Gabapentin question

[mjan]

fishead,

Over the course of the years, my dosage has gone up and down- depending on what is going on.

I currently have 600 mgs tablets. I take 300 3x a day and then 1200 at bedtime.

If I need more or less, I take more or less.

I also, however, am really experiencing a lot of pain in my neck, shoulders, and upper back. I, and my neuro, believe spasticity is causing some of my tingling and weird sensations in my arms and shoulders. So, I am also seeing PT and a Massage Clinic for those areas.

Fun, Fun, Fun!

p.s. Isn't Jan's advice always so soothing? When I read her posts, I alway imagine a soft, comforting voice of someone with lots of wisdom and experience.

Take Care

Aww.. thanks.. means a lot~ Best to you and yours!

[fishead]

See Jan? So many people, not only read your posts, but are helped and soothed by them. KUDOS to you

[kebsa]

i have had severe chronic pain for most of my adult life and i am in my 50's now. I struggled along until the mid 90's when i had surgery on an old leg inury that would supposedly fix the problem but it didn't and i went though a whole series of surgical procedures til i had a useless leg and was in constant pain. My professional life was as an RN and i was terrified of being labled as some kind of drug seeker if i went to the p ain units but eventually my right leg was amputated and i was left with low back pain and severe left knee arthritis from yrs of walking badly and just to rub salt to wounds, some phantom pain in my right leg!

i gave in and begged for a referral to a pain unit (a multidisciplinary pain unit where they have Physical therapists, OT's Pain specialist, orthopedists, psychologists and psychiatrists) it was not an easy process, in fact quite confronting at times as chronic pain is usually hand in hand with some degree of depression- they need to find out if the depression was in issue before the pain or if the depression is a result of it, then they need to gradually pull apart the diffiernt components of the pain and even some of the ways we have tried to cope with it. MOst will also include a pain course to teach you better ways to manage your pain and how some of the things that seem common sense ways to get you through may in the long run make things worse with chronic pain- they teach pacing, distraction, relaxation, etc and then the others will be working out the best treatment options for you but one of the big things with chronic pain is that it is not likely that it will be "cured", so it becomes how to manage it and hw to live with it.

if you google the chronic pain toolkit you will some of the stuff i am speaking of

i eventually had a medication pump similar to what some MS 'ers use for BAclofen and it gives low dose morphine and clonidine directly to the intrathecal route (spinal), i also take Lyrica which is similar to neurontin- it was a newer drug in the same class and meant to be more effective for some (both are anti convulsants) at one stage i as on avaza which is an antidepressant but also used to help with chronic pain by altering seratonin levels. Initally when i had my pump i had gotten back to near full time work and the pain was just in the background, a non issue after many yrs. but then i was diagnosed with MS, had had some pain definately related to the MS, the MS also affected my remaining leg and i fell while doing a transfer from ,y wheelchair in the bathroom- i landed hard on my tail and fractured 3 lumbar vertabrae- thats complicated things. yes i have nerve impingement and buling discs, spinal stenosis but also osteoporosis after being non weight bearing for years- i am not a good candidate for surgery for a number of reasons and there is no guarantee that surgery would fix the pain- it doesn't alway. so the pain unit is where i am stil looking to for answers.

narcotic meds are not the bad boys, as long as the people managing your care know what they are doing and evaluate you correctly then re evaluate. but it is not the magic bullet, it will sometimes take a cocktails of a few but also a lot of work from the patient. the sad thing is basic medical training does not train our medical professionals about chronic pain. it generally speaks about it being a symptoms of something that can be fixed, then pain stops, or terminal conditions where its something to be managed til the end. not the place where milions live where is chronic, intractable pain to the point where changes occur within the nervous system so that the pain can continue (central nervous system windup)- the only place you will be sure to find medicos who really understand this horrible problem is at a pain clinic- So for me now, pain is just another chronic pain problem that plays up at times but otherwise gets managed and controlled

get to a pain clinic!!

[mjan]

See Jan? So many people, not only read your posts, but are helped and soothed by them. KUDOS to you

Thanks my dear one~

[Strhuntrss]

Gabapentin

Fishead,

I too was put on Gabapentin (generic for Neurontin) two years ago. I started out with 100mg.

My MS/Neuro told me he starts patients out with a low dose. Titers up as needed. That way the body can take it slow with less side effects.

Fast forward to today ... I am now off of Gabapentin because I was up to 300mg x 6 a day, 2 capsules every six hours (1800mg a day).

Each time the new dosage would work and then with the passing of time it didn't work. I couldn't take the nerve pain and RLS anymore.

