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Gabapentin is a prescription drug, marketed as Neurontin and Horizant, that’s used to treat epilepsy. Doctors can prescribe gabapentin to treat epilepsy in people older than 12, and partial seizures in children ages 3 to 12.

Gabapentin may also be prescribed to treat restless legs syndrome (RLS), to relieve numberness and tingling related todiabetes, to prevent hot flashes, and to relieve pain that can accompany shingles (known as postherpetic neuralgia).

 

Studies have also found Gabapentin to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, some doctors also prescribe gabapentin to cure fibromyalgia pain. For more information, please click here.

Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness.

Pregabalin (Lyrica), a drug similar to gabapentin, was the first medication approved by the Food and Drug Administration (FDA) to treat fibromyalgia. While gabapentin hasn’t been approved by the FDA for the treatment of fibromyalgia, some doctors may prescribe it off-label for such use.

Anticonvulsant drugs, such as gabapentin, are becoming increasingly popular for migraine prevention.

Gabapentin has mush more usages, it can cure nerve pain, prevent migraines and headaches. It is also widely used to treat Insomnia, Fibromyalgia, and Restless Legs Syndrome Pain. For more information, please check What is Gabapentin and What It Is Used For ?

A study in the Canadian Journal of Anesthesia in 2013 revealed that gabapentin may help ease moderate to high levels of anxiety among people about to have surgery. The researchers noted that doctors are increasingly using the drug to treat pain after surgery as well as a variety of psychiatric diseases, such as chronic anxiety disorders.

Gabapentin Warnings

You should know that gabapentin may increase the risk for suicide.

Suicidal thoughts or behavior occurs in about one in 500 people taking medications like gabapentin. This risk may begin within a week of starting treatment.

Let your doctor know if you experience:

  • Thoughts of suicide
  • Symptoms of depression
  • Aggression
  • Irritability
  • Panic attacks
  • Extreme worry
  • Restlessness
  • Acting without thinking
  • Abnormal excitement

You should also let friends and family members know about these symptoms.

Gabapentin Side effects

The most common side effects of gabapentin in adult patients include dizziness, fatigue, drowsiness, weight gain, and peripheral edema (swelling of extremities).[40] Gabapentin may also produce sexual dysfunctionin some patients, symptoms of which may include loss of libido, inability to reach orgasm, and erectile dysfunction. Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity. What side effects can Gabapentin cause?

Gabapentin Dosage

A typical adult dose for postherpetic neuralgia usually starts at 300 milligrams (mg), and your doctor may increase the dose to up to 1,800 mg a day.

A typical adult dose for epilepsy may range from 900 to 1,800 mg a day.

Your doctor will usually start you at a low dose of gabapentin and then increase the dose gradually until you get to a level that works best for you. For More information, please check   How should Gabapentin be used?

Neurontin can be used to treat Fibromyalgia, Migraine, sleep and restless legs syndrome

 

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain. 

For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.

In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.

However, the drug had no effect on acute pain points or depression, the researchers reported.

Although gabapentin, which was used off-label for fibromyalgia, has little, if any, effect on acute pain, it has shown a robust effect on pain caused by a heightened response to stimuli related to inflammation or nerve injury in animal models of chronic pain syndromes, Dr. Arnold said.

Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effect on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain.

The study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, included 150 mainly white fibromyalgia patients (90% women). Of these, 75 took gabapentin at dosages of 1,200 to 2,400 mg daily for 12 weeks, while there were 75 placebo controls.

The study was conducted at three outpatient research centers in the U.S., from September 2003 to January 2006.

The mean pain severity scores, measured by the Brief Pain Inventory (BPI), decreased in both groups but more so among the gabapentin patients (P = 0.015). The estimated difference between groups at week 12 was – 0.92 (95% confidence interval -1.75, -0.71).

Of the gabapentin-treated patients, 51% achieved a response at the endpoint compared with 31% of the placebo patients (P=0.014).

gabapentin overviewGabapentin compared with placebo also significantly improved the BPI average pain interference score, as well as a series of other scores. These included the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity Improvement, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS), the Sleep Problems Index, and the MOS Short Form 36 vitality score.

However, the drug had no effect on acute pressure-point pain or depression (the Montgomery Asberg Depression Rating Scale), the researchers reported.

Overall, the drug was well-tolerated. Of the 150 patients, 19 dropped out due to adverse events, with no significant difference between the treatment groups.

The gabapentin patients reported dizziness, sedation, lightheadedness, and weight gain significantly more often that did the placebo-treated patients. Notably, the researchers said, there was no significant difference in weight change in the two groups as measured in the clinic, although edema may have explained some of the patients’ perceptions. Most treatment adverse events, they reported, were mild to moderate in severity.

The pathophysiology of fibromyagia is unknown, but evidence suggests that it is associated with aberrant central nervous system pain processing, the researchers said.

The drug appears to be effective in reducing abnormal hypersensitivity induced by inflammatory responses or nerve injury. Yet unlike many other pain syndromes, there is no physical evidence of inflammation or CNS damage.

One possible explanation, Dr. Arnold said, is that gabapentin’s effects involve binding to a specific subunit of voltage-gated calcium channels on neurons. This binding, she said, reduces calcium flow into the nerve cell, which reduces the release of some signaling molecules involved in pain processing.

In discussing the study’s limitations, the researchers said that because the study was short, the results may not generalize to longer treatment periods, and long-term efficacy should be studied in future clinical trials.

