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Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain, but exactly how it does this is not fully understood. Gabapentin is also used to treat certain types of long-lasting pain caused by damage to nerves.
Gabapentin belongs to a group of medicines known as anti-epileptic medicines, although it is prescribed for the treatment of several different conditions. You may have been prescribed it for the treatment of partial seizures, which are a type of epilepsy. A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. With a partial seizure, the burst of electrical activity stays in one part of the brain. Therefore, you tend to have localised or ‘focal’ symptoms. Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain. Exactly how it does this is not fully understood.
Gabapentin is also prescribed to treat certain types of long-lasting pain caused by damage to nerves. This type of pain, called neuropathic pain, can be caused by a number of different diseases. These include diabetes (where it is called diabetic neuropathy) and shingles (where it is called postherpetic neuralgia).
Although gabapentin is only licensed for use in epilepsy and neuropathic pain, it is also prescribed to help to prevent attacks of migraine. If you have been given it for this reason then you should speak with your doctor if you have any questions about your treatment.
Before taking gabapentin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking gabapentin it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any problems with the way your kidneys work.
- If you have diabetes.
- If you have ever had a mental health problem known as psychosis.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
Gabapentin Mechanism of action
The mechanism of the anticonvulsant action of gabapentin has not been fully described. Several possible mechanisms for pain improvement have been discussed.
Though similar in structure to the endogenous neurotransmitter GABA, gabapentin has not been shown to bind to GABA receptors at concentrations at or below 1 mM. Gabapentin modulates the action of glutamate decarboxylase (GAD) and branched chain aminotransferase (BCAT), two enzymes involved in GABA biosynthesis. In human and rat studies, gabapentin was found to increase GABA biosynthesis, and to increase non-synaptic GABA neurotransmission in vitro.
Gabapentin has been shown to bind to the α2δ-1 subunit of voltage gated calcium ion channels, which contributes to its pain attenuation effects in diabetic neuropathy and post-herpetic neuralgia. Other neurophysiological findings indicate that gabapentin also interacts with NMDA receptors, protein kinase C, and inflammatory cytokines
What is gabapentin mostly used for?
Gabapentin is an antiepileptic or anticonvulsant treatment originally designed to prevent seizures, but which is now also used to manage certain types of pain and in a variety of other uses.
The medication is also used in veterinary medicine. Note that tablets, capsules or oral solutions designed for human consumption often contain sweeteners which may be poisonous to some species; be sure to buy Gabapentin in veterinary formulations for use in animals.
The medication comes in capsules, which may be opened and mixed into a beverage or soft foods that do not require chewing, though it is difficult to mask its bitter taste.
Gabapentin is most commonly prescribed to prevent certain types of seizures:
- Focal seizures
- Mixed Seizures
- Generalized Seizures
As a preventive treatment, Gabapentin may be used in children as young as 3, but is most often prescribed to people 12 years old and up.
The medication is typically taken 3 times per day, and treatment is usually long-term. Patients are usually started on smaller doses which are then increased if needed. The average dose for adults is 900 to 1800 mg per day.
Daily doses are usually divided into 3 smaller doses, taken morning, afternoon, and at bedtime. Doses should be taken at least 4 hours apart, but not more than 12 hours apart.
It may take several weeks for the medication to become noticeably effective. When working, seizures should occur with significantly less frequency or be eliminated entirely. It does not work on all seizures and is not effective for all patients; if effects are not significant after several weeks of use, speak with doctor about alternative options rather than continuing to buy Gabapentin.
Ending treatment abruptly may cause an increase in seizures; speak with a doctor about tapering off the medication.
Patients planning to buy Gabapentin for pain relief should understand that it only works on very specific types of pain; namely neuropathic pain, or pain caused by damage to the somatosensory system, including:
- Postherpetic neuralgia
- Central neuropathic pain
- Diabetic neuropathy
- Spinal injuries
When given for pain, treatment may last just a few days for flare-ups or weeks or months in cases of chronic pain. Dosage rarely exceeds 1800 mg a day; greater amounts may be taken, but rarely produce additional relief.
Some individuals notice effects within the first day or two of treatment, but it may take several weeks to provide consistent pain relief in chronic conditions.
While some patients find Gabapentin tremendously helpful, others find it has little effect, even when treating the same condition. Speak with a doctor about other options if it is not providing significant relief.
