This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 |
Would whoever made the nice ball-and-stick structure please redo it with either the zwitterionic or H-bonded structure? They are much more stable. Thank you. Laburke ( talk) 22:05, 13 May 2011 (UTC)
The handsome 3 dimensional molecular model shows co-valent bonding of nitrogen to THREE hydrogen atoms whereas the stick model shows -NH2. David P West ( talk) 00:09, 13 February 2012 (UTC)
Oh! I see. I just became less ignorant concerning zwitterions & inner salts. Thanx. David P West ( talk) 00:18, 13 February 2012 (UTC)
—{{}}I have been prescribed gabapentin for my rehmatoid arthritis pain. This is the first time I have been without pain for over five (5) years. The drug has little or no adverse side effects and is much safer than some other drugs used to treat pain.
As a non-professional, I didn't want to edit this page, but hopefully one or more of you are monitoring a RSS of the discussion page...
For context, I'm an individual with a 25+ year history of chronic anxiety &-> depression disorder(s) (mostly social) who has responded very dramatically to Gabapentin in the last six months, so of course I'm enthusiastic about the drug. A few comments about possible edits to the article.
I'm afraid I have to run at the moment, but I hope I've been not-non-helpfull... my intent is to keep an eye out for replies. Thank you for reading this comment.
ml 12:10, 29 April 2006 (UTC)~
Quick PubMed search found one mention of gabapentin use for hot flushes in a male patient undergoing antiandrogen treatment for prostate cancer: PMID 11895055
and several trials of gabapentin for hot flushes in postmenopausal women/women undergoing treatment for breast cancer. These seemed the most interesting:
Guttuso T Jr, Kurlan R, McDermott MP, Kieburtz K (2003).
"Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial". Obstet Gynecol. 101 (2): 337–45.
PMID
12576259.{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
Pandya KJ, Morrow GR, Roscoe JA; et al. (2005). "Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial". Lancet. 366 (9488): 818–24.
PMID
16139656. {{
cite journal}}
: Explicit use of et al. in: |author=
(
help)CS1 maint: multiple names: authors list (
link)
I'll leave a relevance assessment/rewording in the article to other editors. Fvasconcellos 19:26, 20 November 2006 (UTC)
If i had siezures when i was a baby, will this medication make me have siezures again? The only time i have them now is when i have a fever & go to sleep. If anyone can answer my question, please post it as a comment so i know what will happen if i start taking this medication!!! —The preceding unsigned comment was added by 12.72.235.233 ( talk) 20:34, 13 May 2007 (UTC).
My doc prescribed this for my fibromyalgia, and I read somewhere that there are studies being done to prove it's effectiveness for that use. It is currently being prescribed off-label for fibro... could this be added anywhere? Arinna 20:31, 25 June 2007 (UTC)
According to the clinical study by Lesley Arnold and others (et al) entitled "Gabapeentin in the treatment of Fibromyalgia" (I.D.I.S. # 574153) there was a 30% reduction in the BPI Brief Pain Inventory scale, ans was an iprovement over placebo in the Medical Outcomes Study but also was inconclusive in the mean tender point pain threshold and the Montgomery Asberg Depression rating. Also there was some evidence that gabapentin would influence sleep, which would traditionally be to the advantage of those with fibromyalgia who report problems sleeping. —Preceding
unsigned comment added by
216.30.201.151 (
talk)
00:45, 26 October 2007 (UTC)
"Outrageously expensive"? Isn't that a rather opinionated turn of phrase for a wikipedia article?
eveningscribe 14:32, 29 June 2007 (UTC)
It's an interesting phrase to be sure. Here a box of 100 600mg pills costs $215, or $30 with an authoritative prescription (that's 22 days worth). In contrast a box of 20 20mg oxycontin costs $70 ($5.95 with authority) (10 days worth). Given the difference in abuse potential and general 'strength' I think the double the price rate is a bit steep.
WierdJohn (
talk)
07:02, 9 December 2007 (UTC)
I have a question I someone can answer:) I have been put on a NO sodium diet and need to know whether Gabapentin contains salt of any kind? any ideas on where I might find an answer? —The preceding unsigned comment was added by 201.170.80.144 ( talk • contribs) 17:47, 12 August 2007 (UTC)
what does the article mean by this? according to the Drug Abuse article, the term is pretty broadly defined, and it's unclear what definition the article uses. is it referring to the potential for addiction? someone clarify. 71.60.151.41 14:47, 29 September 2007 (UTC)
I believe the abuse/misuse potential is grossly under-stated. I work in a pharmacy in Boston and probably half of the patients on this drug clearly have no neropathic pain, are not diabetic, and are just looking for a way to get high. The only mood disorders they have is when they get mad at me when we won't fill it for them because "someone stole their meds." I'm amazed this drug isn't a schedule V because that would make it just that much harder to get, since the laws get much stricter when you're dealing with a controlled, verses almost uncontrolled drugs. Gleb Budilovsky ( talk) 21:48, 20 January 2009 (UTC)
I take gabapentin, and honestly it does have a great, long-lasting buzz . . . the first couple times you take it. Then, nothing. Your tolerance builds so fast even a massive dose won't re-capture the effects, unless you abstain for a week or more. The high does seem to happen to everyone, but even for those for whom it does, attempts at long-term abuse will be frustrated. 98.246.184.50 ( talk) 17:14, 11 June 2009 (UTC)
