Is Gabapentin ( Neurontin ) Addictive and How to Treat Gabapentin Addiction ?

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.

Gabapentin, also known by the brand name Neurontin, is a prescription painkiller belonging to its own drug class, Gabapentinoids. It is considered an anti-convulsant, and is most commonly used to treat epilepsy, restless leg syndrome, hot flashes, and neuropathic pain. It is often used as a less-addictive alternative to opioids; however, Gabapentin addiction and abuse still occur in many patients.

Gabapentin has a similar chemical structure to Gamma-aminobutyric acid (GABA), the brain chemical which affects the body’s nervous system. It can produce feelings of relaxation and calmness, which can help with nerve pain, anxiety, and even poor sleep.

Gabapentin is prescribed to treat nerve pain, alcohol and cocaine withdrawals, restless leg syndrome, diabetic neuropathy, fibromyalgia, and seizures. It works by altering one’s calcium channels to reduce seizures and ease nerve pain. Some brand names of Gabapentin are Neurontin and Gralise. The drug’s known street names are “gabbies” or “johnnies.”

Dosages of Gabapentin

Adult and pediatric dosages:

Capsule

      • 100 mg
      • 300 mg
      • 400 mg

Tablet

      • 300 mg (Gralise)
      • 600 mg (Gralise, Neurontin)
      • 800 mg (Neurontin)

Dosage Considerations – Should be Given as Follows:

Reducing the dose, discontinuing the drug, or substituting an alternative medication should be done gradually over a minimum of 1 week or longer.

Geritric dosing considerations:

Renal impairment is present, gabapentin dose reduction may be required, depending on renal function.

Partial Seizures

Neurontin

Adjunctive therapy for partial seizures with or without secondary generalization.

Initial: 300 mg orally every 8 hours.

May increase up to 600 mg orally every 8 hours; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated

Post herpetic Neuralgia

Neurontin

Day 1: 300 mg orally once per day.

Day 2: 300 mg orally every 12 hours.

Day 3: 300 mg orally every 8 hours.

Maintenance: Subsequently titrate as needed up to 600 mg orally every 8 hours; doses greater than 1800 mg/day have demonstrated no additional benefit.

Gralise

Dose gradually to 1800 mg/day orally; take once a day with evening meal.

Day 1: 300 mg orally once a day.

Day 2: 600 mg orally once a day.

Days 3-6: 900 mg orally once a day.

Days 7-10: 1200 mg orally once a day.

Days 11-14: 1500 mg orally once a day.

Day 15 and after (maintenance): 1800 mg orally once a day.

Dosing considerations:

Gralise tablets swell in gastric fluid and gradually release gabapentin. Swallow Gralise tablets whole; do not cut, crush, or chew them.

Dosing Modifications:

Renal impairment (Neurontin)

Creatinine clearance greater than 60 mL/min: 300-1200 mg orally twice daily

Creatinine clearance 30-60 mL/min: 200-700 mg every 12 hours

Creatinine clearance 15-29 mL/min: 200-700 mg once per day

Creatinine clearance less than 15 mL/min: 100-300 mg once per day

Hemodialysis (Creatinine clearance less than 15 mL/min):

Administer supplemental dose (range 125-350 mg) post hemodialysis, after each 4 hour dialysis interval; further dose reduction should be in proportion to Creatinine clearance (a Creatinine clearance of 7.5 mL/min should receive one-half daily post hemodialysis dose)

Renal impairment (Gralise):

Creatinine clearance is greater than or equal to 60 mL/min: 1800 mg daily with evening meal

Creatinine clearance 30-59 mL/min: 600-1800 mg daily with evening meal

Creatinine clearance greater than 30 mL/min or hemodialysis: Do not administer

In addition its potentially addictive nature, Gabapentin can cause suicidal thoughts, moods swings, and abrupt changes in a user’s behavior. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.

Gabapentin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

      • drowsiness
      • tiredness or weakness
      • dizziness
      • headache
      • uncontrollable shaking of a part of your body
      • double or blurred vision
      • unsteadiness
      • anxiety
      • memory problems
      • strange or unusual thoughts
      • unwanted eye movements
      • nausea
      • vomiting
      • heartburn
      • diarrhea
      • dry mouth
      • constipation
      • increased appetite
      • weight gain
      • swelling of the hands, feet, ankles, or lower legs
      • back or joint pain
      • fever
      • runny nose, sneezing, cough, sore throat, or flu-like symptoms
      • ear pain
      • red, itchy eyes (sometimes with swelling or discharge)

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

      • rash
      • itching
      • swelling of the face, throat, tongue, lips, or eyes
      • hoarseness
      • difficulty swallowing or breathing
      • seizures
      • difficulty breathing; bluish-tinged skin, lips, or fingernails; confusion; or extreme sleepiness

Gabapentin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Gabapentin Abuse

Gabapentin abuse tends to occur in people who already have an addiction to opioids or other drugs. The effects of Gabapentin intoxication have been described as a sense of calm, euphoria, and a high similar to marijuana.

