Gabapentin??

[Wobbly]

Hi..I went to see my GP today, he asked how it went at the Neuro and I told him....how the Neuro said "why r you here"...etc... and how after he did the Neuro exam he wants to look further into my file etc...incase he missed something..now with the new MRI info...he feels it should give the Neuro the info he needs.  

My GP would not say I have MS or ?? He said to wait to see the Neuro and see what he has to say..... I told him my leg pains are worse and the numbness, tingling is so bad...he gave me a prescription for Gabapentin...

is there anyone who uses this or has tried this med??  What side effects...?  online the list is so long...
I don't know if I want to take new Meds until I have a final Dx...?  If that will ever happen?

will taking this Meds interfer with the Dx process?

thanks for any info guys...

take care
andie

[Wobbly]

thanks for both sides of the decision... it's good to see both sides ..  I can understand you point as well.  What kind of narcotics are given for these types of pain... do you mean something like Percocet??  

I'm not familiuar with pain meds...thanks again.
andie

[Wobbly]

thanks Quix...my Neuro is not in the office till Sept.. so I can call the office in Sept...and start the meds first...or wait till Sept...

decisions, decisions...thanks for the info on this..

my pain is so bad and the Tylenol three doesn't help much...so I'll most likely start the meds slowly..

thanks
andie

[wishforchange]

Am eating now so will calm down shortly.  I wasn't saying that pain relief shouldn't be given until the cause is found, would make all that I take a bit hippocritcal!  I was just pointing out that gabapentin is not a general pain reliever, but I get your point on diagnostic trials.
I was offered this drug myself once and refused it.  I decided from the nature of my symptoms and also as narcotics work for me the pain was maybe not neuropathic, so didn't see the benefit of taking it just to come off narcotics.  Also I was biased because of what I had witnessed at work.  But without giving too much away my patient group were those who were often misdiagnosed and had mostly non neurological problems, but had been offered gabapentin as they were in severe pain and their GPs did not like to prescribe narcotics.  I personally felt this was not the right reason to use it, as it is not an alternative, it treats an entirely different type of pain as you said.  I'll look at the HP.  Of course pain needs to be treated regardless of whether the cause is found or not, but I am just uncomfortable with this drug as it is not a general analgesic.  Hope this makes sense.  Also I know that this forum being what it is of course most pain here is likely to be neurological.  I never did the trial with gabapentin, it is still in my fridge, out of date now I think.  Who knows, it may have even worked for me...just had my opinions set from my experiences, which were of a patient group not typical of those here.  Anyway, it's always good to get two sides of an argument, wobbly is either now very well informed or confused!  I'm just about to reach for the narcotics again.  They may well be doing me more damage.  And all the morphine I can take is still not doing anything for my eye.  So it seems that may well be a nerve pain?

[Quixotic1]

Well, I have a little different take on this than Wish.  Her opinion is held by many in the medicaL world, so I'm not saying she is wrong.

If you read the HP on Nerve Pain, which was written by a pain management doc, you will see that there are only two kinds of pain - regular pain and neuropgathic pain.  When pain does not respond to "pain" meds, the other alternative is that it is neuropathic pain.  Rather than spending time and money to verify what you already have evidence of it makes sense to try what is called a diagnostic trial of a med for neuropathic pain.  A diagnostic trial can do two things.  It can relieve pain (the immediate goal) and by relieving pain can provide the diagnosis that it is, indeed, nerve pain.

I get very frustrated with doctors who delay symptomatic treatment until they have "proven" the diagnosis.  This is rarely necessary.  It is necessary in cases like suspected appendicitis where the decision to operate is based largely on the behavior of the pain.  If you give narcotics, the pain will be suppressed and you can sit there and miss a hot appendix while it ruptures.  But, most of the time, the pain relief is needed for the well-being of the patient and does not hide the cause.

The need for prompt and effective palliative care has been proven.  Pain diminishes the quality of life and diminishes the person's strength to fight stress and infection.

Gabapentin is often very useful in treating pain.  You just have to go up slowly and remember that the initial side effects, if any, will usually subside in a week or too.

Good luck with it.  I think it is up to you to wait on talking to your neuro about it.  But, why wait until you see him?  Tell him in a letter that your GP is trying to relieve your pain  and has prescribed Gabapentin.  Ask if that is okay or would he rather use something else.  Request that he have his office assistant call you back with the answer and give your contact info.  Then fax it to his office, followed up by a call to his front desk to expect it and make sure the neuro gets it.

Quix

[Wobbly]

thanks for the info... the Dr said to start slowly...1 pill one day, then 2 the second...then 3 the third...300mg pills.  900mg a day....

I have had a EMG...which was Neg..all the blood tests...not thyroid..I do have postivie ANA, and high sed rate...and high CRProtein.  everything else looked normal...these tests were done a few months ago.