I can certainly confirm this. When I start taking gabapentin again, I'm more stoned than on any drug I personally have ever taken. I have to stay at home or even in bed because I become a very wise swami with all the answers of the universe, and then, unfortunately for the world, I fall asleep. But only the first pill! — Preceding unsigned comment added by 24.130.0.5 ( talk) 21:00, 5 September 2014 (UTC)
I have taken gabapentin 300 mg 1 every 2 hours or thereabouts, for about 5 years now for severe diabetic neuropathy in my feet. I feel I am qualified to say that it has no psychoactive effects at all except for on exception which I will detail in a moment. All the effects are physical. It somehow dampens down the nerve messages in my feet, and I'm thankful because my feet feel like they're in freezing electrified water without the pills. I also notice when I'm outside that i see sparkles because my rods and cones in my eyes are over-reacting or something, and my eyes are sensitive to light. Also they cause my breath to suddenly indraw involuntarily, like a sigh, but only every so often. All the effects are physical except every now and then, about 4 times in the last 5 years I have felt euphoric. Not really something to base abuse of the drug on. The article states it causes people to be social and overly talkative, I imagine this is an effect brought on by the person and not the drug. — Preceding unsigned comment added by 207.6.77.130 ( talk) 03:34, 26 September 2011 (UTC)
Some other articles link here mentioning this as a muscle relaxant, yet there's no info on the article about that...? -- 212.159.16.241 ( talk) 00:03, 9 December 2007 (UTC)
The article doesn't mention what category gabapentin is for breastfeeding. Anybody know? I had a prescription but went off while I was pregnant and want to know if I can take this now. 71.197.31.63 ( talk) 05:01, 9 December 2007 (UTC)MMurray
I have been put on 300mg x times a day, this is my saecond day. I have Trigeminal Neuralgia and the pain is still there. How long do you have to give the drug to take effect before you concider increacing the dosage.does anyone has any experience with this ?-- Tn pain ( talk) 04:37, 12 March 2008 (UTC)
It looks like the last line of the Clinical Uses section should be deleted because the information is already in the 10th paragraph. Or perhaps they should be merged.
Ex2golem ( talk) 18:05, 27 August 2008 (UTC)
I do not wish to edit this page but I have a question.
I have been taking Lyrica for Fibromyalgia, the side affects of falling asleep while talking to someone or while eating or driving (with no warning) has made it impossible for me to take it during the day. Taking this medicine for over a month has not changed this. I have tried this with 75 mg dosage as well as 50 mg dosages. I take 50 mg at night and none during the day and am able to stay awake but the pain is dibilitating and really has affected my life. Also the weight gain is terrible and I don't need this either. I believe it adds to the stress on my muscles. I have two choices, I can take the Lyrica during the day and stay home and sleep or I can not take it and hurt so badly I can barely function. I don't like either choice.
My insurance company has suggested Gabapentin as a replacement. I read one of the comments on this discussion page and am led to believe the sleepiness disappears after taking Gabapentin for a couple of weeks, is this the norm? Also what about weight gain? I saw nothing about this on the discussion page. I have talked to my pharmacist and got wishy-washy answers. I hope you can help me to make an informed decision about whether to ask my doctor to change my medication. 64.24.48.2 ( talk) 23:24, 28 September 2008 (UTC)
If you read through this article, it only makes references to the legal status of gabapentin in the United States' Controlled Substances Act. We need more data about the legal status of the drug worldwide.-- Metalhead94 ( talk) 19:58, 25 October 2008 (UTC)
That line toward the bottom about use of Gabapentin rather than "other benzos" implies that it's a benzodiazapine! It is not. Plus, slang like "benzos" should not be used in the interests of accuracy. I'm not doing any editing today but I do suggest somebody remove the word "other." 63.22.170.236 ( talk) 15:03, 19 February 2009 (UTC)Ellie
Does it actually work for epilepsy? Or is it not used to treat that any more? 129.31.243.59 ( talk) 18:13, 14 April 2009 (UTC)
I can't say for sure since I am not sure (yet) as to whether I have been professionally diagnosed as having epilepsy, rather than a seizure disorder (accompanied by about a half a dozen other disorders (PTSD?, TBI, bipolar, and others I can't recall due to recent grand mals; all prior to gabapentin use...). But to quote www.epilepsy.com/medications: "Brain cells need to work (fire) at a certain rate to function normally. During a seizure, brain cells are forced to work much more rapidly than normal. Gabapentin helps prevent brain cells from working as fast as a seizure requires them to. In this way, seizures can be stopped when they are just beginning." Hope this helps some. —Preceding unsigned comment added by 71.97.147.217 ( talk) 03:56, 12 May 2009 (UTC)
Uncommonly used, its anti-seizure effect is kinda weak. 202.146.15.12 ( talk) 07:30, 30 May 2009 (UTC)
Does Gababentin cause weight gain? —Preceding unsigned comment added by 141.110.70.59 ( talk) 22:16, 28 July 2009 (UTC)
im wondering what would happen if you were to take to many gabapentin in a short period of time. not meaning to just not 8 hours in between taking them —Preceding unsigned comment added by 123.3.164.32 ( talk) 01:56, 31 July 2009 (UTC)
http://www.ncbi.nlm.nih.gov/pubmed/12645962 This study examined the effects of gabapentin consumption ranging from 50mg to 35,000mg (35g). Although sedation, dizziness, vomiting and other effects occurred, none of them were severe enough to warrant medical attention.
"CONCLUSION: In this cases series, gabapentin exposures caused no or minimal toxicity."
