side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
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. Your Ratings & Reviews of, Comments About, and Experiences with Neurontin (gabapentin), and More
- 15.1 Rate Neurontin (gabapentin)
- 15.2 Neurontin Reviews
- 15.3 Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions
- 15.4 Prescribing Information and Patient Information from Around the World
- 15.5 Review Sites
- 15.6 Other Sites of Interest
- 15.7 Discussion board
- 16. Bibliography
|US brand name: Neurontin|
|Generic name: gabapentin|
- Big ass, rock hard, 600 & 800mg tablets.
- Extended-Release - under the brand name of Horizant
2. Other brand names & branded generic names1
- Eplentin: South Africa
- Gantin: Australia
- Kaptin: Colombia
- Nupentin: Australia
- Нейронтин: Russia
- 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
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:
- All sorts of neuropathic pain
- HIV/AIDS-related neuropathy
- Phantom Limb Pain
- 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, Horizant/Neurontin might be worth a try for RLS if nothing else works.
And where it’s a placebo with side effects, albeit a fairly low side effect profile for an AED:
- Bipolar Disorder
- Sleep Disorders
- 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.
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.
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.
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.
Taste perversion, abnormal accommodation, libido increased, baby you are coming over to my house right now! I’ve got plenty of Neurontin on hand!
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.
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.
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.
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!
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
Half-life: 5–7 hours. It’s out of your system in 2 days.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream2, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what3, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.
Steady state is usually reached two days after you’re taking Neurontin at least three times a day.
Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.
- Capsules: 3 years.
- Tablets: 2 years.
|Keep Crazy Meds on the air. Donate some spare electronic currency you have floating around The Cloud|
15. Your Ratings & Reviews of, Comments About, and Experiences with Neurontin (gabapentin), and More
An overall zero-to-five rating is absolutely useless information regarding medications. It is little more than a purely emotional and subjective value judgment on a med that has no bearing on how effective a drug is or, more importantly, if Neurontin (gabapentin) is the right drug for you. So why do I have it? Mainly because it’s cathartic for anyone who is taking or has taken Neurontin (gabapentin)4. Love it? Hate it? Here’s your chance to let everyone know. You don’t need to be a forum member or anything like that. You get all of one vote which can’t be changed, so make sure it’s what you want.
Get all judgmental about Neurontin (gabapentin)
Rating 3.1 out of 5 from 88 criticisms
Vote Distribution: 15 – 9 – 7 – 7 – 23 – 27
For various technical and page design reasons I had to move the actual reviews to their own page. While anyone can read the reviews, only registered members of the Crazy Meds Talk forum can write them.
15.3 Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions
- Australian Neurontin Product Information
- Canadian Neurontin Product Monograph
- South African Epleptin Patient Information
- UK Neurontin SPC
- 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
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
If you have any questions about Neurontin (gabapentin), the best place to ask them is on the Crazy Meds’ Neurontin (gabapentin) discussion board.
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) 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.
2 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
3 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
4 At some point I may have multiple one-to-ten ratings for individual aspects of medications, such as efficacy and side effects. That could be potentially useful.
|Date created Monday, 25 April, 2011 at 13:18:11||Page Author: JerodPoore||Last modified on Friday, 06 December, 2013 at 01:08:55 by some med critic.|
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.
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2013. All rights reserved.
Support Crazy Meds by
joining my doubleplusgood circle jerk adding me to your Google+ circle.
Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, and 2013 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on the Crazy Meds Forum.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality.
‘Everything is true, nothing is permitted.’ - Jerod Poore
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.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[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 a forerunner of 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]