effect - as being kind of tipsy - is very accurate.  I am really hoping that this gets better with time...

I am taking it for the burning/tingling/numbness that I have.  I am not familiar with any of the other medications for these types of symptoms - the Gabapentin is the first one I have taken.  It is my understanding that the Gabapentin is the one with the fewest side effects...but of course everyone is different, so that may not be the case for everyone who tries it.

Chrisy
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864831_tn?1243622272
I don't remember what dosage I was taking but I remember feeling like a zombie. I got pregnant and after I was put on lyrica . My side effects were bad with both of these drugs. The main reason why I stopped Neurontin was because I felt worse. Lyrica is pretty much the same drug but my eye sight got really bad. I already have limited vision and it was impossible to see anything . As soon as I stopped taking them I got better.
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147426_tn?1317269232
Hi, I was also loopy on it.  The effects gradually wore off after a week or two.  

Chrisy, please read the HP on General Principles of Treating Neuropathic (Nerve) Pain.  that explains that it is important to start at a low dose and move up in order to give the med the best chance.  Treating paresthesias is the same principle as treating neuropathic pain.  If you can tolerate this dose, then fine.  But if the level of loopiness would otherwise make you stop it, then ask to work up more gradually.  Or you might do better with a lower dose taken more frequently.

http://www.medhelp.org/health_pages/Multiple%20Sclerosis/General-Principles-of-Treating-Neuropathic-Nerve-Pain/show/452?cid=36

Neurontin has a huge range of dosing.  Some people are okay at the lower end and some need to push it upwards toward 3600mg/day or so.

Good luck,

Quix

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751951_tn?1299202836
I also just started this drug, on Friday.  I took one 300mg capsule per day through Sunday, then today I bumped it to two per day, or at least I am supposed to; I haven't taken the second one yet.  I don't recall being told to take it at bedtime.  Thursday, I am supposed to begin taking 3 of them per day, & the neuro-ophthalmologist said it could be several weeks before I adapt to it.  It says 3x/day, not 3 per day at any particular time, so I planned to spread them out, one at bedtime, one when I get up in the morning, and another when I come home from work.

Frustrating to hear that so many drugs might worsen the worst problems I already have.  This was given to help prevent migraine symptoms, if I understood and remember correctly.  Balance and vision have been all goofed up for months, and are both worse today; I pray that this isn't why I felt so crummy today.
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382218_tn?1341185087
Re: gabapentin, I started at 100mg 3x/day, and gradually titrated up to the 3600mg daily max dose (1200mg 3x/day).  I recently tried to reduce my dosage and found I really need to stay at the max dose.  I still have neuropathic pain but found that I am getting a good amount of relief from this medication.

In addtion to gapapentin, I am taking 125mg per day of amitriptyline as an adjunct pain treatment.  Started about 6 months after starting gapapentin.  It also takes the edge off the pain and discomfort.  It sometimes but not always makes me drowsy.  Not a problem as I take it before bedtime.  I am noticing some urinary retention as I have gradually titrated up to the 125 mg dose (started at 25mg).  Not a major issue so far but something I am carefully monitoring, due to increased risk of UTI.

I have had zero noticeable side effects from gapapentin.  It has never made me drowsy/loopy, including when I first started taking it to working my way up to the very high max dose.  No effect even when I have a glass or two of wine.  So odd because most people I know who have taken it found it made them drowsy, at least initially.  My neuro says he likes it as he has found it is generally well tolerated, effective, with the least amount of side effects compared with other meds for neuropathic pain.  
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620877_tn?1282767697
Wow - thanks for all of the responses.  

Quix - a question:  it looks like everyone that responded is titrating up to some higher dosage, but my Internist did not do it that way.  I am taking 300 mg every night until I see her in 4 weeks.  Is that unusual?  Thank you for the link to the HP - as usual very helpful!!!  I love those HP's!

The side effects that I am experiencing aren't that bad - and I am willing to give it some time to see if they get better as my body adjusts to the medication.