Gabapentin is used in a wide range of other conditions, though it is not always the most effective option for certain ailments:
- Menopausal symptoms
- Uremic pruritus in liver failure
- Restless leg syndrome
- Anxiety disorders
Many of this product’s off-label uses are somewhat controversial, as some claim there is no evidence the medication provides any benefit in some of the above conditions, while others claim it produces good results for some individuals.
In other cases the medication is recognized as being effective, but is not typically the preferred treatment; in these situations Gabapentin may be given when first-line treatments are ill-advised for some reason.
Patients are not advised to buy Gabapentin for off-label use without doctor collaboration, particularly if there are any preexisting major medical conditions.
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Use only the brand and form of gabapentin that your doctor has prescribed. Check your medicine each time you get a refill at the pharmacy, to make sure you have received the correct form of this medication. Do not stop taking Gabapentin unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week. If you stop taking gabapentin suddenly or before your doctor tells you, there is an increased risk of seizures.
What you should know before you buy gabapentin online ?
Patients should be aware of the therapeutic dosing for neuropathic pain to establish realistic expectations and improve compliance and likelihood of remaining on therapy.
The conversation may be as follows: “Gabapentin may reduce nerve pain at 600 mg 3 times a day but patients usually start on a low dose to make sure they tolerate it and is then increased slowly to give the body a chance to get used to it.
If dose increases along the titration cause intolerable side effects such as dizziness or drowsiness, this can often be overcome by reducing back to the previous dose and escalating more slowly over a longer period of time.” Patients should be encouraged to follow-up with their prescriber for continued titration.
How to take gabapentin
- Before starting this treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about gabapentin and will provide you with a full list of the side-effects which you may experience from taking it.
- Take gabapentin exactly as your doctor tells you to. There are several different strengths of gabapentin tablets and capsules available, and you could be prescribed more than one strength.
- You will be advised to take a low dose when you first start taking gabapentin, and then to increase the dose over a few days. This is to allow your body to get used to it. Most people take three doses a day once they are on a regular maintenance dose. Your doctor will explain all this to you, and the dosing directions will be printed on the label of the pack. If you are still unsure about how to take your doses, ask your pharmacist to advise you.
- You can take gabapentin before or after food. Swallow the tablets/capsules with a drink of water. If you have been supplied with oral liquid medicine, see the instructions below for using the oral dosing syringe.
- Once you are taking a regular amount of gabapentin, try to take your doses at the same times each day. This will help you avoid missing doses.
- If you do forget to take a dose, take one as soon as you remember. Try to take the correct number of doses each day, but do not take two doses at the same time.
- If you need to take an antacid or indigestion remedy, do not take it during the two hours before or the two hours after you take gabapentin. This is because antacids reduce the amount of gabapentin that your body absorbs.
Instructions for using the dosing syringe with Gabapentin Rosemont Oral Solution
- Remove the bottle cap, and push the syringe adaptor into the top of the open bottle.
- Insert the syringe into the adapter.
- Turn the bottle (with the syringe connected to it) upside down.
- Gently pull out the plunger of the syringe so that the solution fills the syringe to the mark which corresponds to your dose.
- Turn the bottle the correct way up again, and remove the syringe from the bottle.
- Put the tip of the syringe into your mouth, and gently push the plunger so that the liquid is released into your mouth.
- Replace the bottle cap. Wash the syringe with water after each use.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this. If you are a woman and want to have a family, make sure that you discuss this with your doctor before you become pregnant. This is so that you can be given advice about your treatment from a specialist.
- People with epilepsy must stop driving. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
- A small number of people have developed mood changes or thoughts about suicide whilst being treated with anti-epileptics. If this happens to you, you must tell your doctor about it straightaway.
- If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines.
- You must take gabapentin regularly every day. Stopping treatment suddenly can cause problems. If it becomes necessary for the treatment to stop, your doctor will want you to reduce your dose over a few days.
How to Store Gabapentin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Once a bottle of Gabapentin Rosemont Oral Solution has been opened it will keep for one month. Do not use it after this time, and make sure you have a fresh supply.
