Withdrawal symptom theory question

[BusyGrl]

Recently, I have been posting about my excessive morphine withdrawal symptoms and the lack of empathy from my pain manager. Ever the self-manager, I am trying to research ways to alleviate the symptoms since my pain manager won't, and I found a couple of articles that *might* fit together. If you have a medical background, please comment:

One article says that "scientists' analysis revealed that a transporter molecule for the neurotransmitter GABA was responsible for the electrical abnormalities that produce a hyperexcitability in the neurons."  A second one says "Gabapentin prevents epileptic fits by preventing the excessive electrical activity in the brain. It is thought to do this by mimicking the activity of a neurotransmitter called GABA."

If these data points have any connection, what effect might Neurontin have on excessive withdrawal symptoms? I had been taking Neurontin while I was taking morphine and I stopped because of intolerable body twitching day and night. I wonder if it would help or hinder the symptoms at this point. Any comments? Am I going down a rat hole? I'm desperate, but fearful of adding things in that might do more harm.

[BusyGrl]

This is encouraging...

http://www.ispub.com/journal/the_internet_journal_of_pharmacology/volume_4_number_2_37/article/gabapentin_assisted_benzodiazepine_withdrawal_in_a_multidrug_dependent_patient/page/1.html

[Mollyrae]

Hi BusyGrl:

I think your question would be better answered in the Substance Abuse Forum. There are not many members in the Pain Forum interested in or who are able to stop their pain meds.
Thanks,
Molly

[Tuckamore]

In my opinion it takes a pharmacist (or similar study) to truly understand and explain the complicated inter-workings of medications on neurotransmitters, receptors and the like.

I am puzzled as to why your PMP is unwilling to help you through withdrawal. I have not heard of Neurontin being utilized for w/d symptoms. It is non addictive. It may not hurt but I would certainly discuss this with your physician.

And Molly is correct. The substance abuse forum is better equipped to respond to this question. Good luck to you, Tuck

[whatelsecanIdo]

I havent seen your postings for your withdrawl symptoms but one thing I can say is MS Contin is what I use to take and to me theres no way around it your gonna go through some bad withdrawls.Yes insomnia is probably the because it would make things much easier to deal with if you could just sleep.If your pain manager wont address your problems i would go to your regular doctor.Mine prescribed me some sleeping pills and other things to help go through them with less disomforrt.I dont know how long its been for you but it took me about 3 to 4 weeks to get through it. Try to deal with it and in a little while you'll feel so much better.

[nick30]

perhaps you could ditch the MScontin all together and try a different nerve med like sodium valproate or something similar. some nerve meds cause twitching, it may not be the morphine thats doing it

nick

[BusyGrl]

Thanks for your caring responses. I realize now that this topic does not fit for most people on this forum. I do have distracting nerve pain every day of my life; I just chose not to be on narcotics any more if at all possible due to the bothersome side effects.

It is puzzling to me why my pain manager (actually it's her physician's assistant) won't help me. She's either sloppy or too busy or both. I saw a doctor at another facility today who suggested a short course of short-acting morphine to end the taper, so I asked my prescriber to do that, and the physician's assistant refused! I am working on getting out of my contract with that provider now, but it has been weeks of torment trying to taper. They prescribed so easily and then just hung me out to dry when I wanted out. I don't know what the lesson is here. I told her my concerns about withdrawal when I started, and she reassured me it would be OK.

And for the record, the physician's assistant told me that gabapentin DOES help lessen the withdrawals. We'll see. I don't trust much of what comes out of her mouth any more. I just wanted to add that here in case people search for it. Everybody's journey is a little bit different.

[nick30]

it seems to be a common story that a lot of ppl are given drugs easily and then cut off suddenly or not given help to taper. i really don't understand why. surely dr's should be happy that someone wants to take less drugs?

[sandee1818]

One thing I have learned over the years of dealing with pain is it is always best to go straight to the doctor. The NP may not even be telling the doctor what your going through.
Your contract is with your doctor not her NP and I would ask to see her and tell her if she can't help you that you need to cancel your contract and find a caring doctor that will.

[nurseaudrea]

It is so sad to hear if your PM doctor won't help you taper and make it comfortable at the same time. When I hear stories like this it makes me so mad. I wish everyone had a doctor as great as mine. I have had to taper 3 times in the past ten years for surgeries and every time my doctor would help me taper and give me meds when it became uncomfortable. Everytime I got down to a low dose of course I felt some wd symptoms. It is unavoidable. My doctor understands this and he always gave me meds to help me with the insomnia and anxiety that goes with it. I take an extended morphine and when I get down to the lowest dose he would switch me to short acting and go down from there. He would also give me Valium or Xanax for about a week. It always made it bearable.  There should be no reason why a PM doctor does not do this for anyone who wants to get off their meds or needs to for whatever reason. This is why it is so important to make sure you have a good relationship with your doctor and find one you can really trust. It may take some time in finding a good one, but they are out there.

[BusyGrl]

It is criminal that PM doctors can do this to patients. I want you to know that I found a doctor who is so good I didn't think it was possible. He works for a healing center at the biggest hospital in town, a teaching hospital. He called my primary care physician, sent me to a physical therapist, and called the pain psychologist I chose and is orchestrating my care. He also gave me liquid morphine so I have a lot of control over my tapering. I guess the PMs are afraid of getting in trouble when they taper people because there are strict laws about who is licensed to detox a patient. My new PM talked about suboxone, but he would have had to send me to a doctor who is licensed to prescribe it. It's really absurd. Still, I don't think this is an excuse for how my prior PM treated me. I was in agony and their always delayed response was make an appointment, and then I can't help you. This is after going through the same thing last fall with oxycodone because my primary doc told me to quit taking 15mg a day. Just quit. Then he denied that I was going through withdrawals and sent me to a psychiatrist to deal with my "anxiety." I don't see him any more, either.

[nurseaudrea]

I am so glad you found a good doctor. That is comforting to hear. Hopefully now you can successfully taper your med. I don't understand why your doctor talked about putting you on Sub because even that would have wd's when discontinued. I have heard the wd's from that is just as terrible as Methadone. I have had experience with Methadone about 4 years ago when I took myself off of it after I had my daughter. It was horrible. I had no idea it was going to be that bad, but I had to suffer through it because the OB would not prescribe it for me anymore and I had to wait several months before I started going back to a PM doctor. The OB wanted to take over my meds so I stopped going to the PM for about a year. It was horrible. The wd's lasted so long and it was torture on my body. I would never suggest going on sub or methadone to get off Morphine unless you have a problem with it like addiction. I am glad you did not choose that route.
Good luck in your endeavors and best wishes.      Audrea