There are also many anecdotal reports of doses up to 52 grams with no life-threatening medical problems. Gabapentin is a drug of diminishing returns. the more you take, the less is actually usable by your body. — Preceding unsigned comment added by Thor214 ( talk • contribs) 05:17, 15 January 2011 (UTC)
[2] [3] - Shootbamboo ( talk) 01:45, 15 November 2009 (UTC)
This article states that restlessness associated with anti-psychotic medications is rare. This is simply not the case, particularly with the older, 'typical' anti-psychotic drugs such as Haloperidol. See this article: http://www.ncbi.nlm.nih.gov/pubmed/10647977?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedreviews&logdbfrom=pubmed This should be changed. —Preceding unsigned comment added by 92.15.30.72 ( talk) 14:35, 13 December 2009 (UTC)
From the article it appears that you dismiss Gabapentins use in anxiety-related illnesses, yet in the referenced document ^ Chouinard, G (May 2006). "The search for new off-label indications for antidepressant, antianxiety, antipsychotic and anticonvulsant drugs". J Psychiatry Neurosci 31 (3): 168–176. ISSN 1180-4882. PMID 16699602. statements are made about its possible effectiveness with severe cases of Panic Disorder, would it not be appropriate to include this within the article as at the moment is appears misleading. —Preceding unsigned comment added by 87.115.163.68 ( talk) 16:09, 29 July 2010 (UTC)
This article contains a number of claims that have not been supported by the data. Gabapentin is NOT approved for neuropathy, but rather only post-herpetic neuralgia. Plus, a number of off-label uses are suggested where more recent data show no benefit or no superiority to extant interventions. Pfizer has been found guilty not only of promoting off-label use illegaly, but also, beyond just scientific misconduct, actual fraud in suppressing negative data that contradicted the indications for which they were pumping up sales. It is important that both clinicians and patients have a clear idea of the data, the risks and the benefits.
Suggested changes below have so far been rejected, however the article as it currently reads may result in misuse of the drug. JaguDorje ( talk) 23:34, 9 August 2011 (UTC)
Gabapentin is approved adjunctive therapy in the treatment of partial seizures with and without secondary generalization in patients over 12 years of age with epilepsy and post-herpetic neuralgia. It has been used off-label by physicians for a variety of conditions. [1]
Gabapentin was originally approved by the U.S. Food and Drug Administration (FDA) in 1994 for use as an adjunctive medication to control partial seizures (effective when added to other antiseizure drugs). In 2002, an indication was added for treating postherpetic neuralgia (neuropathic pain following shingles). [2] As part of a case (CIVIL ACTION NO. 04-cv-10739-PBS) brought by Kaiser Foundation Health Plan against Pfizer, it was noted that "The general neuropathic pain indication cannot be granted for Neurontin based on the clinical trials in painful diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN)." [3] In addition, the FDA black box warning states that "Antiepileptic drugs (AEDs), including Neurontin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication."
Gabapentin (administered orally) is one of two medications (the other being flumazenil, that is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction, however data for treatment of methamphetamine showed no benefit [4] and the drug itself poses a risk for being addictive. Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days. Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol, however Pfizer has been convicted for promotion of off-label use, which is illegal. There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing cravings or desire to use methamphetamine, although this is from a commercial website. [5] It also attenuates the severity of withdrawal symptoms experienced by those physically dependent on opioid analgesics, such as heroin, morphine, and oxycodone. [6] One study also demonstrates a significant reduction in the severity of benzodiazepine withdrawal syndrome. [7]
Gabapentin has been used to treat a variety of conditions for which it was not approved. Such "off-label" use is a purview of physicians. It is, however, illegal for the manufacturer to suggest, recommend or promote such off-label use; Pfizer has been convicted of such efforts (see below). While there may be some indications for which the drug is useful, it is difficult to be certain as the manufacturer had not only promoted off-label use, but further was found having violated the RICO act by fraudulently suppressing publication or awareness of studies that showed no benefit or greater risk of harm.
Gabapentin is frequently used to treat various types of neuralgia and it is approved for this indication. While one study showed small benefit for prevention of frequent migraine headaches, [8] these data are in dispute; its effects on neuropathic pain [9] are not supported by this trial as they used a forced titration to increase the dose beyond its FDA-approved indication, resulting in unblinding of the study and an increase in side effects. In the Saris opinion, it was found that controlling for the two most common side effects wiped out any statistically significant effect, rendering the drug clinically useless. Given the serious uncertainty that arises from the misleading efforts, a study showing benefit for nystagmus should be viewed with skepticism. [10] While it is often prescribed off-label (that is, at the discretion of a physician) for various conditions, this use is probably frequently due to the widespread illicit marketing Pfizer was convicted of, which was communicated via promotional messages through advisory boards, consultants’ meetings, and accredited continuing medical education events posing as independent third-party organizations, co-opting opinion leaders, educational enterprises and academia in their marketing campaign [11].
Gabapentin is widely, but possibly falsely, believed to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly) and nerve pain associated with spinal cord injury. It is doubtful whether it is effective in reducing pain and spasticity in multiple sclerosis, [12] and, additionaly whether it has a superior risk/benefit profile in treating Complex Regional Pain Syndrome, as these are all in dispute. [13] [14]
Gabapentin is approved in the treatment of postherpetic neuralgia and pain. Because dermatological patients suffer pain from painful tumors, after surgery, in conjunction with neuropathic ulcers, during dressing changes involving serious medical conditions, its applications seem manifold, however, again, none of these have been tested in randomized, controlled trials that have been undertaken independent of the company's financial influence and thus, if used for these indications, must be done with great caution and care. [15] FDA, despite frequent attempts by Pfizer, has never approved use of doses in excess of 1800 mg/day (see Saris decision).