Chrisy
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Avatar_f_tn
Hi,

I take gabapentin for neuropathic pain.  I was told to start gradually and increase the dose gradually.  I now take 1200 a day and find that it is great.

I did find myself a bit sleepy when I first started it, so I began on a weekend when I didn't have to do any driving etc. or concentrate.  I take 4 x 300 a day and adjust my dose to suit but initially it was meant to be 3x a day..

I have taken tegretol too in the past but found that not as well tolerated.  My Dr said that Gabapentin is better tolerated than tegretol.  I am like DB I have tried to reduce my dose without success, find this drug really helps my pain.  You do need to give it some time for your body to adjust to it. Don't stop taking it suddenly either, stop gradually the same way you started etc.

Cheers,
Udkas.
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Avatar_m_tn
A scientific study showed an average ~ 1.2 points reduction in pain (on a 10 scale) after ~ 3-4 weeks on a 900mg/day dose. Placebo was ~ 0.5, IIRC (this comes up enough I need to find that link).  I'm on 1500mg/day and feel similar efficacy. Pain is bad, but it was intolerable.  I had similar benefit from 60mg/day of Nortriptylene, but I think the side effects are smaller with Gabapentin regarding tiredness. I also find that I may be developing a tolerance to the pain meds, either that or my pain level is slowly rising, I can't be sure.

doublevision1,
I was wondering if I took a combination of Nortriptylene and Gapapentin I might get a synergistic effect at lower relative doses. Or alternatively, should I stick with one and migrate to higher dose?  I dont enjoy using myself a as guinea pig, so I'm curious how you ended up using two medications vs. picking the "better" of the two and using a higher dose?
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751951_tn?1299202836
Are amitriptylene and nortriptylene the same thing?  I've been taking a very small dose of amitryptilene at bedtime.
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Avatar_f_tn
I take 300 mgs a day of Neurotin. I started at 200 mgs and asked my dr to increase it since it was helping with most of the nerve pain but not as effective with the spasms. Since he increased it about 2 months ago the spasms have almost ceased (smiles).

As far as the side effects I havent really experienced any just taking that one pill. New PCP wanted to start me on Lyrica for the nerve pain. I declined because the Neurotin is helping me and why mess with a good thing. He stated Neurotin has high side effects. I've read differently. You do have to be careful of what medications you take with it. I had some adverse effects with Mysoline and Celexa.
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Avatar_f_tn
I took 200 mg 3-4 times a day.  It helped tremendously with the pain and tingling that I had.  Of course I worked up to that dosage and did not start there.  I can honestly say that I did not experience any side effects.  I loved it.

If you have side effects many doctors will let you try Lyrica instead.  I did not like this one, but you might if the side effects don't go away.

Tahiri
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620877_tn?1282767697
Bumping this up for Quix - it looks like everyone that responded is titrating up to some higher dosage, but my Internist did not do it that way.  I am taking 300 mg every night until I see her in 4 weeks.  Is that unusual?

Also, have any of you noticed that when you began taking Gabapentin that your symptoms worsened initally,  or that it induced a flare or maybe a pseudo flare?

I woke up in the middle of the night last night with a raging headache (which is one of my symptoms) and today I am home with a number of my "typical" symptoms - my left arm is tingling, tired beyond belief, my left side of my face is numb...

Just wondering if this is coincidence or if the meds caused a flare?

Thanks
Chrisy
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751951_tn?1299202836
I know that my balance and vision problems, my most annoying and most persistent symptoms, have been substantially worse this week, plus I am so groggy I'm afraid I'll hit my head on the desk when I finally can't take it any more.  This is supposed to go away in a couple of weeks?
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620877_tn?1282767697
Like you I am wondering if my sudden worsening of symptoms is due to the Gabapentin.  I have called my doctor to ask - just spoke to the nurse & she is asking the doctor and will be calling back shortly.

I will let you know what I hear.

