I shared my experience with gabapentin not too long ago. Please forgive me for using copy-paste-revise editing to respond here.
It’s odd - with some drugs (like our DMDs) it's a universal dose. Take it all or not at all. With others it seems there is a great deal of variability in how sensitive people are. Gabapentin apparently fits into that category. It has worked well for me but I had to increase it VERY, verrrry slowly.
If I remember correctly, you have said in the past that your goal was to live as naturally as possible - including drug free, until MS made that impossible. I also think you have had to start with half doses of other drugs. Do you think your history causes your system more drug sensitive than the average bear’s?
You also take baclofen, right? Baclofen and gabapentin make a good combo against pain but sometimes you need to use lower doses of each when using them together.
To me, gabapentin dosing is something like judging how much garlic the sauce needs. It depends a lot on what an individual diner likes and will tolerate.
I started taking gabapentin the first week in September (2011). The Rx read to take 400mg at bedtime for a week, then twice a day for a week and three times a day thereafter.
The first 400mg knocked me out as I sat in a chair. I awoke at 3am wondering what had happened and where I was. I barely managed to stagger safely to bed through the dizzy, stomach churning haze.
I don't like to be hit hard and fast by drugs but convinced myself to try this a few more nights. The second night I took the capsule and went straight to bed. I woke up in the morning with my CPAP mask in my hand. I remember picking it up but guess I fell asleep before I could get it on my face! Whoa....
But I had no more nausea, lots less morning hang-over and a significant decrease in pain within a few days so I stuck with it. I did decide not to add a daytime dose until I could maintain some wakefulness after the night dose. The doc told me some patients get adequate pain relief with a single bedtime dose and never need to add more. My pain was tolerable through the day as long as I moved the baclofen doses around to cover that time slot - for a while.
It was a good SIX WEEKS before I decided I needed daytime gabapentin for daytime pain. Since I was still getting knocked out cold (ok, maybe just cool) by the 400mg dose I asked the doc for a lower daytime dose. He ordered a supply of 100mg capsules. I took the first one the morning of October 18th. Within a few days I was taking 100mg in the morning, 100mg in the early afternoon and the 400mg at night - AND was able to decrease the baclofen to three 10mg doses each day.
The first of February (2012) I started taking 200mg in the morning, 100mg in the early afternoon and 400mg at night until all the 100mg caps were used. I was fully titrated to a 400mg dose each morning and night by mid March. I've missed a baclofen or two along the way with no bad result but less than that and spasms begin to increase.
My pain is adequately controlled (well, on most days) with NO MORE gabapentin ick, dip or weave. I can stay awake during the day (thanks to CPAP and Nuvigil) and long enough at night to get myself tucked in properly. I used to need an occasional Ativan to help me get though a night. I’ve used it rarely since that first dose of gabapentin. Maybe sleep is easier when pain isn't interrupting all the time ;)
Physical needs required my initial slow introduction to gabapentin. Once I had some relief I chose to continue to take it slow so I could remain alert at work. I don't have a plan right now to add the third daily dose that was originally prescribed. Tylenol is enough to handle pain that breaks through my present pharmaceutical line of defense. I'll deal with future needs as they present themselves.
Not everyone needs to take it this slow.
Not everyone will have the luxury of waiting so long for satisfactory pain relief.
My pain threshold isn't higher or better.
This is just where I got relief.
So, a lot of words and explanation to suggest you might want to hang in there a while and talk to your doc about just how much zest your palate prefers when spicing your pain life.
You may need to start with a lower dose and take it more often. Typically neurontin should be taken 2x a day. You may be experiencing some withdrawals. This would make you have more symptoms as you are never getting your body used to the med.
Talk to your doctor.
I was all the way up to 2700mg a day on neurontnin and it did nothing but make me tired. I switched to Lyrica and it made a HUGE difference.
the dose only at night was the first instruction on my bottle, after I week, I can move up to twice a day and then a week later, can move up to 3 times a day.
I took Lyrica for 3 years and it did nothing for me but was H..L to wean off of. Will never go back on that!
Hi, my 2 cents worth ??? I am now told to go to 3000mg because it does not seem to be doing much for the pain. My Dr. said that if my hubby took that does, he would be out cold, as would most people. He deduced that I'm a hard one to knock down..LOL ............. But, I have started this along time ago, and went up gradually, but it never made me tired, the disease did, but not the med..............
So, work with it, and find out what cocktail works best for you, you are you own judge...and the best one at that....
Thank you for your excellent summary, Mary! It helps.
True, I struggled to stay off of drugs however as MS has progressed
and my more than intelligent neuro pointed out that i was enduring
pain I did not have to endure, I gave in.
I have indeed had to start low with dosages and too wonder if its because of past drug history or just that my body is now more sensitive to drugs. I have found that baclofen and neurontin are indeed a wonderful combination for pain/spasm relieve, particularly at night. Still not sleeping all not (not even on 300mg of neurontin) but sleeping in longer spurts than before (any gain is a gain).
Always learning more from our forum family! Thanks everyone
I have been on a combination of long acting tegretol and neurontin (Gralise) for trigeminal neuropathy. Gralise is almost a completely different drug than regular neurontin. It doesnt make you sleepy or excessively hungry. These were the two biggest complaints I had. I really like the combination of the two drug and I think the long acting drugs have less dips in blood levels for pain to crop up. When you have been on neurontin for a while it might be good to ask your doctor.
"El-Kabonged" me a bit too much. but was worth trying.
i stopped it to check iif it was gabapentin causing my severe fatigue or not. no gabapentin, and still get brain crushing fatigue periods.
never went back to the gabapentin though for some it works really well.
I started Gabapentin last night. Makes me sleepy!! However, I slept 4 hours and then couldn't fall back to sleep. Holy tiring!! Hoping it will get better!!!
i think it will. Just keep it up and gradually increasing until you get to a therapeutic dose. I remember it was hard for me to tolerate 100mg at first. It is worth the effort however because of the pain relief.
I've adjusted to the night dose, and unfortunately, it does not help me sleep any better but the pain is diminished somewhat. I think I will wait until I arrive at my summer destination before adding the 2nd dose because I know it will make me loopy for awhile. By the time I start back in the fall, I will be on my 3 doses a day and a happy camper.
Mary, you can be my workaholic any day, I always learn something with your posts