I wasn’t looking for advice - there is some specific (as I understand it) mechanism by which these drugs work - they block this, replace that, etc.
This is not an opinion, it is a bio-chemical reaction of some sort.
It’s the “catch-all but do-nothing” medicine they give when they don’t really know what to do. It’s a mainstay for spinal cord injury patients. I was given it after my injury and I still have absolutely no idea why. It did ABSOLUTELY NOTHING except make me gain weight.
I was given it for neuropathy due to radiation treatments, and it has made a world of difference. A new doctor suggested I try it after I was telling him my arm hurt, thirty years or so after the radiation, and he suggested I try it. For me it’s been wonderful, and I haven’t noticed any side effects.
Gabapentin was developed as an anticonculsant. It is used for neuropathies- especially in diabetes, post shingles pain, and central neuropathic pain. Off label uses are quite common and also commonly less successful. I believe that since its pain management action is unclear/unknown, that its use may or may not help. If it is the wrong brain chemical (you don’t need more GABA) then it’s not likely to work.
There are other neurotransmitters that might help. Some of the older less popular (and way less expensive) drugs like nortriptyline used at bedtime can help. Dry mouth is easier to tolerate than sleeping for three days ;).
So, I take it that the use of Gabapentin as a substitute for an analgesic is off, off label, and continued use absent obvious improvement (original prescription called for:
1st week: 300 mg / day
2nd week: 600 mg / day
etc) is contra-indicated.Well. at least this off-off label is known outside a single practice.
I had heard of the re-class hydrocodone previously, was a bit surprised it actually got traction this time.
At least I’m in CA - may give marijuana a shot. Unfortunately, I have a roomie (I’m also poor) who I do not trust near “fun” drugs.
Pills do not emit a distinctive smell.
Oh well, for a few years there, I was free of physical pain. Should have known that would not have been allowed to last.
It was heavily marketed and pushed by Parke-Davis as a good medication for pain. Totally off-label.
Neurontin for everything! (Link takes you to the New England Journal of Medicine – a history of the off-label use and corporate push for it to be sold that way.)
My mother in law responded well to pregabilin brand name Lyrica, she was RXed it for shingles pain but it also improved her mental functioning(she had had a stroke but it was not detected at the time). My wife said it was pretty dramatic improvement, but quickly tapered off as she gained a tolerance.
(Pregabilin is a slightly modified version of gabapentin AKA Neurontin).
I had it prescribed about 10 years ago for pain relating to a pinched sciatic nerve. It was utterly and completely useless for that purpose. It provided no relief at all.
Starting to smell like a marketing push which found a product - right down to titrating dosage (my original script).
Of all the hassles I’ve had with analgesics (they don’t work*), I find it interesting that the only time I’ve heard of this stuff is when the good doc didn’t want to prescribe an opiate - never as a first course of treatment.
from age 16 (orthdontics/root canals) and 21 (emergency appendectomy), I found exactly 2 analgesics which worked - Vicoden and Demerol.
At least with the CKD, I no longer need to fight the “just use NSAID’s” bullshit
For those who had the stuff work: would it kill pre-existing pain, or did it simply prevent a new round of pain?
I’m getting the idea I’m supposed to take one of the opiates to kill pain, and then take the Gabapentin with the shut-down cocktail to prevent re-occurrence during sleep.
Found this quote from the NEJM:
Executive to new hire:
"We can’t wait for [physicians] to ask, we need [to] get out there and tell them up front. Dinner programs, CME programs, consultantships all work great but don’t forget the one-on-one. That’s where we need to be, holding their hand and whispering in their ear, Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything… I don’t want to hear that safety crap either, have you tried Neurontin, every one of you should take one just to see there is nothing, it’s a great drug.”
Love the part of “don’t want to hear that safety crap either”.
You know you’ve got a great drug when you’re telling your marketing people to ignore “safety crap”.
Gabapentin can be a bad drug. In some people it casuses personality changes, like lack of impulse control, anger, depression.
Some doc gave it to my husband a few years ago to help with smoking cessation*. Not only did it not work for that, it made aa mild, sweet person into a raging lunatic.
*He did eventually quit successfully and has been smoke free for 7 years. He did it with councelling, no drugs.
I’ve had the complete opposite experience. I had it prescribed for the same thing, pinched sciatic nerve due to stenosis/arthritis in the spine. It’s been a miracle. I went from not being able to walk more than 15 feet without severe pain to an almost normal existence. It did take a few months to build up to the level where it was effective. Maybe you didn’t take it long enough? It’s not a painkiller per se; as my neurologist explained it in layman’s terms, it seems to “quiet” the nerve.
Any ideas why I get it only when the MD doesn’t want to prescribe an opiate?
If it is such a wonderful drug, why isn’t it the first drug prescribed, not the “can’t/won’t dole out a real drug, but maybe try this” basis I’m getting it for?
Sure, it’s going to be beneficial for some people. A great many people, even. But the way the medication has been improperly dispersed throughout the patient community is what is appalling. It’s the “IBS” of prescription drugs.