Table of Contents (hide)
- 1. Other forms:
- 2. Other brand names & branded generic names1
- 3. FDA Approved Uses
- 4. Off-Label Uses of Neurontin (gabapentin)
- 5. Neurontin’s pros and cons
- 6. Side Effects
- 7. Interesting Stuff Your Doctor Probably Won’t Tell You
- 8. Neurontin’s Dosage and How to Take Neurontin
- 9. How Long Neurontin Takes to Work
- 10. How to Stop Taking Neurontin
- 11. How Neurontin (gabapentin) Works
- 12. Neurontin’s Half-Life & Average Time to Clear Out of Your System
- 13. Days to Reach a Steady State
- 14. Shelf life
- 15. Discussion board
- 16. Your Reviews of, Comments About, and Experiences with Neurontin
- 17. Full US PI sheet, Global SPCs & PILs, Consumer Reviews & Ratings Sites, check for drug-drug interactions
- 18. Bibliography
US Brand Name: Neurontin
generic name: gabapentin
§1. Other forms:
- Big ass, rock hard, 600 & 800mg tablets.
- Extended-Release - under the brand name of Horizant
- Eplentin: South Africa
- Gantin: Australia
- Kaptin: Colombia
- Nupentin: Australia
- Нейронтин: Russia
§3. FDA Approved Uses
- As an add-on to treat partial epileptic seizures in adults and children.
- Postherpetic neuralgia (the physical pain from shingles) in adults.
- RLS, but only as Horizant
§4. Off-Label Uses of Neurontin (gabapentin)
What isn’t Neurontin used for? It’s the late-20th century’s most successful snake oil! Sometimes Neurontin is a valid therapy for the following, and sometimes it is utter quakery and placebo. There was one big-ass settlement against Parke-Davis (acquired by Warner Lambert, acquire by Pfizer) for their pushing Neurontin on doctors for inappropriate uses. So remember to check on who paid for the studies in question, as it will tends to make the results more favorable for the company paying for it (on average 3.6 times more likely, according to a Yale study).
These are just some of the off-label uses of Neurontin we’re aware of. Let’s start with some that it’s actually good for:
And where it’s a placebo with side effects, albeit a fairly low side effect profile for an AED:
- Bipolar Disorder
- Sleep Disorders
- Restless Leg Syndrome/PLMD - Note the new extended-release form under the name Horizant has FDA approval to treat RLS, but it is still an off-label application for classic immediate-release Neurontin (gabapentin). It made Mouse’s RLS so much worse I had to sleep on the couch. She could sleep through it, so if you sleep alone, or with someone who can sleep through being kicked repeatedly all night, Neurontin might be worth a try for RLS if nothing else works.
- Chronic Fatigue. But what isn’t used for chronic fatigue?
- Menopausal Symptoms
- Cocaine Abuse
- And probably a bunch of stuff I don’t even know about. Maybe it’s quite useful in these applications, sometimes it’s prescribed first just because it’s an anticonvulsant with a very low side effect profile and doctors are sick and tired of people whining about how medication sensitive they are.
§5. Neurontin’s pros and cons
It has a very low side effect profile. Given that what you take is what works on your brain there are few drug-drug interactions (but they are wacky). Neurontin (gabapentin) is a proven pain reliever that doesn’t mess with you as much as the other anticonvulsants do, and works better for non-migraine pain better than most of the others.
It doesn’t work for a lot of people, mostly because of bioavailability issues. Because of Parke-Davis’ allegedly sleazy marketing practices you probably can’t get samples from your doctor anymore.
§6. Side Effects
§6.1 Typical Side Effects
The usual for Antiepileptic drugs, albeit to a lesser degree for most people. Although at the higher dosages Mouse and I, especially Mouse, experienced memory problems. The main problems with Neurontin are dizziness, cloudy thinking, fatigue and klutziness.
§6.2 Not So Common Side Effects
Edema. Really goofy thinking - hence the nickname “Morontin.” If being treated for bipolar disorder, don’t be surprised if it results in hypomania instead of working as a mood stabilizer - as that has been reported in the clinical trials for epilepsy, in at least one of the studies on Neurontin (gabapentin) as a treatment for bipolar, and several times in the online support groups.
§6.3 Freaky Rare Side Effects
Taste perversion, abnormal accommodation, libido increased, baby you are coming over to my house right now! I’ve got plenty of Neurontin on hand!