While the studies that show benefit for some symptoms of opiate withdrawal, [16], these should be scrutinized in light of the fraud that litigation has revealed was committed. Further, tests for smoking cessation treatment have had mixed results. [17] [18]
Additionally, gabapentin has been prescribed to menopausal patients being treated with anti-androgenic compounds to reduce the incidence and intensity of the accompanying hot flashes [19], though two other studies showed no greater efficacy than low-dose transdermal estrogen [20] or a variety of other agents, as evaluated in a meta-analysis, including clonidine, paroxetine, venlafaxine, gabapentin and black cohosh, that each may be beneficial in the treatment of menopausal vasomotor symptoms. [21] Again, claims that Gabapentin may help deepen sleep, positively affecting deep, slow wave sleep, and reducing arousals during the night may be true, however such studies should be viewed with skepticism. [22]
Gabapentin has been prescribed in the mental health context. Numerous trials show that it is not effective as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. Indeed, for such conditions, there was a higher rate of suicidal ideation, despite Pfizer's efforts to promote the use of gabapentin in the treatment of bipolar disorder. Gabapentin has probably little or no usefulness in the treatment of anxiety disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia. [23] [24] Gabapentin can also cause weight gain. [25]
A double blind, randomized controlled trial found gabapentin ineffective for the treatment of idiopathic subjective tinnitus. [26] JaguDorje ( talk) 23:34, 9 August 2011 (UTC)
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I am an emergency medicine professor who has been an MD for ten or so years. There are more off label uses of medications than I could ever count, but that does not make them "wrong". Our FDA is beyond messed up, mostly bc of big pharma companies, so getting an approved use doesn't mean it's any safer. Check avandia and phenergan. Horrible patient issues for approved uses and not withdrawn off market for thousands of bad outcomes. With experience and years of patient treatments, I can say professionally that gabapentin is one of the more effective drugs for neuropathic pain. Better than opiods often. And yes I use it off label, just like hundreds of other drugs. Most drugs these days aren't even marketed for the purpose for which they were developed. Linezolid was supposed to be an antidepressant not an antibiotic. Is Eli Lilly hiding stuff? Absolutely. They're awful. Just check out their paxil problems. But I will not deny the patient a chance at pain relief because the drug company didn't tell us everything or wasn't smart enough to figure out the best uses of a particular drug. I have little faith in drug company research and much more in years of patient observation.
Please try to limit the bias in the article. The off label uses and legal issues dominate what should be an article with clear benefits vs side effects and concerns. If I were a lay patient, I'd have no idea what I was reading.
Lastly, I have had the pleasure of being a pain patient this past year after a spinal accident. I can personally say that the type of pain from a spinal radiculopathy cannot be adequately described. I've worked through kidney stones, broken bones, migraines and 104+ fevers, and nothing has put me down like this nerve pain. It is excruciating, and it has solidified my belief in off label use for patients who get no relief from FDA approved drugs, which are just as dangerous in this day and age. Neurontin has saved many patients from unrelenting pain. I simply hope this article can be revised not to terrify patients looking for relief. An unbiased honest dual-sided explanation of risks and benefits would be more suited to Wikipedia. Thank you for your time. Drtyson ( talk) 23:51, 26 February 2012 (UTC)
This page has so much BS about not trusting the manufacturer, criticizing off-label Rx of this drug neurontin - as far as I can tell, ALL of the off-label uses are justified. This drug has mild effects on ALL nerves because it acts on Ca channels which are present on all neurons at the presynaptic terminal; this explains analgesia, anxiolytic, and basically all other effects. Whoever wrote this page needs to lay off the warnings about an essentially innocuous drug with many legitimate off-label applications. And the poor pharmacist who doesn't like filling bottles for people with Rxs should find another job. Nixietech ( talk) 23:18, 7 April 2012 (UTC)
I am a 65-year of age female, normally very healthy, but now tending to back problems I received from an auto accident. I have been going through severe pain with a disk protrusion, penetrating pain down my leg. Overall, I've been mostly bedfast. Lots of meds were given to me by doctor, ER, and pain clinic, along with one [thus far] lumbar epidural. None hardly made a difference. I was given a new script yesterday for gabapentin 600 mg. I took 1/2 pill about 4 p.m. Since I was lieing down, I could not tell if it helped the nerve pain or not. I seemed ok, nothing unusual. I awoke close to 4 a.m. and noticed I was in quite a bit of pain, unusual for lieing flat on my back that usually soothes me. I took anothe 1/2 pill approximately 5 a.m. I went back to sleep for a few hours, awoke hallucinating like crazy, talking out of my head, slurring so much I could only get words out of my mouth slowly and not in sentences, not in my normal tone of voice, feeling numbness on my lips one side of my face, wobbly, seeing things and people that were not there, etc. This med is 'pure dope' the way I see it, dangerous, and should have never been approved by the FDA. Please be careful with it. It is still in my system at this writing. If my personality does not fully return within the next hour, I am going to ER, especially for fear of a stroke. |
Betty — Preceding unsigned comment added by 206.29.182.191 ( talk) 20:18, 18 March 2012 (UTC)
Has this drug never been prescribed for relief of sinus pressure or sinus issues — Preceding unsigned comment added by 199.188.86.198 ( talk) 02:28, 30 March 2013 (UTC)
hi i just s it a good med for painstared takin gabapentin,is it a good pain medication — Preceding unsigned comment added by 71.54.34.134 ( talk) 04:19, 11 February 2014 (UTC)
Should a person taking gabapentin be allowed to work? Im taking 200 mg a day and it works for my condition wondrfully. I feel much better. But im drowsier and not as quick with my thoughts at all. Lower concentration and i wont drive anywhere that isnt close to home at all. B — Preceding unsigned comment added by 173.218.97.168 ( talk) 21:36, 21 March 2014 (UTC)
The Pharmacology section states: "The mechanism of action is simply unknown.". However the following section is titled: "Mechanism of action". This seems contradictory. — Preceding unsigned comment added by Alan8 ( talk • contribs) 03:52, 14 April 2014 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 |
Would whoever made the nice ball-and-stick structure please redo it with either the zwitterionic or H-bonded structure? They are much more stable. Thank you. Laburke ( talk) 22:05, 13 May 2011 (UTC)
The handsome 3 dimensional molecular model shows co-valent bonding of nitrogen to THREE hydrogen atoms whereas the stick model shows -NH2. David P West ( talk) 00:09, 13 February 2012 (UTC)
Oh! I see. I just became less ignorant concerning zwitterions & inner salts. Thanx. David P West ( talk) 00:18, 13 February 2012 (UTC)
—{{}}I have been prescribed gabapentin for my rehmatoid arthritis pain. This is the first time I have been without pain for over five (5) years. The drug has little or no adverse side effects and is much safer than some other drugs used to treat pain.
