Gabapentin question

[Kassia]

I have nerve damage from a surgery I had a year ago and my surgeon just prescribed gabapentin.  I'm hesitant to take it due to the side effects (I am struggling with depression, anxiety, and post-concussive syndrome).  

Does anyone know if the gabapentin actually treats the nerve or does it just help with symptoms?  I don't have nerve pain - just annoying pins/needles feeling.  Like when the novocaine at the dentist is wearing off and your lip feels all big and tingly.  I don't want to take it it's just for symptom relief but would maybe try it if it would actually fix the problem permanently.

[Terabith]

I don’t know much about how it works on nerve pain, but it was a miracle drug for my anxiety and depression.  

[cintinative]

according to Google (and this was my memory from when they suggested this for me): this is how Gabapentin works: 

GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. Gabapentin mirrors the effects of GABA calming excited neurons.

So it will not cure you, it is designed to try to disrupt the pain signal transmission.

You should know the other side effects because it makes some people very tired.  

 

[Storygirl]

When DS17 started taking it, I asked the same question of the neurologist, and he said that it should help the pain and might help the condition itself improve. But I'm not an expert. It's just what we were told. He said that sometimes nerves repair themselves, and sometimes they don't, and he couldn't predict it.

For DS, it definitely helps his pain and symptoms. He's been on it for more than a year, and I can't say whether his condition has improved. He would have to go off of it, I think, for us to have an opinion about that. But he's not going off of it, because it helps him. It definitely hasn't cured him.

[Kassia]

4 minutes ago, Storygirl said:

When DS17 started taking it, I asked the same question of the neurologist, and he said that it should help the pain and might help the condition itself improve. But I'm not an expert. It's just what we were told. He said that sometimes nerves repair themselves, and sometimes they don't, and he couldn't predict it.

For DS, it definitely helps his pain and symptoms. He's been on it for more than a year, and I can't say whether his condition has improved. He would have to go off of it, I think, for us to have an opinion about that. But he's not going off of it, because it helps him. It definitely hasn't cured him.

Thank you.  Did/does he have side effects?

 

 

[Pawz4me]

My mother took gabapentin for years for nerve pain due to spinal stenosis. For her it just helped with the nerve pain, of course--it sure couldn't fix spinal stenosis. She never had any adverse side effects, but I know some people do.

[J-rap]

I've heard of lots of different stories with gabapentin...  it seems to really vary person to person.  My dd has been taking it for over a year now for endometriosis pain.  She thinks it helps, definitely no bad side effects.  (But no permanent improvements with it.)  My dh took it after a surgery which had a painful recovery.  It had a weird side-effect for him -- nothing terrible, but it seemed to over-activate his nerves so he had to stop.  

I always assumed it was to help treat symptoms, not for re-training or re-directing the neuropaths, but I could be wrong.  The more I learn about the brain, the more I realize that at least some of our neurologic reactions are based on patterns, so possibly interrupting a pattern can slowly cause a real change?

If I had issues that nothing else was really helping, I'd certainly give it a try!

ETA:  I've never known anyone personally who had emotional reactions to it.

Edited January 10, 2023 by J-rap

[Harriet Vane]

I took it for two months to help with a pinched nerve.

It did help with the pins and needles as well as the pain.

 I was super sleepy the first several days and then adjusted. A friend who has been taking it more than a year had the same progression—she warned me to plan for a sleepy weekend at first. Once adjusted, my energy was fine.

It did not make me depressed. I actually think it might have improved mood.

One doctor told me it only helps with symptoms and another doctor told me it helps heal the nerves. I don’t know what to think about that.

For me personally, it made me a little spacey and sometimes felt as though I couldn’t find words. But I have a good friend who has been taking it for a year with no such effects at all. And the husband of a friend has been taking gabapentin for many years with no such effects. Quite the opposite—both of these friends are articulate and intelligent and interesting conversationalists. I personally tend to over-react to medication—a little bit goes a long way with me. It’s a feature of my metabolism and I could tell you quite a few other drugs that affect me in weird ways when others are fine. So take my side effects with a grain of salt.

