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Gabapentin side effects


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Since starting Gabapentin I'm experiencing pain pretty much everywhere from really tight achey calfs to bone and joint pain. Absolutely everything aches. I rang my GP who just said that as its also used as a painkiller it wouldn't be the meds. A little googling and I've found that joint pain is possible but has anyone experienced bone pain? I know usually most side effects die down after you've been on a drug a while but so far I feel like they are increasing. For anyone taking Gabapentin did your side effects lesson after a while? I'm taking it for epilepsy and have now started to skip doses (stupid I know). I can't get hold of my neuro and my gp is less then helpful. 

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They lessened somewhat. Used to make me extremely itchy where I'd have to take a first gen anti-histamine an hour in advance before I took it, otherwise i'd break out/itch.

Now i'm at 4x the original 200mg dose and can get away with a single OTC zyrtec 10 mg pill that I can take with the gabapentin, instead of having to take it prior. For me the analgesic effects started at about 300mg/day, however didn't really become extremely effective until 800mg/day.

I've been on gabapentin for about 11 months right now (not consecutive. there was a 2 month stop from march to may of 2018)

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8 hours ago, argh said:

They lessened somewhat. Used to make me extremely itchy where I'd have to take a first gen anti-histamine an hour in advance before I took it, otherwise i'd break out/itch.

I wonder why you take an old 1 gen antihistamine ? Zyrtec is the drug of choice for hives, itchy skin, ect. In a few people Zyrtec passes the BBB, so it can make you tired. The majority find this a no drowsy option. 

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1 hour ago, notloki said:

I wonder why you take an old 1 gen antihistamine ? Zyrtec is the drug of choice for hives, itchy skin, ect. In a few people Zyrtec passes the BBB, so it can make you tired. The majority find this a no drowsy option. 

Only because the 2nd gens didn't initially work. Zyrtec was basically a sugar pill. Initially hydroxyzine was the only thing that would help...well Remeron did as well since it's  a super crazy H1 antagonist as well as an AD.

Believe you me, the last thing I want to be on is an anticholenergic.

Edited by argh
speeling / grammer
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Zyrtec is an analogue of hydroxyzine, about as close as you can get to being the same thing. To put it another way, Cetirizine contains L- and D-stereoisomers. Chemically, levocetirizine is the active L-enantiomer of cetirizine. The drug is a member of the diphenylmethyl piperazine group of antihistamines. Analogues include cyclizine and hydroxyzine.

Edited by notloki
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7 hours ago, notloki said:

Zyrtec is an analogue of hydroxyzine, about as close as you can get to being the same thing. To put it another way, Cetirizine contains L- and D-stereoisomers. Chemically, levocetirizine is the active L-enantiomer of cetirizine. The drug is a member of the diphenylmethyl piperazine group of antihistamines. Analogues include cyclizine and hydroxyzine.

This pretty much was trial and error over a few nights. They might be structurally similar but at least for me, no 2nd gen has the raw punching power of a 1st gen.

Night 1: Had rash/itch. Took 10 mg of zyrtec. Nada. Ended up falling asleep about 4 hrs later due to exhaustion

Night 2: Had rash/itch. Took 20 mg of zyrtec. Still nada. Sleep due to exhaustion hrs later

Night 3: Same as above, Took 30 mg of zyrtec. Still nothing.

Night 3: Rash/itch..well fuck this shit..took 25 mg of hydroxyzine. Knocked it out in about 30 minutes.

Night 4: Took 10 mg of zyrtec at the same time as gabapentin. Nada, still broke out/itched

Night 5: Same as above with 20mg of zyrtec

Night 6:  Fuck this shit, need sleep. Took 25mg of hydroxyzine at the same time as the gabapentin. No rash/no itch

Night 7: Took zyrtec 10 mg 1 hr before gabapentin...rash/itch was back. Well shit.

Cool..

then pdoc took me off of it due to risk of SJS or anaphylaxic shock. Went on Remerom.

2 months later..ok Remeron is horrible, gabapentin was great for my mood...pls doc I promise i'll try to not die from this.

Night 1: Started at a lower gabapentin dose of 200 mg (I had ended prior at 600mg). Ok cool

Night 2: 300 mg...mildly itchy but not too bad

Night 3: 400 mg..a bit itchier but not as bad as 400 prior..ok interesting

Night 4: 400mg but took a zyrtec 1 hr earlier...get those H1 receptors marinated..less itchy than without but bearable.