As a non-professional, I didn't want to edit this page, but hopefully one or more of you are monitoring a RSS of the discussion page...
For context, I'm an individual with a 25+ year history of chronic anxiety &-> depression disorder(s) (mostly social) who has responded very dramatically to Gabapentin in the last six months, so of course I'm enthusiastic about the drug. A few comments about possible edits to the article.
I'm afraid I have to run at the moment, but I hope I've been not-non-helpfull... my intent is to keep an eye out for replies. Thank you for reading this comment.
ml 12:10, 29 April 2006 (UTC)~
Quick PubMed search found one mention of gabapentin use for hot flushes in a male patient undergoing antiandrogen treatment for prostate cancer: PMID 11895055
and several trials of gabapentin for hot flushes in postmenopausal women/women undergoing treatment for breast cancer. These seemed the most interesting:
Guttuso T Jr, Kurlan R, McDermott MP, Kieburtz K (2003).
"Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial". Obstet Gynecol. 101 (2): 337–45.
PMID
12576259.{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)
Pandya KJ, Morrow GR, Roscoe JA; et al. (2005). "Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial". Lancet. 366 (9488): 818–24.
PMID
16139656. {{
cite journal}}
: Explicit use of et al. in: |author=
(
help)CS1 maint: multiple names: authors list (
link)
I'll leave a relevance assessment/rewording in the article to other editors. Fvasconcellos 19:26, 20 November 2006 (UTC)
If i had siezures when i was a baby, will this medication make me have siezures again? The only time i have them now is when i have a fever & go to sleep. If anyone can answer my question, please post it as a comment so i know what will happen if i start taking this medication!!! —The preceding unsigned comment was added by 12.72.235.233 ( talk) 20:34, 13 May 2007 (UTC).
My doc prescribed this for my fibromyalgia, and I read somewhere that there are studies being done to prove it's effectiveness for that use. It is currently being prescribed off-label for fibro... could this be added anywhere? Arinna 20:31, 25 June 2007 (UTC)
According to the clinical study by Lesley Arnold and others (et al) entitled "Gabapeentin in the treatment of Fibromyalgia" (I.D.I.S. # 574153) there was a 30% reduction in the BPI Brief Pain Inventory scale, ans was an iprovement over placebo in the Medical Outcomes Study but also was inconclusive in the mean tender point pain threshold and the Montgomery Asberg Depression rating. Also there was some evidence that gabapentin would influence sleep, which would traditionally be to the advantage of those with fibromyalgia who report problems sleeping. —Preceding
unsigned comment added by
216.30.201.151 (
talk)
00:45, 26 October 2007 (UTC)
"Outrageously expensive"? Isn't that a rather opinionated turn of phrase for a wikipedia article?
eveningscribe 14:32, 29 June 2007 (UTC)
It's an interesting phrase to be sure. Here a box of 100 600mg pills costs $215, or $30 with an authoritative prescription (that's 22 days worth). In contrast a box of 20 20mg oxycontin costs $70 ($5.95 with authority) (10 days worth). Given the difference in abuse potential and general 'strength' I think the double the price rate is a bit steep.
WierdJohn (
talk)
07:02, 9 December 2007 (UTC)
I have a question I someone can answer:) I have been put on a NO sodium diet and need to know whether Gabapentin contains salt of any kind? any ideas on where I might find an answer? —The preceding unsigned comment was added by 201.170.80.144 ( talk • contribs) 17:47, 12 August 2007 (UTC)
what does the article mean by this? according to the Drug Abuse article, the term is pretty broadly defined, and it's unclear what definition the article uses. is it referring to the potential for addiction? someone clarify. 71.60.151.41 14:47, 29 September 2007 (UTC)
I believe the abuse/misuse potential is grossly under-stated. I work in a pharmacy in Boston and probably half of the patients on this drug clearly have no neropathic pain, are not diabetic, and are just looking for a way to get high. The only mood disorders they have is when they get mad at me when we won't fill it for them because "someone stole their meds." I'm amazed this drug isn't a schedule V because that would make it just that much harder to get, since the laws get much stricter when you're dealing with a controlled, verses almost uncontrolled drugs. Gleb Budilovsky ( talk) 21:48, 20 January 2009 (UTC)
I take gabapentin, and honestly it does have a great, long-lasting buzz . . . the first couple times you take it. Then, nothing. Your tolerance builds so fast even a massive dose won't re-capture the effects, unless you abstain for a week or more. The high does seem to happen to everyone, but even for those for whom it does, attempts at long-term abuse will be frustrated. 98.246.184.50 ( talk) 17:14, 11 June 2009 (UTC)
I can certainly confirm this. When I start taking gabapentin again, I'm more stoned than on any drug I personally have ever taken. I have to stay at home or even in bed because I become a very wise swami with all the answers of the universe, and then, unfortunately for the world, I fall asleep. But only the first pill! — Preceding unsigned comment added by 24.130.0.5 ( talk) 21:00, 5 September 2014 (UTC)
I have taken gabapentin 300 mg 1 every 2 hours or thereabouts, for about 5 years now for severe diabetic neuropathy in my feet. I feel I am qualified to say that it has no psychoactive effects at all except for on exception which I will detail in a moment. All the effects are physical. It somehow dampens down the nerve messages in my feet, and I'm thankful because my feet feel like they're in freezing electrified water without the pills. I also notice when I'm outside that i see sparkles because my rods and cones in my eyes are over-reacting or something, and my eyes are sensitive to light. Also they cause my breath to suddenly indraw involuntarily, like a sigh, but only every so often. All the effects are physical except every now and then, about 4 times in the last 5 years I have felt euphoric. Not really something to base abuse of the drug on. The article states it causes people to be social and overly talkative, I imagine this is an effect brought on by the person and not the drug. — Preceding unsigned comment added by 207.6.77.130 ( talk) 03:34, 26 September 2011 (UTC)
Some other articles link here mentioning this as a muscle relaxant, yet there's no info on the article about that...? -- 212.159.16.241 ( talk) 00:03, 9 December 2007 (UTC)
The article doesn't mention what category gabapentin is for breastfeeding. Anybody know? I had a prescription but went off while I was pregnant and want to know if I can take this now. 71.197.31.63 ( talk) 05:01, 9 December 2007 (UTC)MMurray
I have been put on 300mg x times a day, this is my saecond day. I have Trigeminal Neuralgia and the pain is still there. How long do you have to give the drug to take effect before you concider increacing the dosage.does anyone has any experience with this ?-- Tn pain ( talk) 04:37, 12 March 2008 (UTC)
It looks like the last line of the Clinical Uses section should be deleted because the information is already in the 10th paragraph. Or perhaps they should be merged.