I've had a few MRI head and C spine...my last one I had was July 28, 2008...waiting to see the Neuro for his opinion on the results... (I posted the results a few days ago on the forum)... he's on vacation till Sept.

I'm going to think about waiting to start this till I see the Neuro..I'll talk with my DH about it too.

I'm taking Tyn 3...for pain at the moment and I might wait to see what comes from the appt in Sept...

thanks again for you info..I'll keep you guys updated..
all the best
andie

[spastic]

Hi Sweetie, I have taken gabapentin for years and I will have to tell you it is a wonderful drug, if it works for you.  You might be tired at first but it will quickly fade, take your first dose at bedtime.  You might feel a little loopy at first but that will soon pass too.  How much has he started you on?

I didn't have weight gain with it but some people might.  It interrupts the pain signals in the central nervous system.  I was given this when the heaviness and numbness started after my hysterectomy.  I still think the surgeon severed some nerves there.  It might take awhile for it to start working, I started out at 100mg's at bedtime, and then titrated up to 800mg's 3xday.  You can safely take 3600 mg's of it a day.

Sorry Andie, this is jumbled up.  The da** zaps going down my spine through me for a loop!!!

I hope this helps a little.

Love Ya,

Ada

[wishforchange]

What is this rush to give you Gabapentin without confirming the pain is neuropathic.  Have you had an EMG and nerve conduction study done?  MRI's. Full blood tests for signs of muscle disorders, thyroid, adrenal etc. etc.?

I really, really don't understand why doctors just hand out Gabapentin like it's a regular painkiller.  it is NOT.  It will only work if the pain is genuinely neuropathic, and a lot needs to be assessed and eliminated to come to this decision, the drug with many people has a heap of unpleasant side effects, and once started is difficult to come off.  It does wonders for those who's symptoms match its effects, but if it is being prescribed before the right diagnosis is reached you are taking a gamble which could leave you feeling very unwell.  Or it may be the perfect drug.  My point is don't be too hasty to take this medication before you know why and the full reasoning of the neurologist.

Sorry if this is coming across too strong.  I have a lot of experience with patients on this family of medications who were not benefitting, had side effects, and yet were continuing to be prescribed them.  It angered me.  it's not a dangerous drug, just I feel given a little to quickly by some practitioners before they have a full picture of the patien.  Just my opinion.  I'm hungry and have had a bit of an unsuccessful day with my own doctor hence my curtness.  Really am just trying to help.  I hope others will post with other suggestions so you can make an informed decision.

[doublevision1]

I've been taking gabapentin since February.  I started at 300mg per day and by June was up to the max dose of 3600mg per day.  

Initially it seemed to help, ie: Lhermitte's Sign decreased, as well as some other mild tingling, and the stabbing feelings in my foot.  However as the effectiveness seemed to diminish, I upped my dose.  I was hoping this would also help treat the neuropathic pain in my left hand that develped a few months later, due to a relapse.  However the gabapentin has not seemed to help my hand, as this pain continues despite titrating to such a high dose.  

I recently started on amitriptyline for my neuropathic pain, am up to 50mg per day, and I think it is helping.  The stabbing and burning sensations are lessened, although the numbness and incoordination remain.  Because I seem to be responding better to this latter drug, I am now slowly weaning off the gabapentin.  I guess if the pain increases as I go off the gabapentin, this will tell me it was helping more than I realized.  

I have no side effects from the gabapentin, even at such a high dose.  I do find the 50mg amitriptyline makes me very drowsy, and may need to scale it back to 40mg if this side effect continues.

db

[wonko]

Gebapentin is generic Neurontin.  Same stuff, different name, to the best of my knowledge.

I'm trying this med with mixed results.  I'll note too that I have no diagnosis.  

Did your GP suggest that you start small, then up your dosage (or "titrate")?  If not, I would perhaps consider waiting to ask your neuro about the best use.  I started at 300 mg/day and went up to 1200 mg/day.  I think the "max" is 3600 mg/day.

When I started I took it only at night until I got my dosage up.  This is a good way to evaluate side effects before trying it during the active part of the day.  One big effect listed is drowsiness, though I didn't that issue.  The worst typical issue I got was some *slight* dizziness/disorientation.

It was also the case for me that I noticed quickly (withing days) that the med helped me sleep better, whereas before my symptoms would wake me up often during the night.   But it took a bit longer (more than a week) to get more relief from burning, tingles, etc.  It will likely vary on your dose and level of discomfort, but be prepared to need some patience.

I do not want to alarm you, but I did end up having a not so fun reaction to the med.  It can be difficult to determine the dosage that is high enough to knock out symptoms, but low enough to minimize side effects.  Make sure you talk to your doctors about how well the med is, or is not, working.

Good luck!