Also, because the study was relatively small, they said it may have lacked the power to detect potentially relevant differences between the groups. Finally, they wrote that the results may not apply to patients with some comorbid psychiatric disorders, such as bipolar disorder, or to patients with other painful musculoskeletal disorders.

“In this, the first randomized, placebo-controlled study to evaluate gabapentin in the treatment of fibromyalgia, the results demonstrated that gabapentin, taken for up to 12 weeks, is effective and safe in the treatment of pain and other symptoms associated with fibromyalgia,” Dr. Arnold concluded.

Gabapentin may be useful in the treatment of comorbid anxiety in bipolar patients, (however not the bipolar state itself). Gabapentin may be effective in acquired pendular nystagmus and infantile nystagmus, (but not periodic alternating nystagmus). It is effective in hot flashes. It may be effective in reducing pain and spasticity in multiple sclerosis. Gabapentin may reduce symptoms of alcohol withdrawal (but it does not prevent the associated seizures). Use for smoking cessation has had mixed results. Gabapentin is effective in alleviating itching in renal failure (uremic pruritus)  and itching of other etiologies. It is well-established in the treatment of restless leg syndrome. (A prodrug form, gabapentin enacarbil, is also effective.)  Gabapentin is effective in insomnia.

Primary Source

Arthritis and Rheumatism

Source Reference: Arnold LM, et al”Gabapentin in the Treatment of Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial”Arthritis Rheum 2007; 56: 1336-1344.

https://en.wikipedia.org/wiki/Gabapentin

Gabapentin is the best medications to treat Fibromyalgia

The symptoms of fibromyalgia include pain and tenderness throughout the body that is often associated with other conditions that reduce a person’s ability to function and affects her quality of life. People with fibromyalgia often have difficulty sleeping, feel tired during the day, and experience irritability and depression, all of which can affect their life at work and at home.

Between 1 percent to 5 percent of adults in the U.S. have fibromyalgia, with women much more likely to develop it than men—about 80 to 90 percent of fibromyalgia sufferers are women. It can strike children and teens, but it’s more common in older adults, with most cases occurring between the ages of 40 and 70.

Because there is not a single, specific cause of fibromyalgia and the symptoms can vary from patient to patient, choosing an effective treatment can be challenging. Experts say the best, overall strategy includes medications and nondrug therapies, such as exercise, counseling, and stress relief.

The medications used to treat fibromyalgia includeantidepressants (amitriptyline, nortriptyline, fluoxetine, paroxetine, duloxetine, milnacipran), a few anti-seizure medications (gabapentin, pregabalin), and a muscle relaxant (cyclobenzaprine). But studies show that the benefits of these medications are generally small. There is no clear evidence that one drug is better than another, and all of them probably lose their benefit over time.

gabapentin800mgtabEach drug differs in the risks it poses to you. All antidepressants should be used with caution in those with a history of suicide attempt or who are at risk of suicide, especially in people 25 years old or younger. Amitriptyline, cyclobenzaprine, gabapentin, and pregabalin all cause increased sedation and should be used with caution in the elderly.

The medications differ substantially in price, so cost might be an important factor in determining which one you choose. The monthly cost for these drugs ranges from as little as $6 to more than $500. Taking into account the evidence of their effectiveness and safety as well as their price, we have chosen three Consumer Reports Best Buy Drugs as initial options to consider if you and your doctor have decided that a medication is appropriate for your fibromyalgia symptoms:

  • Generic amitriptyline
  • Generic gabapentin
  • Generic paroxetine-IR (immediate release)

All of these medications have been on the market for 15 years or more and have been widely used. They are all available as inexpensive generics and are at least as effective and safe as the other fibromyalgia medications.

Although side effects of sedation, dry mouth, and dizziness are common, serious side effects are rare.

Gabapentin and pregabalin are classified as antiseizure medications, but they are also used to help relieve pain in people with fibromyalgia. Both medications alter the brain chemistry. Pregabalin decreases levels of chemicals in the brain called neurotransmitters that build up because of the constant firing of the nerves in the spinal cord and the brain. It also increases other neurotransmitters that help suppress the constant firing of the nerves, which helps relieve pain. It’s unclear which neurotransmitters are affected by gabapentin or pregabalin.

Both drugs improve pain, sleep, fatigue, and the quality of life in people with fibromyalgia to about the same degree as amitriptyline. In clinical trials, 70 percent of people with fibromyalgia who took gabapentin for 12 weeks said they felt better compared with 40 percent of those who took a placebo. In addition, 51 percent of those who took gabapentin experienced a reduction of one-third in their pain compared with those who took a placebo.

In another trial, between 40 percent and 80 percent of people who took pregabalin said their pain was reduced by nearly a third, compared with 28 percent to 38 percent of those who took a placebo. For doses of 300 mg to 600 mg per day of pregabalin, 20 percent to 24 percent of patients said their pain was reduced by half compared with 12 percent of patients taking placebo.

One of the most common side effects of pregabalin and gabapentin is sedation. This is why they are often given at higher doses at night, which seems to help with sleep. Other side effects can include confusion, blurred vision, dizziness, liver and kidney impairment, and problems with concentration. In particular, they should be used with caution in elderly people due to side effects of confusion, dizziness, and sedation. Both drugs can also cause swelling, so people with heart failure should not take them. Gabapentin has been shown to increase the risk of suicide in depressed people and should be avoided in those at increased risk of suicide attempt.

Above report is from http://www.consumerreports.org/cro/2014/02/evaluating-prescription-drugs-used-to-treat-fibromyalgia/index.htm