Ex2golem ( talk) 18:05, 27 August 2008 (UTC)
I do not wish to edit this page but I have a question.
I have been taking Lyrica for Fibromyalgia, the side affects of falling asleep while talking to someone or while eating or driving (with no warning) has made it impossible for me to take it during the day. Taking this medicine for over a month has not changed this. I have tried this with 75 mg dosage as well as 50 mg dosages. I take 50 mg at night and none during the day and am able to stay awake but the pain is dibilitating and really has affected my life. Also the weight gain is terrible and I don't need this either. I believe it adds to the stress on my muscles. I have two choices, I can take the Lyrica during the day and stay home and sleep or I can not take it and hurt so badly I can barely function. I don't like either choice.
My insurance company has suggested Gabapentin as a replacement. I read one of the comments on this discussion page and am led to believe the sleepiness disappears after taking Gabapentin for a couple of weeks, is this the norm? Also what about weight gain? I saw nothing about this on the discussion page. I have talked to my pharmacist and got wishy-washy answers. I hope you can help me to make an informed decision about whether to ask my doctor to change my medication. 64.24.48.2 ( talk) 23:24, 28 September 2008 (UTC)
If you read through this article, it only makes references to the legal status of gabapentin in the United States' Controlled Substances Act. We need more data about the legal status of the drug worldwide.-- Metalhead94 ( talk) 19:58, 25 October 2008 (UTC)
That line toward the bottom about use of Gabapentin rather than "other benzos" implies that it's a benzodiazapine! It is not. Plus, slang like "benzos" should not be used in the interests of accuracy. I'm not doing any editing today but I do suggest somebody remove the word "other." 63.22.170.236 ( talk) 15:03, 19 February 2009 (UTC)Ellie
Does it actually work for epilepsy? Or is it not used to treat that any more? 129.31.243.59 ( talk) 18:13, 14 April 2009 (UTC)
I can't say for sure since I am not sure (yet) as to whether I have been professionally diagnosed as having epilepsy, rather than a seizure disorder (accompanied by about a half a dozen other disorders (PTSD?, TBI, bipolar, and others I can't recall due to recent grand mals; all prior to gabapentin use...). But to quote www.epilepsy.com/medications: "Brain cells need to work (fire) at a certain rate to function normally. During a seizure, brain cells are forced to work much more rapidly than normal. Gabapentin helps prevent brain cells from working as fast as a seizure requires them to. In this way, seizures can be stopped when they are just beginning." Hope this helps some. —Preceding unsigned comment added by 71.97.147.217 ( talk) 03:56, 12 May 2009 (UTC)
Uncommonly used, its anti-seizure effect is kinda weak. 202.146.15.12 ( talk) 07:30, 30 May 2009 (UTC)
Does Gababentin cause weight gain? —Preceding unsigned comment added by 141.110.70.59 ( talk) 22:16, 28 July 2009 (UTC)
im wondering what would happen if you were to take to many gabapentin in a short period of time. not meaning to just not 8 hours in between taking them —Preceding unsigned comment added by 123.3.164.32 ( talk) 01:56, 31 July 2009 (UTC)
http://www.ncbi.nlm.nih.gov/pubmed/12645962 This study examined the effects of gabapentin consumption ranging from 50mg to 35,000mg (35g). Although sedation, dizziness, vomiting and other effects occurred, none of them were severe enough to warrant medical attention.
"CONCLUSION: In this cases series, gabapentin exposures caused no or minimal toxicity."