Gabapentin Side Effects
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- increased seizures;
- severe weakness or tiredness;
- upper stomach pain;
- chest pain, new or worsening cough with fever, trouble breathing;
- severe tingling or numbness;
- rapid back and forth movement of your eyes;
- kidney problems–little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or
- severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
How to treat the Side Effects caused by gabapentin?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with gabapentin. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common gabapentin side-effects
||What can I do if I experience this?|
|Feeling sleepy, tired, unsteady or dizzy; blurred vision and other eyesight problems||Do not drive or use tools or machines|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Feeling or being sick, indigestion, stomach ache||Stick to simple foods – avoid rich or spicy meals|
|Diarrhoea||Drink plenty of water to replace the lost fluids|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Infections, flu-like symptoms, increased appetite, flushing,
increased blood pressure, changes in weight, changes in emotions or mood, fits, movement difficulties, feeling shaky, difficulties sleeping, breathing difficulties, cough, gum changes, bruises, muscle or joint pains, impotence, and swollen feet or ankles
|If any of these become troublesome, speak with your doctor for advice|
Important: gabapentin has been associated with a number of unwanted effects which affect the blood, pancreas and liver. Although these occur less commonly than the side-effects listed above, you must let your doctor know straightaway if you notice any of the following as they could be serious:
- Persistent stomach pain with sickness (these could be symptoms of an inflamed pancreas).
- A skin rash, or any swelling of your mouth or face (these could be symptoms of an allergic reaction).
- Any yellowing of your skin or of the whites of your eyes (these could be symptoms of jaundice).
- Any unusual bruising or bleeding (these could be symptoms of a blood disorder).
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
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Gabapentin is an Addiction Treatment Medication
Gabapentin is used to treat cases of addiction in an off-label manner. Different companies, including Parke-Davis, Greenstone, and Teva, manufacture several varieties of the generic drug. Other drugs that have been used to treat the symptoms of addiction withdrawal, for specific substances, include:
- Other anticonvulsants, such as Tegretol and Depakote
- Methadone and buprenorphine
Available in capsules, tablets, and as an oral liquid, dosages range from 100 mg to 800 mg. The frequency with which a dose is repeated depends on the specific dose, which is usually based on the severity of withdrawal and the client’s weight. The drug’s half-life is around 5-7 hours.
Generally, it is used during medical detox and throughout subsequent treatment modalities to support relapse prevention while clients adjust to their new sober lifestyles.
Treating Substance Abuse
Despite its therapeutic role in neuropathic pain, gabapentin produces psychoactive effects and has an abuse liability. Gabapentin abuse typically involves taking higher doses in a single administration. The median single dose for gabapentin abuse is 3600 mg, which is 3 times the maximum recommended single dose of 1200 mg. Risk factors for gabapentin abuse include current or previous opioid abuse, previous cocaine use, and/or concurrent use of benzodiazepines or cannabis. Alcohol use disorder is not generally a predictor of gabapentin abuse.
According to Medscape, gabapentin can inflict users with suicidal thoughts and abrupt changes in behavior. For this reason, it should only be used under medical supervision. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.
While it has been used to treat addictions to other substances, gabapentin is most often used to treat alcoholism — an addiction some 16.6 million adults suffered from in 2013, per the National Institute on Alcohol Abuse and Alcoholism.
During withdrawal from alcohol abuse or dependency, clients may experience anxiety, tremors, agitation, and irritability. In order to understand how gabapentin works, there must be a basic understanding of how the brain works first. Nervous system activity is partially controlled by GABA neurotransmitters. Gabapentin works by reducing activity among GABA. As a result, signals for pain, agitation, and anxiety are reduced, too.
An American Journal of Psychiatry study showed impressive results during the 16-week treatment of 150 people who were dependent on alcohol, noting better results among those who were treated with both gabapentin and naltrexone than the latter alone. TheJournal of Clinical Psychiatry reported on another study in which individuals treated for alcoholism with gabapentin showed a significant reduction in how much they drank and a greater rate of abstinence than those in the placebo group.
Gabapentin has the same calming effect on individuals who are detoxing from marijuana and benzodiazepines. Despite claims from fans of the plant-based drug, marijuana is indeed addictive. In 2012, 305,560 people checked into rehab citing cannabis as their primary drug of abuse, per the Substance Abuse and Mental Health Services Administration. One Neuropsychopharmacology study that analyzed the use of gabapentin in the treatment of marijuana addiction and withdrawal noted individuals in the gabapentin treatment group used less marijuana, had fewer withdrawal symptoms, and experienced improvements in cognitive functioning, compared to the placebo group.
Gabapentin is used to treat Neuropathic pain
Painful neuropathy is a common and disabling problem in patients with longstanding diabetes mellitus. Tricyclic antidepressant drugs and other chronic analgesics have been beneficial in some patients, but no agent successfully relieves pain in most patients and adverse effects often preclude their use in high doses. Anecdotal reports suggest that gabapentin ameliorates pain associated with neuropathy and other neurological conditions with few side effects.