Chrisy
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620877_tn?1282767697
So the Nurse just called back & said that what I am experiencing may be side effects from the Gabapentin.  She recommended that I stop taking it for the next couple of days & see if the symptoms get better.  I am to call back Friday to let them know.

She said that I may need to start at a lower dose to allow my body to adjust.

We shall see what happens over the next couple of days....

Chrisy
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559187_tn?1330786456
The nurse sounds like she is on the ball.  I don't know why, but doctor's prescribing these meds for neuropathic pain start patients on doses that are just toooo high.  

See how you do the next couple of days and then get the nurses' suggestion on which "lower" dose you could try next.  

Your body will get used to it, but easing into it is worth the extra time it takes to get the pain control versus the yucky side effects we get from being on the wrong starting dose.

Hang in there. The meds will really help.

Julie
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620877_tn?1282767697
Thanks for your input - I am really trying to fight the feelings of discouragement right now.  I was so excited to FINALLY have someone address my symptoms - even if they still don't know what is causing them - and to be feeling so crummy after only a few days of the medication...

I hope that the next couple of days are better...and that easing into a lower dose is less symptomatic!  Lord knows none of us need more symptoms to deal with!!!  :)


Take care,
Chrisy

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Avatar_m_tn
I have submitted to a couple other posts, but thought I would add my two cents here too.  I have been taking 4x900 for 10 point pain attacks. It finally took the max to stop these attacks.  Here's my unique side effects- swollen feet, slight weight gain, plus:

I think my vision changed slightly as the dosage of gabapentin was changed, so I had to update glasses a few times. Catching the vision change thing for me reduced the ongoing feeling of dizziness because it was just the need for different glasses.  There's room for it to be a coincidental age thing, but eye exams showed changes matched dosage changes. Noticed certain fluorescent lights take time to adjust to, but can't say if it is connected to gaba.  

Initially when on 300mg/d, I learned if I skipped gaba more than a day, I would pay with adjustment side effects of dizziness, etc. all over again the next time I took it.  I have gerd/acid reflux and initially had to be careful of med timing because of certain gerd meds blocking the amount of gaba dosage absorbed and causing side effects. Not as much of a factor now. I do get a 30 minute buzz in the afternoon some days.

Even though it says on the insert to stay away from grapefruit and maybe other citrus while on gaba, I also discovered that drinking Squirt and some other popular clear sodas with citrus will greatly interact with gaba and cause dizziness and other negatives like feeling of being slightly drunk.  

My concentration definitely changed, but improved in the long haul.  I still asked the doc if I could cut back after a year or so, but quickly learned I needed the high dosage. I learned to use additional tools to help keep organized and reminded. I would be 100% disabled without gabapentin.
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Avatar_f_tn
Wow, I must be a "lightweight"!  Doc started me on 300 mg. gab a night for 3 nights, then 1 more in the am for 3 days and then another one at 3:00pm.  By the time I got to the second pill a day I was a zombie.  So sleepy (like narcolepsy) and I kept stumbling off to the right side!  He then gave me 100 mg pills and said to take 1 or 2 three times a day instead for a few weeks.  I have worked up to 2 pills 3X a day and I am not even functional.  Its has been three weeks now and all I want to do is lay down and sleep.  I am also having some headaches and I am starving all the time!  Does anyone else have this problem?
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1253197_tn?1331212710
Just to add to everyone else's posts. I am taking 300mg of gabapentin 3x a day and 10mg of amitriptylin at night also.  I started on 100mg 1x a day and slowly increased it after a few days to 100mg 2x a day and then again up to 100mg 3x a day. My neuro told me to go up to 900mg a day but to do this very slowly and see how I felt. I was initially extremely tired and at that time I was also taking 20mg of amitriptyline but I found this just made me too groggy in the morning and that I was needing at least 9-10 hours of sleep every day.