A 2013 study in Kentucky found that of the 503 participants reporting illegal drug use, 15% reported using Gabapentin in addition to other drugs to get high in the previous six months. Another study, working with a sample of participants meant to represent the national population, found almost a quarter of patients with co-prescriptions of opioids and Gabapentin were getting more than three times their prescribed amount to supply their addiction. People using the drug without a prescription is a growing problem in many areas. Due to the drug’s legal status, this is difficult to address from a policing standpoint. States where Gabapentin abuse is becoming more common are beginning to classify the drug as a more strictly controlled substance.

Signs of a Gabapentin Overdose

Effects of excessive Gabapentin use include:

      • Drowsiness
      • Coordination problems
      • Tremors
      • Dizziness
      • Depression
      • Suicidal thoughts/behaviors
      • Changes in mood
      • Dizziness
      • Poor coordination
      • Forgetfulness
      • Anxiety
      • Difficulty speaking
      • Inability to feel pleasure

It is important to try to recognize these symptoms and to be wary of other red flags, such as the presence or abundance of pill bottles. These effects can be detrimental to one’s health, livelihood, and overall safety.

Many Gabapentin users in early recovery abuse Gabapentin because at high doses (800mg or more), they may experience a euphoric-like high that does not show up on drug screens. Gabapentin abusers typically take the drug in addition to opioids to produce their desired high, a dangerous and potentially deadly combination. It is possible to fatally overdose on Gabapentin, both on its own or in conjunction with other drugs. However, there is currently no antidote that can be administered to someone in the case of a Gabapentin overdose as there is with opioid overdoses. If you find a loved one showing signs of an overdose–drowsiness, muscle weakness, lethargy and drooping eyelids, diarrhea, and sedation—seek medical attention immediately.

Signs of Gabapentin Addiction

      • Lying about or exaggerating symptoms to doctors
      • Seeking out multiple doctors to get extra doses
      • Switching doctors after the original doctor refuses to continue prescribing the medication
      • Changes in social habits and/or circles
      • Changes in personal hygiene and grooming habits
      • Constant preoccupation with the drug
      • Unease at the thought of the drug being unavailable
      • Refusal to quit despite social, financial, or legal consequences
      • Failed attempts to quit

Treating a Gabapentin Addiction

Frequent and excessive use of Gabapentin can lead to a physical and psychological dependence on the drug. This is when someone becomes so accustomed to taking a drug that they need it to feel and function normally. Quitting a drug like Gabapentin cold turkey can be dangerous and induce several withdrawal symptoms of varying severity.

These include anxiety, insomnia, nausea, pain, and sweating. Quitting also increases one’s likelihood of having a seizure which can lead to personal injury or the development of medical problems and life-threatening emergencies. Trying to quit should be done at a rehab facility or with the guidance and supervision of a professional during a medical detox.

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What is gabapentin?

Gabapentin is a prescription drug. It comes as an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.

Gabapentin oral capsule is available as the brand-name drug Neurontin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Gabapentin (Generic Neurontin ) was developed to treat epilepsy, but it is now used to treat various forms of chronic pain. It works by reducing the number of signals sent through the nerves. If the signals are reduced then the pain will be reduced. Research has shown that Gabapentin can help in treating various types of nerve pain.

Why Gabapentin is used

Gabapentin oral capsule is used to treat the following conditions:

    • Seizures: Gabapentin is used to treat partial (focal) seizures. It’s taken together with other seizure medications in adults and in children 3 years of age and older who have epilepsy.
    • Postherpetic neuralgia: This is pain from nerve damage caused by shingles, a painful rash that affects adults. Shingles appears after infection with the varicella zoster virus. This virus occurs in people who have had chicken pox.

Gabapentin may be used as part of a combination therapy. This means you may need to take it with other drugs.

How Gabapentin works

gabapentin mechanism of actions
gabapentin mechanism of actions

Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It’s not fully understood how gabapentin works. For postherpetic neuralgia, it seems to prevent the increase in sensitivity to pain that occurs. For seizures, it may alter the effect of calcium (low levels of calcium may cause seizures).