...did that for about a month or so. Noticed that I got less and less itchy so long as I took the zyrtec 1 hr before.

Then tried taking zyrtec at the same time as I eventually got to no itch. Worked just fine.

been doing that ever since.

 

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1 hour ago, notloki said:

Millions take this drug with success. Your one little experience is not very significant.They are analogues...not structurally "similar". They are mirror images of each other.

Fair. You asked why I took a first gen, and I answered.

My entire point is that it was useless at first for me, however as I got more acclimated to gapabentin, it now has enough punch to take care of it...so to the OP,  yes, at least for me, the side effects lessened in severity over time.

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On 1/3/2019 at 4:17 PM, argh said:

They lessened somewhat. Used to make me extremely itchy where I'd have to take a first gen anti-histamine an hour in advance before I took it, otherwise i'd break out/itch.

Now i'm at 4x the original 200mg dose and can get away with a single OTC zyrtec 10 mg pill that I can take with the gabapentin, instead of having to take it prior. For me the analgesic effects started at about 300mg/day, however didn't really become extremely effective until 800mg/day.

I've been on gabapentin for about 11 months right now (not consecutive. there was a 2 month stop from march to may of 2018)

I'm glad they lessened. I'm a zombie that hurts all over atm. 

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So far its not helped at all. Just made me so sleepy. I've been trying to get hold of my neurologist but my next appointment is months away. He picked Gabapentin as he didn't want to prescribe an antidepressant and said this may help with my mood as well as the seizures.  I know he retires this year so I'm not sure if I should just wait and see what the next neurologist is like and see if they are a bit more helpful.  I'm not under any mental health service so kind of buggered when it comes to getting any help. 

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2 minutes ago, Raspberry said:

So far its not helped at all. Just made me so sleepy. I've been trying to get hold of my neurologist but my next appointment is months away. He picked Gabapentin as he didn't want to prescribe an antidepressant and said this may help with my mood as well as the seizures.  I know he retires this year so I'm not sure if I should just wait and see what the next neurologist is like and see if they are a bit more helpful.  I'm not under any mental health service so kind of buggered when it comes to getting any help. 

Have you tried lamictal? It’s been well studied for mood, particularly depression. Granted that the research has been mostly bipolar depression, not unipolar, but it might be worth a shot. It does treat a different type of seizure vs gabapentin so I’m not sure if it will help you there.

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29 minutes ago, argh said:

Beyond the side effects, does the gabapentin help with either mood or seizures? If so a possible switch to lyrica may help, as it’s related to gabapentin.

"pregabalin, which boasts a greater than 90% bioavailability across a dosage range from 75 mg to 900 mg daily in divided doses." Gabapentin has 80 % which falls to 27% if you dose it every 1600mg every 8 hours.

"Gabapentin is more slowly and variably absorbed, with peak plasma concentrations around 3 hours post-dose. Pregabalin is quickly absorbed, with the maximum rate of absorption being 3 times that of gabapentin. It reaches peak blood concentrations within an hour after ingestion.

"Finally, food increases the AUC of gabapentin by about 10%, with no change in time to maximum concentration (tmax). In contrast, the AUC of pregabalin is unaffected by food, though absorption is slower"

https://www.pharmacytimes.com/contributor/jeffrey-fudin/2015/09/how-gabapentin-differs-from-pregabalin

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47 minutes ago, argh said:

Have you tried lamictal? It’s been well studied for mood, particularly depression. Granted that the research has been mostly bipolar depression, not unipolar, but it might be worth a shot. It does treat a different type of seizure vs gabapentin so I’m not sure if it will help you there.

Lamictal is my main epilepsy med. The biggest problem I have is that my GP is reluctant to prescribe me meds for any psychiatric condition due to drug interactions increasing seizures and a previous overdose. My 10 minute appointments with a neuro every 6 months get me nowhere. I don't have much say in what is prescribed which I hate, I feel like I don't have any say or control in my mental and physical health conditions. I can't afford to see a neuro or psychiatrist privately either. I don't understand all the actually pharmacology stuff about the meds. I see a few people post here with how meds work and I google obsessively but I really don't get it. Feel lost about what to do. 