There are also many anecdotal reports of doses up to 52 grams with no life-threatening medical problems. Gabapentin is a drug of diminishing returns. the more you take, the less is actually usable by your body. — Preceding unsigned comment added by Thor214 ( talk • contribs) 05:17, 15 January 2011 (UTC)
[2] [3] - Shootbamboo ( talk) 01:45, 15 November 2009 (UTC)
This article states that restlessness associated with anti-psychotic medications is rare. This is simply not the case, particularly with the older, 'typical' anti-psychotic drugs such as Haloperidol. See this article: http://www.ncbi.nlm.nih.gov/pubmed/10647977?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedreviews&logdbfrom=pubmed This should be changed. —Preceding unsigned comment added by 92.15.30.72 ( talk) 14:35, 13 December 2009 (UTC)
From the article it appears that you dismiss Gabapentins use in anxiety-related illnesses, yet in the referenced document ^ Chouinard, G (May 2006). "The search for new off-label indications for antidepressant, antianxiety, antipsychotic and anticonvulsant drugs". J Psychiatry Neurosci 31 (3): 168–176. ISSN 1180-4882. PMID 16699602. statements are made about its possible effectiveness with severe cases of Panic Disorder, would it not be appropriate to include this within the article as at the moment is appears misleading. —Preceding unsigned comment added by 87.115.163.68 ( talk) 16:09, 29 July 2010 (UTC)
This article contains a number of claims that have not been supported by the data. Gabapentin is NOT approved for neuropathy, but rather only post-herpetic neuralgia. Plus, a number of off-label uses are suggested where more recent data show no benefit or no superiority to extant interventions. Pfizer has been found guilty not only of promoting off-label use illegaly, but also, beyond just scientific misconduct, actual fraud in suppressing negative data that contradicted the indications for which they were pumping up sales. It is important that both clinicians and patients have a clear idea of the data, the risks and the benefits.
Suggested changes below have so far been rejected, however the article as it currently reads may result in misuse of the drug. JaguDorje ( talk) 23:34, 9 August 2011 (UTC)
Gabapentin is approved adjunctive therapy in the treatment of partial seizures with and without secondary generalization in patients over 12 years of age with epilepsy and post-herpetic neuralgia. It has been used off-label by physicians for a variety of conditions. [1]
Gabapentin was originally approved by the U.S. Food and Drug Administration (FDA) in 1994 for use as an adjunctive medication to control partial seizures (effective when added to other antiseizure drugs). In 2002, an indication was added for treating postherpetic neuralgia (neuropathic pain following shingles). [2] As part of a case (CIVIL ACTION NO. 04-cv-10739-PBS) brought by Kaiser Foundation Health Plan against Pfizer, it was noted that "The general neuropathic pain indication cannot be granted for Neurontin based on the clinical trials in painful diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN)." [3] In addition, the FDA black box warning states that "Antiepileptic drugs (AEDs), including Neurontin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication."
Gabapentin (administered orally) is one of two medications (the other being flumazenil, that is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction, however data for treatment of methamphetamine showed no benefit [4] and the drug itself poses a risk for being addictive. Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days. Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol, however Pfizer has been convicted for promotion of off-label use, which is illegal. There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing cravings or desire to use methamphetamine, although this is from a commercial website. [5] It also attenuates the severity of withdrawal symptoms experienced by those physically dependent on opioid analgesics, such as heroin, morphine, and oxycodone. [6] One study also demonstrates a significant reduction in the severity of benzodiazepine withdrawal syndrome. [7]
Gabapentin has been used to treat a variety of conditions for which it was not approved. Such "off-label" use is a purview of physicians. It is, however, illegal for the manufacturer to suggest, recommend or promote such off-label use; Pfizer has been convicted of such efforts (see below). While there may be some indications for which the drug is useful, it is difficult to be certain as the manufacturer had not only promoted off-label use, but further was found having violated the RICO act by fraudulently suppressing publication or awareness of studies that showed no benefit or greater risk of harm.
Gabapentin is frequently used to treat various types of neuralgia and it is approved for this indication. While one study showed small benefit for prevention of frequent migraine headaches, [8] these data are in dispute; its effects on neuropathic pain [9] are not supported by this trial as they used a forced titration to increase the dose beyond its FDA-approved indication, resulting in unblinding of the study and an increase in side effects. In the Saris opinion, it was found that controlling for the two most common side effects wiped out any statistically significant effect, rendering the drug clinically useless. Given the serious uncertainty that arises from the misleading efforts, a study showing benefit for nystagmus should be viewed with skepticism. [10] While it is often prescribed off-label (that is, at the discretion of a physician) for various conditions, this use is probably frequently due to the widespread illicit marketing Pfizer was convicted of, which was communicated via promotional messages through advisory boards, consultants’ meetings, and accredited continuing medical education events posing as independent third-party organizations, co-opting opinion leaders, educational enterprises and academia in their marketing campaign [11].
Gabapentin is widely, but possibly falsely, believed to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly) and nerve pain associated with spinal cord injury. It is doubtful whether it is effective in reducing pain and spasticity in multiple sclerosis, [12] and, additionaly whether it has a superior risk/benefit profile in treating Complex Regional Pain Syndrome, as these are all in dispute. [13] [14]
Gabapentin is approved in the treatment of postherpetic neuralgia and pain. Because dermatological patients suffer pain from painful tumors, after surgery, in conjunction with neuropathic ulcers, during dressing changes involving serious medical conditions, its applications seem manifold, however, again, none of these have been tested in randomized, controlled trials that have been undertaken independent of the company's financial influence and thus, if used for these indications, must be done with great caution and care. [15] FDA, despite frequent attempts by Pfizer, has never approved use of doses in excess of 1800 mg/day (see Saris decision).