I would call the ms/neuro and he would up my dosage. When I got to 1800mg a day, I told him no more. If it is not working steadily by now, it never will. He then wanted to put me on Lyrica or Miraplex.

My gut was telling oh know not again, more of the same.

I, like mjan, have found that chiropractic has helped me through the bad days when the meds are not giving me relief (I have ortho issues too, I'm old, lol).

My old chiropractor had cracked me face down with the use of an adjustable table. I have issues with osteoarthritis in my neck, L4, L5 and S1 areas and I have severe
RLS (restless leg syndrome) in both my legs.

I now found a chiropractor that is also a wellness center. I told him about my concerns with the increased dosage of Gabapentin(1800mg a day) and the increase of swelling and not sleeping.

He cringed, and then said how about asking your ms/neuro if he could wean you off of the gaba and that if he is ok with an herbal supplement.

I talked with my ms/neuro and he said give it a try. We weaned me off the gaba and I started taking the herbal supplement.

WOW, what a difference! I am noticing in the past month, the RLS is lessening and I am sleeping soooo much better and sounder.

There are nights that I forget to take the supplement and I am able to sleep like a baby. I am back to getting my 8 hours sleep.

But I do try and go to bed at the same time every night.

This chiropractor and his way of adjusting me is working for now. I almost feel like a new person.

He also has me stretching and doing various exercises for my spasticity. I have to do them everyday. He knows when you haven't, lol.

I got tired of the same old way of treating me from my drs.
The old ones just gave me another pill and sent me out the door.

Now that I am living here in the country, I am getting a new set of eyes with my old physical problems.

I know I have to come to terms with having RRMS, but I do not have to let it take me.

The new chiropractor said the first day I talked with him was ..."A symptom is the answer, and you have to know what the right question is".

In saying that ... he said, "you don't always have to live with the answer if it doesn't help you. With MS and other autoimmune diseases .. there are always other answers. You just have to find the one that works best for YOU!

Also, he explains to me each time he gives me a new exercise, in how and why it is helping my body. I look on- line and low and behold he is right.

So, I will update you in three months and see how it goes.

Don't ever give up! You know your body more than anyone. If something is not right even after treatment find someone else to help you. They are out there and I found mine.

And for me .... GOD is always in my equation, without him, I am nothing!

[DianeD]

Horizant

My neuro has just given me Horizant (gabapentin/enacarbil) 600 mg., extended release tablets. I have an itch problem, no rash, localized in right foot. I've been to three docs regarding ther itchj, which is intense. There simply is no other explanation, except nerve damage. My neuro says the itch process is similar to pain experienced with nerve damage.

All I can say is it is worse at night. Probably because I'm tired. I can't sleep, scratching, itch relief cremes, lotions and sprays, do nothing. So...I have to resort to meds, which I hate taking.

I am concerned about taking the Gabapentin. A lot of medications cause dry mouth as well as dizziness.

Has anyone taken the Horizant? Just wondering what you experienced. This is tough.

Diane

[fishead]

kebsa,

Your post was VERY VERY helpful!!! Thank you for the information (I too, am/was an RN and understand the back issue, though not to the extent of problems you have). I have the number for a "pain clinic doctor" and need to get off my bottom and CALL and make an appointment. Not sure WHY, all of a sudden, I am afraid of doing it. I think it may be from what I had said in an earlier post=being frightened that they, too, will "punt" my pain as being "drug seeking (I am NOT, I went off all my narcs to prove I wasn't "drug seeking"). I am paying for it now...sometimes my pain is pretty bad. My Gabapentin does seem to help some, though!

[fishead]

Strhuntress,

Thank you for your input!!! It is good to hear that a chiro is,indeed, helping you!! I TRUSTED mjan, but it is always good to hear from others!

[fishead]

All I can say is it is worse at night. Probably because I'm tired. I can't sleep, scratching, itch relief cremes, lotions and sprays, do nothing. So...I have to resort to meds, which I hate taking.

I am concerned about taking the Gabapentin. A lot of medications cause dry mouth as well as dizziness.

Has anyone taken the Horizant? Just wondering what you experienced. This is tough.

Diane

I am sorry you are "paying" for seeking relief of pain. It does seem, that any ailment is far worse at night. I hope you can find someone who can help you!

[TerriLC]

Neurontin

Although I think this post needs to be in the "medications" section, I've been taking neurontin for nerve pain. Started with 300mg twice daily, but now I take 300mg, x3, three times daily.

[fishead]

TerriLC,

You right, I really should have posted this in "medications & treatments". My stupid brain (dang MS).