§7. Interesting Stuff Your Doctor Probably Won’t Tell You
Neurontin (gabapentin) is a prime example of the Law of Diminishing Returns in that the more you take the less you get. Seriously. It’s right there in the PI sheet / PDR:
As dose is increased, bioavailability decreases. Bioavailability of gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively.” You can try to squeeze out a little more absorption by taking it with food, but you buy a whopping 14% increase, on average, in the bioavailability. Sometimes every little bit helps. —Neurontin PI sheet
And if that wasn’t complicated enough for you, magniseum supplements can interfere with absorbing Neurontin.
§8. Neurontin’s Dosage and How to Take Neurontin
Given all the different things for which Neurontin (gabapentin) is used, I’m not about to cover all the possible dosages. I’m just going to cover the FDA-approved applications in adults. For everything else it’s between you and your doctor.
For shingles start with 1 300mg dose. On day 2 take your 300mg dose two times a day. On day 3 take it three times a day. Then work your way up as required to a dosage range of 1,800 to 3,600mg a day divided over three to four doses a day.
For epilepsy Parke-Davis recommends you start right out with the therapeutic dosage of 900mg a day, divided over 3 300mg doses. What the hell? This is an add-on medication folks, how about a little titration? My advice is to follow the schedule for shingles. Give your body a chance to get used to this stuff. The effective therapeutic range is 900 to 2,400mg a day, in doses taken three to four times a day. You shouldn’t let 12 hours pass between doses.
§9. How Long Neurontin Takes to Work
It should start to do something for you a couple days after you reach 900mg a day. But because of the whole bioavailability issue it may not be until you’re somewhere in the range of 900–1800mg a day, presuming it will do anything at all for you.
§10. How to Stop Taking Neurontin
Your doctor should be recommending that you reduce your dosage by 100–300mg a day every two days, 5–7 hour half-life, if not more slowly than that.
Like any anticonvulsant, if you’ve been taking Neurontin (gabapentin) for more than a couple months and you’re up to or above 900mg a day you just can’t stop cold turkey if you’re not at the therapeutic dosage for another anticonvulsant that you know works for you, otherwise you risk partial-complex, absence seizures or even tonic-clonic grand mals, despite your never having had a seizure disorder before! Granted, the risk is a lot lower than with most AEDs, but it’s still greater than 0.
The risk is worse if you’re taking a lithium variant, Wellbutrin (bupropion hydrochloride), or an antipsychotic. Anyone with a history of a seizure disorder who needs to stop taking an anticonvulsant cold turkey needs to be discussing that with two neurologists and not getting your information from some stupid web site. Get off your computer and start making appointments!
§11. How Neurontin (gabapentin) Works
Hah! That’s like asking the half-life of Lamictal or the taxonomy of the Leratiomyces ceres. While the Mechanism of Action/Pharmacodynamics section of the PI sheet for every drug on the planet is predicated with some variant of “We have no freaking clue of how it works. We’re pretty sure what it doesn’t do. So our best guess is…” Parke-Davis doesn’t even bother with the guesswork. We get a whole bunch of clues from the PI sheet that map how everyone thought it worked at one time or another:
Gabapentin is structurally related to the neurotransmitter GABA (gamma-aminobutyric acid) but it does not modify GABAA or GABAB radioligand binding, it is not converted metabolically into GABA or a GABA agonist, and it is not an inhibitor of GABA uptake or degradation.
In vitro studies with radiolabeled gabapentin have revealed a gabapentin binding site in areas of rat brain including neocortex and hippocampus. A high-affinity binding protein in animal brain tissue has been identified as an auxiliary subunit of voltage-activated calcium channels. However, functional correlates of gabapentin binding, if any, remain to be elucidated. —Neurontin PI sheet
Stahl elucidates the current consensus on how Neurontin (gabapentin) and Lyrica (pregablin) work:
pregabalin and gabapentin reduce neurotransmission in activated neurons by blocking voltage-gated presynaptic N and P/Q calcium channels. —Anticonvulsants and the Relief of Chronic Pain: Pregabalin and Gabapentin as alpha~ 2delta Ligands at Voltage-Gated Calcium Channels
§12. Neurontin’s Half-Life & Average Time to Clear Out of Your System
Half-life: 5–7 hours. It’s out of your system in 2 days.
§13. Days to Reach a Steady State
Steady state is usually reached two days after you’re taking Neurontin at least three times a day.
§14. Shelf life
- Capsules: 3 years.