We conducted a randomised, double blind, placebo controlled trial to study the effect of low dose gabapentin in patients with painful diabetic neuropathy.
The results of this study suggest that gabapentin is probably ineffective or only minimally effective for the treatment of painful diabetic neuropathy at a dosage of 900 mg/day.
These calcium ions act as secondary messengers that initiate protein kinase C activation, proto‐oncogene expression (c‐fos, c‐jun) and nitric oxide production. NMDA receptor activation therefore increases the excitability of the nociceptive system.
The rationale for the use of anticonvulsant drugs for the treatment of neuropathic pain is based on the similarities in the pathophysiological events observed in epilepsy and neuropathic pain models.
Gabapentin is used to treat Postherpetic Neuralgia
Gabapentin is reported to be efficacious in the treatment of neuropathic pain associated with postherpetic neuralgia. In a multicentre, randomised, double‐blind, placebo‐controlled, parallel design, 8‐week study involving 229 subjects with postherpetic neuralgia, Rowbotham et al.
demonstrated the efficacy of gabapentin in the treatment of postherpetic neuralgia. Patients were received gabapentin to a maximum of 3600 mg.day−1 of gabapentin or matching placebo. The study showed a statistically significant (p < 0.001) decrease in pain scores (using an 11‐point Likert scale) from 6.3 to 4.2 for the gabapentin group, compared with 6.5–6.0 in the placebo group.
Secondary measures of pain, as well as sleep interference, were improved with gabapentin (p < 0.001). The NNT for gabapentin was 3.2, compared with a combined analysis of three randomised controlled trials on carbemazepine in postherpetic neuralgia in which the NNT was 2.5 .
Gabapentin is also used to treat Alcohol Withdrawal
I am still on gabapentin. Dose is 600mg three times a day – total 1800mg in a 24 hour period. I had not had a drink “craving” since August 11, 2014 when I quit. (I did this within one week of starting gabapentin). I did have a glass of wine at Christmas, one beer on my birthday, and one glass of wine at Easter. That’s it. I use to have 10 beers a day, and three glasses of wine or gin for bad panic attacks and generalized anxiety. So for me (not everyone) I can have that occasional drink with friends, at party or any social event – then come home and not touch the stuff and WITHOUT ANY CRAVINGS AT ALL – as I had during my 40-year binge. Still, this drug is amazing. AA never worked for me.
“I went on gabapentin for alcoholism that troubled me for 10 years when nothing including Alcoholics Anonymous barely worked. I read anecdotal information that it helped with alcoholism, went on 600mg twice daily and it was the first thing that helped me. Now I take 1200mg twice daily and find it works great! Afterwards I read a study in the Journal of American Medicine, Gabapentin in Alcohol Dependance, 2014 that confirmed it works well in many people for cravings and binge drinking. This medicine should be further studied to confirm it works well. On this site it is obvious it helps a lot of people struggling with alcoholism which I have, along with Bipolar Disorder. I call Gabapentin my” happy pills” that also takes away my anxiety
I’ve detoxed several times. The last one was really bad. This time My Dr. put me gabapentin 300 mg. 3 times a day and Lithium. I usually suffer withdrawals for 5-7 days. I did have anxiety for two days, but I’m on day 3, no anxiety and no cravings
Important information about all medicines
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty, so the doctor knows what has been taken.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you. If you have any questions about this medicine ask your pharmacist.
Gabapentin for Migraine prevention
There are a number of second-line migraine treatments. The anti-seizure medication gabapentin has been demonstrated to be mildly useful in migraine and tension headache prophylaxis. In a large study on migraine, doses averaged approximately 2,400 mg per day, but lower doses are usually prescribed. Some patients do well with very low doses (200 or 300 mg per day). Sedation and dizziness may be a problem; however, gabapentin does not appear to cause end-organ damage, and weight gain is relatively minimal. Gabapentin can be used as an adjunct to other first-line preventive medications. Pregabalin (Lyrica) has a similar mechanism of action to gabapentin. Lyrica is fairly safe, but sedation and weight gain often occur.
A safe, non-addicting muscle relaxant, tizanidine is useful for migraine and chronic daily headache. Tizanidine may be used on an as-needed basis for milder headaches, or for neck or back pain. Cyclobenzaprine (10 mg) is helpful for sleeping, and helps some with migraine and chronic daily headache.