The dose I am on now keeps the edge of my tingling and pins and needles but in the day I am aware of feeling it wearing off after about 3-4 hours. I probably need to increase the dosage a little but I am reluctant to take more than I really need and am still waiting for my body to settle down after last relapse so will wait and see.

I think that if you were started on 300mg a day it would have been better to have taken this as 100mg 3x a day rather than giviing your body a blast when it has not got used to the drug. It is still a low dose..but as everyone else has said seems to work best by gradual introduction and I would vouch for that.

Cheers

Sarah
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1312898_tn?1314571733
I currently take 300mg 3 times a day.  It does help me but the effect wears off within 2 hours.  I haven't felt groggy or sleepy.  I still have great difficulties sleeping, I can get to sleep after taking a klonipin (klonopin) and ambien but wake up 4-5  times per night so I never really feel rested.

I am going to suggest that we increase the dose at my next appointment.  

I don't think I have had any negative side effects.  I think it is a good medication for nerve pain

hope this helps

lois
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Avatar_f_tn
Hi Chrissy!

I'm sorry it's making you so wonky :(  I think it's probably worth it to stick with it, though - just going off my experience, it really does get better :)

I started it about four weeks ago now - I did 300mg for over a week, then 600, and now I'm up at 900.  For me, it took about a full week (sometimes more) for the side effects to truly go.  I had some big-time dizziness and clumsiness that was usually down by a couple days, but the grogginess lasted.  I've been about 10 days on my current dose (300 mg morning, afternoon, and night) and I'm FINALLY feeling symptom-free :)  

I hope you have a similar experience! :)  I hope the medicine is really working for you, too.  I started noticing a BIG benefit after 5-6 days at 900 mg.  

Good luck to you!

Louey
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233622_tn?1279338505
I started out on 300mg at bed time.  I am now up to 2100 mgs through out the day.

I know it is helping me.  But my weight has become ridiculous!

LA dx'd MS
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1045086_tn?1332130022
Amitriptylene and nortriptylene  belong to the same class of antidepressants, the tricyclics. They have a somewhat different structure;but, similar side effects and toxicities.  They are also sometimes effective in assisting with pain relief.   Amitriptyline tends to be somewhat more sedating so may work better as a sleep adjunct.

Mary
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751951_tn?1299202836
Wow, Mary.  One of the things that I find both really neat and really annoying about the MH forum is that sometimes an old thread is brought up for discussion and the conversation picked up as though it was ongoing.  My question about those two drugs was written thirteen months ago.  Nevertheless, I greatly appreciate you taking the time to answer!

I've long been off the amitriptylene, so long I can't remember how long or why.  I think we just concluded it wasn't much help, but it might've been adding to the balance problems.  I am still on gabapentin, 400mg x3/day.  Since all my other symptoms seem to be in remission, I wonder if I could cut back, but I am reluctant to attempt that without some smaller pills to allow more flexibility in dosing options.

To anyone still working out how to use gabapentin, I'd reiterate that you should read our health page on treating neuropathic pain; it was a great help to me.  The one lesson I learned through experience was that I need to ramp up my dosage more gradually than the doc suggested, otherwise I do feel like a zombie, as someone else described it.
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Avatar_f_tn
Hi there..
I take 400 mg of gabapentin the the morning, 300 mid day and 300 at bedtime for a pinched nerve in my neck. My hands, arms, legs and feet often go to sleep.  I also have 3 herniated disks in my lower back. Never knew it was for MS.. wow that scared me for a sec when I saw that and yes I am tired. but well worth it and not having my limbs asleep all the time.  I can function like a person again and actually went back to work part time.. it is a a struggle.. but well worth getting back to the living again. Do not forget to eat.


Susan
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3173124_tn?1344208160
im curently taking gabapentin 100 mg 3xday just wanted to know if i can take 2 in the afternoon i take it for neruopathy and thank you
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1831849_tn?1383231992
Prissy - I think that question is best directed at the prescribing MD :-) Welcome to our little world.

Kyle
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