While the studies that show benefit for some symptoms of opiate withdrawal, [16], these should be scrutinized in light of the fraud that litigation has revealed was committed. Further, tests for smoking cessation treatment have had mixed results. [17] [18]
Additionally, gabapentin has been prescribed to menopausal patients being treated with anti-androgenic compounds to reduce the incidence and intensity of the accompanying hot flashes [19], though two other studies showed no greater efficacy than low-dose transdermal estrogen [20] or a variety of other agents, as evaluated in a meta-analysis, including clonidine, paroxetine, venlafaxine, gabapentin and black cohosh, that each may be beneficial in the treatment of menopausal vasomotor symptoms. [21] Again, claims that Gabapentin may help deepen sleep, positively affecting deep, slow wave sleep, and reducing arousals during the night may be true, however such studies should be viewed with skepticism. [22]
Gabapentin has been prescribed in the mental health context. Numerous trials show that it is not effective as a mood-stabilizing treatment for bipolar disorder and so has no therapeutic advantage in having fewer side-effects over better established bipolar drugs such as lithium and valproic acid. Indeed, for such conditions, there was a higher rate of suicidal ideation, despite Pfizer's efforts to promote the use of gabapentin in the treatment of bipolar disorder. Gabapentin has probably little or no usefulness in the treatment of anxiety disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia. [23] [24] Gabapentin can also cause weight gain. [25]
A double blind, randomized controlled trial found gabapentin ineffective for the treatment of idiopathic subjective tinnitus. [26] JaguDorje ( talk) 23:34, 9 August 2011 (UTC)
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I am an emergency medicine professor who has been an MD for ten or so years. There are more off label uses of medications than I could ever count, but that does not make them "wrong". Our FDA is beyond messed up, mostly bc of big pharma companies, so getting an approved use doesn't mean it's any safer. Check avandia and phenergan. Horrible patient issues for approved uses and not withdrawn off market for thousands of bad outcomes. With experience and years of patient treatments, I can say professionally that gabapentin is one of the more effective drugs for neuropathic pain. Better than opiods often. And yes I use it off label, just like hundreds of other drugs. Most drugs these days aren't even marketed for the purpose for which they were developed. Linezolid was supposed to be an antidepressant not an antibiotic. Is Eli Lilly hiding stuff? Absolutely. They're awful. Just check out their paxil problems. But I will not deny the patient a chance at pain relief because the drug company didn't tell us everything or wasn't smart enough to figure out the best uses of a particular drug. I have little faith in drug company research and much more in years of patient observation.
Please try to limit the bias in the article. The off label uses and legal issues dominate what should be an article with clear benefits vs side effects and concerns. If I were a lay patient, I'd have no idea what I was reading.
Lastly, I have had the pleasure of being a pain patient this past year after a spinal accident. I can personally say that the type of pain from a spinal radiculopathy cannot be adequately described. I've worked through kidney stones, broken bones, migraines and 104+ fevers, and nothing has put me down like this nerve pain. It is excruciating, and it has solidified my belief in off label use for patients who get no relief from FDA approved drugs, which are just as dangerous in this day and age. Neurontin has saved many patients from unrelenting pain. I simply hope this article can be revised not to terrify patients looking for relief. An unbiased honest dual-sided explanation of risks and benefits would be more suited to Wikipedia. Thank you for your time. Drtyson ( talk) 23:51, 26 February 2012 (UTC)
This page has so much BS about not trusting the manufacturer, criticizing off-label Rx of this drug neurontin - as far as I can tell, ALL of the off-label uses are justified. This drug has mild effects on ALL nerves because it acts on Ca channels which are present on all neurons at the presynaptic terminal; this explains analgesia, anxiolytic, and basically all other effects. Whoever wrote this page needs to lay off the warnings about an essentially innocuous drug with many legitimate off-label applications. And the poor pharmacist who doesn't like filling bottles for people with Rxs should find another job. Nixietech ( talk) 23:18, 7 April 2012 (UTC)
I am a 65-year of age female, normally very healthy, but now tending to back problems I received from an auto accident. I have been going through severe pain with a disk protrusion, penetrating pain down my leg. Overall, I've been mostly bedfast. Lots of meds were given to me by doctor, ER, and pain clinic, along with one [thus far] lumbar epidural. None hardly made a difference. I was given a new script yesterday for gabapentin 600 mg. I took 1/2 pill about 4 p.m. Since I was lieing down, I could not tell if it helped the nerve pain or not. I seemed ok, nothing unusual. I awoke close to 4 a.m. and noticed I was in quite a bit of pain, unusual for lieing flat on my back that usually soothes me. I took anothe 1/2 pill approximately 5 a.m. I went back to sleep for a few hours, awoke hallucinating like crazy, talking out of my head, slurring so much I could only get words out of my mouth slowly and not in sentences, not in my normal tone of voice, feeling numbness on my lips one side of my face, wobbly, seeing things and people that were not there, etc. This med is 'pure dope' the way I see it, dangerous, and should have never been approved by the FDA. Please be careful with it. It is still in my system at this writing. If my personality does not fully return within the next hour, I am going to ER, especially for fear of a stroke. |
Betty — Preceding unsigned comment added by 206.29.182.191 ( talk) 20:18, 18 March 2012 (UTC)
Has this drug never been prescribed for relief of sinus pressure or sinus issues — Preceding unsigned comment added by 199.188.86.198 ( talk) 02:28, 30 March 2013 (UTC)
hi i just s it a good med for painstared takin gabapentin,is it a good pain medication — Preceding unsigned comment added by 71.54.34.134 ( talk) 04:19, 11 February 2014 (UTC)
Should a person taking gabapentin be allowed to work? Im taking 200 mg a day and it works for my condition wondrfully. I feel much better. But im drowsier and not as quick with my thoughts at all. Lower concentration and i wont drive anywhere that isnt close to home at all. B — Preceding unsigned comment added by 173.218.97.168 ( talk) 21:36, 21 March 2014 (UTC)
The Pharmacology section states: "The mechanism of action is simply unknown.". However the following section is titled: "Mechanism of action". This seems contradictory. — Preceding unsigned comment added by Alan8 ( talk • contribs) 03:52, 14 April 2014 (UTC)