Short version of the story: After having minor-ish back surgery a year ago, the severe nerve pain made a sudden reappearance a month ago following a cross-country flight. While we wait for the MRI results (and I’m off work, boo! yes, I actually like–love–my work), the doc prescribed me neurontin/gabapentin.
When I read the descriptor sheet that came with it, I thought I’d been given the wrong meds. It says it’s an anticonvulsant used to treat seizures associated with epilepsy. Whaaaaa? Then I read the next sentence: “It may also be used in adults to treat nerve pain…” Oh, okay, I think. Then I keep reading. “…following a herpes zoster infection.” I repeat: Whaaaaaa?
I was told it was to “calm the nerves” as my sacral nerve root (root of the sciatic) is likely all pissed off AGAIN by something the L5/S1 and/or L4/L5 said. But reading about this drug and its drowsy side effects (plus the sheer number of pills the doc wants me to take each day) has me spooked. I haven’t taken a single pill.
Of course, there’s the highly unlikely, but not impossible, chance I’m pregnant, so I don’t want to start anything like that until it’s definitive (taking test in a day or so). In all the stress of traveling/back going out/in pain, I missed some BC pills…and apparently, some of the meds I’ve been on interfere with the BC pill. Oops.
Anyway–help the drug-shy gal understand why I was given an anti-convulsant. I assume it has to do with the whole neurological thing. I’m curious about the mechanisms behind it.
Generic: Gabapentin, nongeneric: Neurontin. It’s in the OP, at the end of the second sentence. I swear I didn’t leave that out, if neglecting to capitalize it.
My original prescription was for Lyrica, but the insurance wouldn’t cover it.
Many drugs have applications beyond the original use. Aspirin can be used by heart patients to thin blood to prevent heart attacks, for example. Viagra was originally used to treat pulmonary hypertension. Gabapentin/Neurontin is one of these. It relieves pain in addition to helping epilepsy.
One of its uses is to manage neuropathic pain, also called neuropathy. Effectively, the nerves are creating their own pain signals, and the gabapentin helps to stop that little vicious cycle.
Sometimes, tricyclic antidepressants (an oldie but goodie class of meds) are used for similar purposes in pain management.
The mode of action is not fully known, but gabapentin was designed to mimic GABA, a neuotransmitter. It’s believed to influence one or more calcium ion channels. It’s obvious that such a drug will affect a wide variety of nerve functions, and generally a drug is only tested and approved for one of these (gabapentin has two labeled indications). 90% of gabapentin prescriptions are off-label, as it’s been used to treat epilepsy and other seizures, migraines, postherpetic and post-operative neuropathy, nystagmus, bipolar disorder, anxiety, OCD, depression, insomnia, drug addiction, tinnitus, and hot flashes.
My dad’s been using that for a few months because of some severe nerve damage to his left hand from a fall down the steps. He tells me that he’s still in the most pain that he’s ever been in his life (this from a man with a painful and permanently debilitating disability). But the Neurontin has helped a LOT.
Generally, the precise mechanisms of action of anti-seizure meds for pain relief is unknown. Regardless, they can be quite effective. This is especially the case for pain that develops as a result of nerve damage (neuropathy).
I was on this for several months, along with spinal surgery, to help with a very bad disk herniation crushing my sciatic nerve root. It helped a great deal. I highly recommend it, unless there’s some problem with pregnancy. Highly, highly, highly.
My Dr said gabapentin reduces spurious nerve activity, that is, nerve activity that is not in response to stimulation of the end area the nerve is supposed to serve. So, what the patient feels as leg or foot pain, but is caused by crushing stimulation at the root, goes away or reduces with gabapentin. Similar to other posts.
I’m trying to imagine this. “So I saw C3 hanging out with the coccyx yesterday, and I was all like, YOU DID NOT! not after what L3 said to you, you bitch!”
The question asked in the OP is exactly what pharmacists are for. They don’t just dispense the pills - they know the purpose of the pills and the potential interaction between different drugs. Why not talk to your pharmacist about the purpose of the anti-convulsant pills and whether there is any chance of interference with your birth control pills?
I take another anti-convulsant (topamax) for off label purposes. It affects depression and compulsive eating. An unexpected side effect has been that I’ve also quit smoking and compulsive shopping and saved up money. Amazing! I also sleep a lot.
Mrs. Fear is taking neurontin for neuropathic pain caused by spinal stenosis. Seems to help, and the side effects (woozy and disoriented) disappeared after only a few days.
