What is Gabapentin and What It is Used for ?

US Brand Name

      1. FusePaq Fanatrex
      2. Gabarone
      3. Gralise
      4. Neurontin

Descriptions

Gabapentin is used to help control partial seizures (convulsions) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

Gabapentin is also used to manage a condition called postherpetic neuralgia, which is pain that occurs after shingles.

Gabapentin works in the brain to prevent seizures and relieve pain for certain conditions in the nervous system. It is not used for routine pain caused by minor injuries or arthritis. Gabapentin is an anticonvulsant.

This medicine is available only with your doctor’s prescription.

This product is available in the following dosage forms:

      • Capsule
      • Tablet
      • Solution
      • Suspension

Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy. Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Gabapentin Dosage and Administration

Typically, your doctor will prescribe 300 mg once a day, usually in the evening, to start. The dose will then be increased every three to five days. Some people will take 600 mg/day, others will increase to 3,600 mg/day—the maximum dose approved by the FDA.

If used as a mood stabilizer or anti-depressant, the dose is usually between 900 and 2,000 mg a day. But, it may also be increased for better results. Some people see improvement in their symptoms about a week after starting treatment. Others need about a month before they see significant improvement.

Gabapentin has a half-life of about six hours, so it must be taken three to four times a day.

How To Discontinue Gabapentin

Like other psychotropic drugs, you should ease off gabapentin gradually. There are some known withdrawal symptoms. This mostly comes from people who take high doses of the drug and suddenly stop. You should only abruptly discontinue this drug because of a serious side effect, and even then, it should be done with your doctor’s supervision and direction.

Gabapentin Overdose and Toxicity

It’s possible to fatally overdose on gabapentin. Reports of gabapentin being abused alone, and with opioids, prompted the FDA to release a warning statement (in December 2019) about the fatal risk of respiratory depression. Signs of overdose include:

  • Ataxia (decreased muscle coordination)
  • Diarrhea
  • Drooping eyelid
  • Drowsiness and lethargy
  • Double vision
  • Excitation
  • Hypoactivity
  • Labored breathing
  • Marked sedation
  • Slurred speech

If you suspect an overdose, you need immediate medical treatment. The only way to remove the drug is through kidney dialysis in the emergency room.

The off-lable use of Gabapentin for migraine

Neurontin is prescribed for the treatment of the following conditions in adults and children over 3 years:

Various forms of epilepsy. When used for controlling epilepsy, it is usually used in conjunction with another anti-epileptic drug.   Usually doctors prescribe prescribe Neurontin for patients to help them to treat your epilepsy when a current treatment is not fully controlling his/her condition. Neurontin is used as addition to the main treatment of epilepsy.

Peripheral neuropathic pain (long lasting pain caused by damaged nerves). This disease can occur and develop in various conditions: injury, diabetes, shingles, and others.

Your doctor may prescribe you Neurontin for the treatment of other diseases, if he thinks that it is a right medicine for your case which is offl-label use of Neurontin.

It is also widely used to treat Anxiety and Migraine prevention.

Gabapentin Off-Label Usage

One of Gabapentin “off-label” usage is for migraine prevention and treatment, including migraines with or without aura, vestibular migraines. It can reduce the frequency of headaches, pain intensity, and the use of symptomatic medications. Gabapentin is a good preventive therapy for migraines refractory to standard medications.

The chemical structure of gabapentin is related that of gamma-aminobutyric acid (GABA) which is a neurotransmitter in the brain. The exact mechanism as to how gabapentin controls epilepsy and relieves pain is unknown, but it probably acts like the neurotransmitter GABA.

The effective dose of gabapentin varies greatly. Some persons need only 200-300 mg a day whereas others may need 3000 mg or more a day. It may take several weeks to become effective, so it is important to stay on it for an adequate length of time.

The Efficacy of gabapentin in migraine prophylaxis experiment shows  gabapentin is an effective prophylactic agent for patients with migraine.

In the Clinical trials143 patients evaluated gabapentin for migraine prophylaxis.  After 3 months the patients taking gabapentin had a reduction of the migraine frequency by 1.5 migraines per month (or by 35.7%) compared with a reduction of 0.6 migraines per month for the placebo group. Also, gabapentin reduced the headache frequency by 50% or greater in 45% patients compared with only 16% patients on placebo. The most frequently reported adverse events  were asthenia, dizziness, somnolence, and infection.

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