- Tablets: 2 years.
§15. Discussion board
If you have any questions about Neurontin (gabapentin), the best place to ask them is on the Crazy Meds’ Neurontin (gabapentin) discussion board.
§16. Your Reviews of, Comments About, and Experiences with Neurontin
25 April 2011 - 13:18
Jerod Poore wrote:
Tell us what you think about Neurontin
does anyone else on neurotin have increased sex drive? I’ve only been taking it for less than a week at 300mg 3 times a day and this falls in the freakishly rare side effects. not that im complaining my head pain is improving but holy shit i want just about all the time. also how does neurotin help with menoppause since im starting to go through it and im only 45.
I’ve been taking neurontin for approximately four years. I’ve noticed two bothersome side effects: hot flashes (sweating); and horrendous edema in my hands, as well as in my legs (from the knees down) and feet. I have stopped taking it a few times, as I’m not really sure how much it’s helping the chronic pain in my right leg and foot (especially since the edema makes the pain worse), but I keep starting it up again in hopes that it will help. I have stopped “cold turkey”, as well as by tapering down the dosage, and either way, I have withdrawal symptoms consisting of night sweats lasting at least a week. Anecdotally, when I was incarcerated in state prison a few years ago, neurontin was in high demand by inmates who either crushed the pills or opened the capsules in order to snort the powder. Evidently, one can get high that way, though I’ve never tried it myself. Also, most people who took neurontin were prescribed it by the prison psychiatrist as a “mood stabilizer”; only a few of us were taking it for peripheral nerve pain.
My neurologist recently switched me from Trileptal to Neurontin and I seem to be having some very strange and unexpected side effects. To make a long story short, I basically feel like I’m on some sort of stimulant. I’m not tired at all when I’m normally always tired, my heart rate is sometimes increased, I have a decreased appetite, and I just feel spaced out and weird. Has anyone had a similar experience with this medication?
Enter your own Review, Comments & Experiences with Neurontin here.
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§17. Full US PI sheet, Global SPCs & PILs, Consumer Reviews & Ratings Sites, check for drug-drug interactions
§17.1 Prescribing Information and Patient Information from Around the World
- Australian Neurontin Product Information
- Canadian Neurontin Product Monograph
- South African Epleptin Patient Information
- UK Neurontin SPC
§17.2 Consumer Reviews of Neurontin
- Everyday Health Neurontin Reviews
- DailyStrength Neurontin User Reviews
- Drugs.com User Reviews for Neurontin
- AskaPatient Drug Ratings for NEURONTIN
- PatientsLikeMe Gabapentin Treatment Report
- WebMD User Reviews & Ratings - Neurontin Oral
§17.3 Other Sites of Interest
Instant Psychopharmacology 2nd Edition Ronald J. Diamond MD © 2002. Published by W.W. Norton
Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 An imprint of Elsevier.
The Complete Guide to Psychiatric Drugs Edward Drummond, M.D. © 2000. Published by John Wiley & Sons, Inc.
Partial Seizure Disorders Mitzi Waltz © 2001. Published by O’Reilly & Associates.
Healing Anxiety & Depression Daniel G. Amen, M.D., and Lisa C. Routh, M.D. © 2003. Published by G.P. Putnam’s Sons.
Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition by Stephen M. Stahl © 2008 Published by Cambridge University Press.1 The term "branded generic" has three meanings:
1) A generic drug produced by a generics manufacturer that is a wholly-owned subsidiary of the company that makes the branded version. E.g. Greenstone Pharmaceuticals makes gabapentin, and they are owned by Pfizer, who also own Parke-Davis, the makers of Neurontin.
2) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Teva's Budeprion), but otherwise has the same active ingredient as the original branded version (Wellbutrin).
3) A branded generic is also a generic drug given a 'brand' name by the manufacturer (e.g. Sanofi-Aventis' Aplenzin, which is bupropion hydrobromide) and uses a salt of the active ingredient that is different from the original branded version and other generics (Wellbutrin, Budeprion and all the others are bupropion hydrochloride). We aren't sure if that really makes a difference or not. The FDA says they're the same thing. As usual, the data are contradictory, but most evidence indicates that the FDA is right and the differences are negligible.
For our purposes a "branded generic name" refers to the second and third definitions.
Date created 25 Apr 2011 - 13:18 Page Author: JerodPoore Last edited by: Jerod Poore on May 11, 2013, at 11:49 AM
Neurontin is a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
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[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]
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