[Storygirl]

49 minutes ago, Kassia said:

Thank you.  Did/does he have side effects?

 

 

No side effects. Except he started having insomnia around the time that he started taking it. The doctor assures us that the gabapentin wouldn't be the cause of that, so it's just coincidental.

[Kassia]

Thank you everyone!  I wish it were an easy decision.  I am hesitant about the risks of meds and also side effects for a symptom that is just annoying but not painful and doesn't affect quality of life.  If I knew it would treat the issue, it would be a little easier.  

[cintinative]

9 minutes ago, Kassia said:

Thank you everyone!  I wish it were an easy decision.  I am hesitant about the risks of meds and also side effects for a symptom that is just annoying but not painful and doesn't affect quality of life.  If I knew it would treat the issue, it would be a little easier.  

I had the same inner discussion. Mine was caused by transverse myelitis. I decided to wait and see if anything resolved on its own. Unfortunately my mom's mystery nerve issues were treated for years with narcotics and I knew from watching her that I didn't want to go down a path requiring medication unless I really felt it was a quality of life issue.  At the time that gabapentin was offered, I wasn't really having trouble sleeping because of the pain. My biggest life altering problem was fatigue and the gabapentin wasn't going to help with that.

Anyway, it's tough, but you can always wait a few months and then start. My doctor left it open to me to call him if I ever decided i needed it. It turned out my symptoms lessened to where I only had the pain around my monthly cycle (something about stress in the body I guess). So I never went on it. ETA: I guess my doctor is one who felt it wouldn't heal the nerve issue. It's interesting that some think that! If I thought it would, I might have changed my stance on it.

Edited January 10, 2023 by cintinative

[Kassia]

@cintinativethank you so much!  That's where I am now - I don't feel like I need to rush to make a decision if it's not going to heal the nerve issue.  I'd rather deal with annoying symptoms than the risks from meds and possible side effects.  

[gardenmom5]

Not sure which - but dsil has nerve damage (hoping it's not permanent) from his accident, and he takes Gabapentin to ameliorate his symptoms.  I know it's definitely helping as he can do somethings he couldn't do before taking it.

[Amy in NH]

I started taking the OTC supplement GABA as a self-induced trial for anxiety and depression, to boost my dopamine levels. It's the only supplement that has helped (I've tried a bunch), and I could feel the effects of it throughout my body as soon as I took it each day. Unfortunately, the epithelial lining of the lungs contain GABA receptors, which I found out after a severe case of dyspnea which persisted until I figured out that was the problem and stopped taking it.  Gabapentin is an analogue of GABA, and can cause similar/same problem. If you have pre-existing lung problems, as I do, please be wary.

[Amy in NH]

Regarding experiences and/or side effects mentioned by other posters: As an endorphin (natural "morphine") increased dopamine helps with nerve function including pain reduction, affects the temporal lobe including time perception and speech, and can also cause insomnia...

I always took it in the morning to avoid the insomnia.

Edited January 10, 2023 by Amy in NH

[wathe]

Another thing to consider:

Gabapentin is a drug with abuse potential, and is a controlled substance in some states.  Many walk-in clinics and ED's will not refill it.

That's obviously not a reason to not take it if you will benefit.  But good to be aware of.   

[Eos]

11 hours ago, Pawz4me said:

My mother took gabapentin for years for nerve pain due to spinal stenosis. For her it just helped with the nerve pain, of course--it sure couldn't fix spinal stenosis. She never had any adverse side effects, but I know some people do.

Mine also, but for some reason a gerontologist took her off it - I think she was having dizzy-ish spells one year.  The withdrawal from it wasn't  great for her - pain, anxiety, slightly manic episodes - which took about three weeks to get through.  She still has spinal stenosis and her pain levels have been creeping up.  I've considered whether to suggest she go back on it but I think I will wait a bit longer after reading others' replies.

[Terabith]

10 hours ago, wathe said:

Another thing to consider:

Gabapentin is a drug with abuse potential, and is a controlled substance in some states.  Many walk-in clinics and ED's will not refill it.