Also another fun little side effect of the gabapentin is it is making it really difficult to wee! 

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1 hour ago, Raspberry said:

 

Lamictal is my main epilepsy med. The biggest problem I have is that my GP is reluctant to prescribe me meds for any psychiatric condition due to drug interactions increasing seizures and a previous overdose. My 10 minute appointments with a neuro every 6 months get me nowhere. I don't have much say in what is prescribed which I hate, I feel like I don't have any say or control in my mental and physical health conditions. I can't afford to see a neuro or psychiatrist privately either. I don't understand all the actually pharmacology stuff about the meds. I see a few people post here with how meds work and I google obsessively but I really don't get it. Feel lost about what to do. 

Also another fun little side effect of the gabapentin is it is making it really difficult to wee! 

Weeing is definitely important

So it seems that your options given your GP being gun shy and no psych puts you in a situation where you can get elliptic med with hopefully mood improving capabilities. Would that be fair to say?

Given that, here in the US there are a few other anticonvulsants which can impact mood. Some are FDA approved, some not for the indication of mood disorders, as the FDA approval process is lengthy and expensive. Medications which have gone generic will never get FDA approval for specific conditions despite studies and clinical wisdom into their respective efficacy, as there's no money in it.

Per my pdoc, most of them stabilize from the top (i.e. quashes mania or mixed episodes. possibly anxiety) where one stabilizes from the bottom (depression slant..which is lamictal). That is not to say that stabilizing from the top will not help depression, as some of the other folks like jt07 have MDD but is helped greatly by carbamazepine.

Starting with FDA approved:

1. carbamazepine (FDA approved) and oxcarbazapine (by proxy as it is a structural derivative of carbamazapine, as it adds an oxygen atom to carbamazepine)

These two stabilize from the top. To note however, if you are of Asian descent and carry the HLA-B*1502 allele, there is an increased risk of SJS, TENS and other cutaneous issues.

Another thing to note is that carbamazepine can reduce your levels of lamictal as it is a CYP450 inducer. As that is your main medication for seizures, that may be risky. However as carbamazepine is an anticonvulsant, perhaps it might pick up the slack?

oxcarbazapine is said in some circles to be less potent than carbamazepine, however it does come with the benefit of less potential side effects such as potential liver issues, and no blood tests required.

2. valproate (valproic acid, divalproex sodium) is another option. It also stabilizes from the top. It, however, if the dose is too high can actually cause depression. It also increases the risk of PCOS.

Unapproved:

I'm sure there are way more possibilities like zonegran and leviracetam which I have admittedly not looked into.

1. Topamax. The biggest potential issue is cognitive, hence the nickname of "dopamax". That aside, it can in some cases improve mood. My former pdoc presented it as one of the possibilities for my case. It can also cause weight loss; not sure if that's a problem for you or not.

Admittedly, I am of the belief that there is a mood spectrum and in terms of kool-aid I follow the works of of those like Ghaemi, Akiskal, Aiken, Phelps. Much of what I've read comes off of scholarly articles via scholar.google.com and mainly books/sites that Phelps has wrote. At the very least, what Phelps describes as not quite bipolar but not quite pure MDD/unipolar describes my condition quite closely. Yes there may be some projection going on in this post, so as always, I'm not a doc, YMMV. I might be full of shit.

This might all be bollocks to you and the references have been written by a bunch of numpties :)

For more of a lay person read into this not quite pure MDD, but not quite bipolar, here is the site that I generally reference (I have also read the books too)

http://psycheducation.org/

He does go over mood stabilizers which include some of the anticonvulsants

General page

http://psycheducation.org/treatment/mood-stabilizers/

Topamax

http://psycheducation.org/treatment/mood-stabilizers/topiramate-topomax/

Tiagabine

http://psycheducation.org/treatment/mood-stabilizers/tiagabine-gabatril/

Carbamazepine

http://psycheducation.org/treatment/mood-stabilizers/carbamazepine/

Oxcarbazapine

http://psycheducation.org/treatment/mood-stabilizers/carbamazepine/oxcarbazepine/

Valproate

http://psycheducation.org/treatment/mood-stabilizers/valproatedivalproex-divalproex/

 

 

 

 

 

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