US Brand Name: Neurontin

generic name: gabapentin

Class: Antieplieptic drug (AED)/ Anticonvulsant (AC)

1.  Other brand names & branded generic names¹

• Gantin (Australia)
• Kaptin (Colombia)
• Нейронтин (Russia)

2.  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.

3.  Off-Label Uses of

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:

• Monotherapy Treatment for Epilepsy (used all by its lonesome)
• All sorts of neuropathic pain
• HIV/AIDS-related neuropathy
• Phantom Limb Pain
• Anxiety
• Alcoholism (one study has it working well on mild-to-moderate alcohol withdrawal, another showed it to be insignificant for acute withdrawal).
• hiccups

And where it’s a placebo with side effects, albeit a fairly low side effect profile for an AED:

• Bipolar Disorder
• Migraines.
• Depression
• PTSD
• Sleep Disorders.
• Restless Leg Syndrome/PLMS
• MS
• 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.

4.  Neurontin’s pros and cons

4.1  Pros

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.

4.2  Cons

It doesn’t work for a lot of people, mostly because of bioavailabilty issues. Because of Parke-Davis’ allegedly sleazy marketing practices you probably can’t get samples from your doctor anymore.

5.  Side Effects

5.1  Typical Side Effects

The usual for anticonvulsants, albeit to a lesser degree for most people. Although at the higher dosages Mouse and I, especially Mouse, experience memory problems. The main problems with Neurontin are dizziness, cloudy thinking, fatigue and klutziness.

5.2  Not So Common Side Effects

Edema. Really goofy thinking - one person taking it calls the med, “Morontin.” Although from the reports I’m reading the Morontin effect may be more common than I first thought. 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. I haven’t found any studies to back this up, but my doctor tells me that at the higher dosages Neurontin (gabapentin) does start to hit the dopamine receptors. The combination of GABA and dopamine may be just the thing for depression, but can get some people really goofy, and not necessarily in a good way.

5.3  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!

6.  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.

And if that wasn’t complicated enough for you, magniseum supplements can interfere with absorbing Neurontin.

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7.  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.

8.  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.

9.  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! The risk is worse if you’re taking a lithium variant, and/or any antidepressant, especially Wellbutrin (bupropion hydrochloride). 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!

10.  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.

11.  Days to Reach a Steady State

Two days after you’re taking it at least three times a day.

12.  Discussion board

Crazy Meds’ Neurontin discussion board

13.  Your Comments About and Experiences with Neurontin

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.

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Enter your own Comments & Experiences with Neurontin here.
You must be a registered member of the Crazy Meds Talk forum to post a comment on this page.

14.  Full US PI sheet, Global SPCs & PILs, check for drug-drug interactions

Neurontin Full US Prescribing Information / PI Sheet

Check for drug-drug interactions

15.  Bibliography

PDR: Physicians’ Desk Reference 2010

Instant Psychopharmacology 2nd Edition Ronald J. Diamond MD © 2002. Published by W.W. Norton

Primer of Drug Action 12th edition by Robert M. Julien Ph.D, Claire D. Advokat, Joseph Comaty © 2011 Published by Worth Publishers.

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.

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 Creator: JerodPoore Last edited by:

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