 Gabapentin off-label usages

Some Research Team performed searches to look for clinical trials where gabapentin was used to treat neuropathic pain or fibromyalgia. They found that 5633 participants had been involved in 37 studies of reasonable quality.  They tested gabapentin against placebo for four weeks or more.  Studies lasting only one or two weeks are unhelpful when pain can last for years.

Neuropathic pain is pain coming from damaged nerves. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, cut, or arthritic knee).

Neuropathic pain is treated by different medicines than pain from damagedtissue. Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.

Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor, but fibromyalgia can respond to the same medicines as neuropathic pain.

Gabapentin is helpful for some people with chronic neuropathic pain or fibromyalgia. Gabapentin comes as a capsule, tablet, or solution. You take it by mouth. Gabapentin is available as the brand-name drugs Neurontin, Gralise, and Horizant.  It’s also available as a generic drug.

By Drugs.com, Gabapentin Can be used for a lot of Nerve Pain related health conditions. Gabapentin is also used for a lot of off-label usage such as  Cough, Hot Flashes, Alcohol Withdrawal, Anxiety 161 reviews, Bipolar Disorder, Trigeminal Neuralgia, Postherpetic Neuralgia, Migraine, Insomnia, Occipital Neuralgia, Peripheral Neuropathy,Vulvodynia, Benign Essential Tremor, Epilepsy, Fibromyalgia, Pain Relief, Diabetic Peripheral Neuropathy , Neuropathic Pain,Reflex Sympathetic Dystrophy Syndrome,Periodic Limb Movement Disorder, Spondylolisthesis, Burning Mouth Syndrome,Pudendal Neuralgia, Small Fiber Neuropathy.

A lot of Patients use Gabapentin (Neurontin) to treat Hot Flashes, Anxiety, Bipolar Disorder, Migraine, Insomnia, Restless Legs Syndrome, Peripheral Neuropathy, Fibromyalgia, Neuropathic Pain. Fe patients use gabapentin to treat Pruritus, Cough, Occipital Neuralgia, Benign Essential Tremor, ement Disorder, Spondylolisthesis, Burning Mouth Syndrome, Pudendal Neuralgia, Small Fiber Neuropathy.

There are totally 1359 reviews on Gabapentin, only eleven reviews are on Epilepsy whereas 1348 reviews are on Gabapentin Off-label usage. The most widely usage of Gabapentin is for Anxiety ( 243 Reviews ), Pain Relief ( 241 Reviews ), Fibromyalgia ( 137 Reviews ), Peripheral Neuropathy (119 reviews ), Bipolar Disorder ( 83 reviews ), Migraine ( 79 reviews), Neuropathic Pain ( 75 reviews ), Hot Flashes (70 reviews ), Restless Legs Syndrome (61 Reviews ) and Insomnia ( 59 reviews). The most effective usage of Gabapentin is for Pruritus and Cough.

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DIN (Drug Identification Number)
02084260     Neurontin 100 mg capsule
02084279     Neurontin 300 mg capsule
02084287     Neurontin 400 mg capsule
02239717     Neurontin 600 mg tablet
02239718     Neurontin 800 mg tablet
How long will I have to take Gabapentin for?

This is different for different people. In general, Gabapentin will have to be taken for as long as you are requiring pain relief for nerve pain. Do not stop taking your Gabapentin suddenly if you have been taking it for a while. Your body will be used to the Gabapentin and stopping it suddenly may cause withdrawal symptoms. Reducing the dose slowly as advised by your pain specialist or GP will help stop withdrawal symptoms happening. You may wish to reduce the dose every so often, to check nerve pain is still a problem.

How to take Gabapentin ?

The dose of gabapentin required varies from person to person. To avoid side effects we build up to the dose gradually. The tables in this leaflet show you how this can be done. Some patients can put their dose up faster than others. We call this faster way the FAST TRACK (see table 1).

If you find you are getting side effects with the fast track way of putting your dose up, you can switch to the SLOWER METHOD. ( see table 2).ther people will need to put their dose up less quickly over a number of weeks. This is THE SLOWER METHOD .

As with any medication it is important to check how well it works.  With gabapentin this can be in a few days but for most patients may take 4-8 weeks to assess the full benefit. If you feel you are getting no benefit from this medication please discuss this with your GP or pain specialist.

Gabapentin other Off-label usages

Gabapentin is one drug that researchers have studied for preventing migraines. It has a high safety profile and few side effects. This makes it a good option for Migraine prevention.  Results from some clinical trials have shown a modest benefit from the use of gabapentin for migraine prevention.

