Gabapentin Overview

Gabapentin is an antiepileptic/analgesic, used in the treatment of epilepsy seizures and nerve pain. Gabapentin may be prescribed by your doctor to treat epilepsy seizures, diabetic nerve pain and nerve pain resulting from herpes. It may also be used in the treatment of chronic pain conditions, as a sympathetic nerve blocker. The sympathetic nervous system controls sweating, temperature, sensitivity, sensation, circulation and skin reactions.

Patients with Complex Regional Pain Syndrome (CRPS) may be prescribed this drug as a means of reducing chronic pain and associated responses. In the case of CRPS, the patient will probably take this drug in combination with painkillers or anti-inflammatories. Gabapentin is not a pain killer, but blocks the nerve signals so that the body can heal and learn to read the signals correctly.

For patients with epilepsy, it may be used as an additional treatment for partial epileptic seizures that are not controlled with other epilepsy medications.It is available in gelatine capsules of 100mg, 300mg and 400mg, in blister packs of 10, 20, 30, 50, 60, 90, 100, 200, 500 and 1000 capsules.

Capsules should be swallowed whole with liquid, with or after food.If you are taking other medicines, your doctor should be made aware of them. Gabapentin may interact badly with some herbal remedies (non-prescription), and both antacids and ibruprofen may affect the way Gabapentin works.

If you have an allergy to lactose, you should inform your doctor, as Gabapentin capsules contain this ingredient.Gabapentin should NOT be taken if you are pregnant or breastfeeding.

USAGE FOR EPILEPSY: The usual starting dose is 300mg for adults and children over 12 years of age. This dose is taken on the evening of the first day. Your doctor may then increase the dose on the second day to 300mg in the morning, and 300mg in the evening. On the third day you may be increased to 300mg three times per day. The maximum dosage is 3600mg per day. Gabapentin is not recommended for children under 12 years.

USAGE FOR DIABETIC NERVE PAIN: The dosage follows the rules for epilepsy, and may be continued for up to 5 months. If you suffer from any kidney problems, the doctor may issue a lower dosage.

USAGE AS A NERVE BLOCK: Gabapentin is not marketed for use as a nerve block, but is commonly used as such following successful applications. The dosage follows the same rules as for epilepsy patients, with a maximum dosage of 3600mg. For chronic pain conditions, Gabapentin may need

Gabapentin for ADHD

Attention deficit disorder (ADD) is characterized by inattentiveness, easy distractibility, impul-siveness, and difficulty completing tasks; excessive activity may or may not be seen. The person can appear to others as forgetful or careless. It begins in childhood and persists into adulthood for fifteen to fifty percent of children. The symptoms may be more subtle in an adult, and may not be easily diagnosed, particularly if hyperactivity is not seen. Those with attention deficit disorder develop more self-restraint and attention span in adulthood. By adulthood it is usually seen in its incomplete form (the modifier, “in partial remission,” is added).

ADHD SIGNS AND SYMPTOMS

  • Squirms in seat; fidgets with hands or feet.
  • Unable to stay seated when required to do so.
  • Easily distracted.
  • Blurts out answers before a question is finished.
  • Difficulty waiting turn in games and lines.
  • Difficulty following instructions.
  • Unable to sustain attention in work or play activities.
  • Shifts from one uncompleted project to another.
  • Difficulty playing quietly.
  • Talks excessively.
  • Interrupts or intrudes on others.
  • Doesn’t appear to listen.
  • Loses items necessary for tasks.
  • Often engages in dangerous activities without considering consequences.

Gabapentin is an anticonvulsant drug released in the United States in 1993 for use as adjunctive therapy in refractory partial epilepsy. The mechanism of action of gabapentin is unknown, but the drug has very favorable pharmacokinetics and a good safety profile, which allows its use in high-risk patients. Several reports have described the successful use of gabapentin for bipolar disorders in adults, but there are no controlled studies in the use of gabapentin in children and adolescents.

We describe a 12-year-old boy with a history of attention deficient hyperactivity disorder (ADHD), reading disorder, mixed receptive and expressive language disorder, encopresis, and bipolar disorder II who was treated with gabapentin 200 mg/day added to methylphenidate 30 mg/day. Within 3 weeks the improvement and stabilization of mood symptoms was remarkable, as noted by mother, teacher, and clinician, and remained so for 6 months of follow-up.

Comorbid bipolar disorder and ADHD is a hotly debated topic in the child and adolescent psychiatric literature, with rates of comorbid ADHD and bipolar disorder ranging from 22% to 90%. Controlled studies are needed to evaluate the possible antimanic mood stabilizing and/or antidepressant properties or gabapentin in youths.

Gabapentin for Migraine Prevention

Gabapentin is a drug that is approved to treat seizures in people with epilepsy. It is also approved to treat nerve pain from shingles, which is a painful rash caused by herpes zoster infection. It’s used off-label for migraine prevention.

Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way. Anticonvulsants help calm nerve impulses. It is believed that this action can help prevent migraine pain.

This drug 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.

What is migraine?

A migraine is not just a headache. Migraines are usually more severe and last longer than headaches. Migraines can last as long as 72 hours. The major symptom of a migraine is pain that you usually feel on one side of your head. This pain is typically moderate or severe. Migraines also include other symptoms, such as nausea, vomiting, and severe sensitivity to light and sound.

About 20% of people who have migraines experience an aura before the pain begins. An aura is a group of symptoms. You could have some or all of the following symptoms during a migraine aura:

  • Changes in your vision, such as seeing squiggly lines or having short-term, partial vision loss
  • Difficulty talking
  • Tingling or numbness of any part of your body

Migraine triggers

It is not known exactly why people have migraines. However, some people can track their migraine back to a certain trigger. Migraine triggers can include stress, lack of sleep, certain foods, and even hormone changes during a menstrual cycle.

Migraine prevention

Some people can prevent migraines by avoiding triggers. Others have prevented migraines successfully through relaxation techniques, acupuncture, or exercise. However, these therapies alone don’t work for everyone. Some people also need treatment with medication to reduce the number of migraines they have. The drugs used to prevent migraines are different from drugs that to treat migraines once a migraine starts. Drugs that prevent migraines, such as gabapentin, must be taken daily.

International and domestic studies that have evaluated Neurontin for migraine prevention suggest that it is effective. In a study of 63 patients with migraine (with or without aura), gabapentin significantly reduced migraine frequency and intensity among 30 patients who received it. In this study, adverse events were mild to moderate in severity.

Similarly, in a large study, 143 people with migraine received daily doses of Neurontin or placebo for 12 weeks. At the end of 12 weeks, the migraine rate had declined from 4.2 migraines before treatment to 2.7 migraines after treatment in those who received this drug.

This decrease was significantly greater than the decrease from 4.1 migraines to 3.5 migraines among those who received placebo. Of the 56 gabapentin recipients, 46% had at least a 50% reduction in the four-week migraine rate. Drug-related adverse events (sleepiness and dizziness) led to drug withdrawal in 13% of patients in the gabapentin group compared with 7% in the placebo group. The researchers concluded that this medication is an effective and well-tolerated preventive for migraine.