That's obviously not a reason to not take it if you will benefit.  But good to be aware of.   

I have questions about this.  It became a controlled substance (but at a lower classification than a lot of other drugs) in my state.  I’ve been taking it for like 23 years, and like I said it was miraculous for me. But I can’t figure out how it could be abused.  It’s not fast acting.  I have certainly never felt high or anything from it.  It just, over the course of several weeks, took my depression from crippling and life threatening to “wow, is this what normal people feel like?”  (And I know it isn’t considered effective for depression or bipolar disorder, but 23 years ago it was considered possibly one and I had had no response to several classes of drugs.  And my long term psychiatrist says that while he knows the studies say it’s not effective at a population level, he has a number of patients for whom it clearly is effective.)  

How is it abused?  Or rather, why?  

 

 

[BlsdMama]

My husband too significant amounts from shortly after his second back surgery until his fusion about two years later. It did help although dosage has to be tweaked. 
 

After his fusion, he decided to go off of it before his doctor recommended. You really need to takes weeks to wean your body off, or at least at the amount he was taking. He ended up having a crazy high spike in blood pressure, an ambulance ride, and an evening in the ER. So, he has no bad experiences with it, no withdrawal cravings, it worked well, but definitely follow directions when coming off it. 

[Harriet Vane]

1 hour ago, Terabith said:

I have questions about this.  It became a controlled substance (but at a lower classification than a lot of other drugs) in my state.  I’ve been taking it for like 23 years, and like I said it was miraculous for me. But I can’t figure out how it could be abused.  It’s not fast acting.  I have certainly never felt high or anything from it.  It just, over the course of several weeks, took my depression from crippling and life threatening to “wow, is this what normal people feel like?”  (And I know it isn’t considered effective for depression or bipolar disorder, but 23 years ago it was considered possibly one and I had had no response to several classes of drugs.  And my long term psychiatrist says that while he knows the studies say it’s not effective at a population level, he has a number of patients for whom it clearly is effective.)  

How is it abused?  Or rather, why?  

 

 

When I researched this before taking it, I learned that there are two concerns. One is that when combined with street drugs, it enhances the effects of those other substances. That's the main concern about it. It does also have addictive potential, but it's really pretty mild in that regard. Most people (including me) simply taper down the dose over a few weeks before stopping taking it. 

[wathe]

7 hours ago, Terabith said:

I have questions about this.  It became a controlled substance (but at a lower classification than a lot of other drugs) in my state.  I’ve been taking it for like 23 years, and like I said it was miraculous for me. But I can’t figure out how it could be abused.  It’s not fast acting.  I have certainly never felt high or anything from it.  It just, over the course of several weeks, took my depression from crippling and life threatening to “wow, is this what normal people feel like?”  (And I know it isn’t considered effective for depression or bipolar disorder, but 23 years ago it was considered possibly one and I had had no response to several classes of drugs.  And my long term psychiatrist says that while he knows the studies say it’s not effective at a population level, he has a number of patients for whom it clearly is effective.)  

How is it abused?  Or rather, why?  

 

 

Euphoria similar to an opiate high for some people.  

It also potentiates opiates, and there is increased mortality when gabapentin is mis-used concurrently with opiates.  CDC report.

Brief report from CMAJ, and another paper from Scotland

Very recent article in JAMA is worth reading, but it's paywalled (and not gift-able)

It's a good drug that's perfect for some people.  But, like many other controlled substances, there is also risk and abuse potential.  Which is why it's important to have a regular prescriber with whom one has an ongoing therapeutic relationship and appropriate followup.  We won't refill it from the ED, because the required risk assessment and followup is impossible in an episodic care environment.

[Carol in Cal.]

My husband took it for a few days because he had bad back pain due to stenosis.  It effected his moods, and very badly—he was flying off the handle a lot, very angry, unreasonable, mean in his speech.  He did not feel like it helped his back pain, and once he realized what it was doing to how he treated people, he stopped taking it and kind of almost isolated himself while he cleared it from his system.  It makes me really cautious about it—it was suggested to me for hand nodule once but I asked for something else instead.