However, the American Academy of Neurology (AAN), the organization that provides guidance for the use of drugs to prevent migraines, has stated that there is not enough evidence at this time to support the use of gabapentin for migraine prevention. Healthcare professionals can choose to prescribe gabapentin when other prevention therapies have not worked, however.

Gabapentin has been proven to be effective for people who have hard-to-treat depression or other mood disorders.  Neurontin is not your traditional anxiety drug. It’s a drug primarily described to those with bipolar disorder, not anxiety. Bipolar disorder is a complicated mental health problem.

Gabapentin was successful in helping with rapid cycling and mixed bipolar states in people who have not received relief from valproate or carbamazepine. It appeared that Gabapentin helped more with anxiety and agitation than the other two drugs.

It has also been shown that Gabapentin could aid people with certain types of tardive dyskinesia. That’s why anyone that has been prescribed Neurontin should strongly consider taking it, despite the side effects above and questions about its effectiveness. Bipolar disorder is not something that should be left to chance.

The total number of patients treated with NEURONTIN in controlled clinical trials in patients with postherpetic neuralgia was 336, of which 102 (30%) were 65 to 74 years of age, and 168 (50%) were 75 years of age and older. There was a larger treatment effect in patients 75 years of age and older compared with younger patients who received the same dosage. Since gabapentin is almost exclusively eliminated by renal excretion, the larger treatment effect observed in patients ≥ 75 years may be a consequence of increased gabapentin exposure for a given dose that results from an age-related decrease in renal function.

However, other factors cannot be excluded. The types and incidence of adverse reactions were similar across age groups except for peripheral edema and ataxia, which tended to increase in incidence with age.

Clinical studies of NEURONTIN in epilepsy did not include sufficient numbers of subjects aged 65 and over to determine whether they responded differently from younger subjects.

Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients.

What form(s) does this medication come in?

Capsules

100 mg – Each hard gelatin Coni-Snap capsule, with white opaque body and cap printed with “PD” on one side and “Neurontin/100 mg” on the other, contains gabapentin 100 mg.

300 mg – Each hard gelatin Coni-Snap capsule, with yellow opaque body and cap printed with “PD” on one side and “Neurontin/300 mg” on the other, contains gabapentin 300 mg.

400 mg – Each hard gelatin Coni-Snap capsule, with orange opaque body and cap printed with “PD” on one side and “Neurontin/400 mg” on the other, contains gabapentin 400 mg.

Tablets

600 mg – Each white, elliptical, film-coated tablet with “Neurontin 600” printed on one side contains gabapentin 600 mg.

800 mg –  Each white, elliptical, film-coated tablet with “Neurontin 800” printed on one side contains gabapentin 800 mg.

How to take gabapentin

The gabapentin dosage your doctor prescribes will depend on several factors. These include:

      • the type and severity of the condition you’re using gabapentin to treat
      • your age
      • the form of gabapentin you take
      • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

We do not sell Gabapentin to all patients!

Normally Gabapentin is suitable for all adult and children bigger than six years old. But you are not allowed to order Gabapentin online especially in our online pharmacies if you have any of following health conditions (But you are OK to order in your local street pharmacies):

      1. You are younger than 18 years old;
      2. You have kidney disease;
      3. Alcohol – you are addictive to alcohol, gabapentin may cause alcohol intolerance;
      4. diabetes – Gabapentin may affect blood sugar levels, you must find a local doctor to prescribe you Gabapentin.
      5. kidney disease,liver disease and heart diseases;
      6. a history of depression, mood disorder, drug abuse, or suicidal thoughts or actions;
      7. (for patients with RLS) if you are a day sleeper or work a night shift;
      8. You are breastfeeding mother or you are pregnant;
      9. have thoughts about suicide.
      10. If you are allergy to Gabapentin

Stop immediately if you have any thoughts about suicide.

Donot order Gabapentin online if you have suicide thoughts. Please go to your doctor to have you completely checked.

We hope you can refill your Gabapentin online using our online pharmacy. You have already checked by your local doctors and they have prescribed you Gabapentin.  After your first prescription, you can order in our websites. Our doctors and pharmacists will review your health conditions too and it is much easier for you to understand the gabapentin prescription you are taking.

Gabapentin may interact with other medications

Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Pain drugs

When used with gabapentin, certain pain drugs can increase its side effects, such as tiredness. Examples of these drugs include:

  • morphine

Stomach acid drugs

When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:

  • aluminum hydroxide
  • magnesium hydroxide