From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Any information on Neurontin
Date: 7 Mar 1998 00:56:16 GMT

In <6dpf4l$m85$1@owl.slip.net> adavis@slip.net writes:

>Please help!
>
>I need information on Neurontin. My girlfriends' doctor prescribed the so
>called "miracle drug," and it has ruined our lives.
>
>He promised that there were no side effects, yet could not provide any
>information (i.e. pamphlets, etc.) on this. I stated that I did not want
>anymore experimental drugs, yet he continued, disregarding my opposition.
>Since she first took them, she has not been the same. She has since
>discontinued taking them, yet she is still not herself. She drifts off
>into space and looses all touch with reality.
>
>He also stated that it would relieve her shaking and tremors, but it only
>seem to increase them. I am at my wits end, and I am about to loose my
>mind over this predicatment.
>
>Please, if anyone can give me any information, or are currently on this
>medication, please let me know if you have any side effects, or any
>adverse reactions, or just some simple information.
>
>All comments will be appreciated. Thank You.



   Neurontin's major side effect is sleepiness and generally decreased
mental acuity.  It's rather like alcohol that way.  It has a very short
half-life, however, and if you quite taking it, it's gone in a few
hours in most people, and overnight in almost everyone.  Rarely do you
see effects more than 2 days, even in the most frail geriatric
patients.  As for "ruining people's lives" I'm afraid you're barking up
the wrong tree on that.

   My sympathies to your girlfriend's doctor, who sounds like he has
two patients, one of whom is psychiatric.  My response to people who
have lots of tales to tell about drug effects lasting for weeks and
months, and ruining their lives, is to head in the opposite direction
as fast as I can, leaving directions to the nearest homopath.  Such
people might as well have stamped on their foreheads: "Lawsuit waiting
to happen."  I certainly wouldn't write them a prescription for
*anything.*

                                      Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.pharmacy,sci.med
Subject: Re: Usual dose of Neurotin (gabapentin) for chronic pain relief
Date: 4 May 1999 09:10:49 GMT

In <7gm6d2$iph$1@nnrp1.dejanews.com> neutrino@annex.com writes:
>
>In article <7gc1th$si3@dfw-ixnews8.ix.netcom.com>,
>  sbharris@ix.netcom.com(Steven B. Harris) wrote:
>> In <372b34b5.40053757@news.annex.com> neutrino@annex.com (Daniel
>> Prince) writes:
>
>>>When Neurotin (gabapentin) is used for chronic pain relief what is the
>>>usual starting dose?  If that dose doesn't provide the desired pain
>>>relief, how soon is the dosage increased and by how much?  What is the
>>>usual maximum dose of Neurotin when it is used for the relief of
>>>chronic pain?  Thank you in advance for all replies.
>>
>>
>>   Older people have to start at 100 mg at bedtime, but younger ones
>>can start at 300.  You then take 100 mg with meals and 300 at bedtime,
>>increasing by 100 mg at a time until you get to 2400 mg a day without
>>too much sleepiness.  The 100 mg caps are expensive, so change to 300 or
>>400 as soon as you can get to those doses.  If it works very well at
>>some dose, you can have a compounding pharmacist make up some
>>methylcelluose goo caps which last a little longer than the powdered
>>ones.
>
>I am not sure I understand this.  Is this correct for a 45 year old?
>
>Day 1    300 mg Bedtime
>
>Day 2    100 mg breakfast
>         100 mg lunch
>         100 mg dinner
>         300 mg bedtime
>
>Day 3    200 mg breakfast
>         100 mg lunch
>         100 mg dinner
>         300 mg bedtime
>
>Day 4    200 mg breakfast
>         100 mg lunch
>         200 mg dinner
>         300 mg bedtime
>
>Day 5    200 mg breakfast
>         200 mg lunch
>         200 mg dinner
>         300 mg bedtime
>
>Day 6    300 mg breakfast
>         200 mg lunch
>         200 mg dinner
>         300 mg bedtime
>
>Day 7    300 mg breakfast
>         200 mg lunch
>         300 mg dinner
>         300 mg bedtime
>
>Day 8    300 mg breakfast
>         300 mg lunch
>         300 mg dinner
>         300 mg bedtime
>
>Day 9    300 mg breakfast
>         300 mg lunch
>         300 mg dinner
>         400 mg bedtime
>
>Etc. until they get to 600 mg four times per day.
>
>
>I have been told that there is a Doctor Jay Seastrunk in Texas that uses the
>following schedule for CFS patients.
>
>NEURONTIN DOSAGE SCHEDULE
>
>Day 1   400 mg. Bedtime
>
>Day 2   400 mg. Breakfast
>        400 mg. Bedtime
>
>Day 3   400 mg. Breakfast
>        400 mg. Lunch
>        400 mg. Bedtime
>
>Day 4   400 mg. Breakfast
>        400 mg. Lunch
>        400 mg. Dinner
>        400 mg. Bedtime
>
>Day 5   400 mg. Breakfast
>        400 mg. Lunch
>        400 mg. Dinner
>        800 mg. Bedtime
>
>Day 6   400 mg. Breakfast
>        400 mg. Lunch
>        800 mg. Dinner
>        800 mg. Bedtime
>
>Day 7   400 mg. Breakfast
>        800 mg. Lunch
>        800 mg. Dinner
>        800 mg. Bedtime
>
>Day 8   800 mg. Breakfast
>        800 mg. Lunch
>        800 mg. Dinner
>        800 mg. Bedtime
>
>What do you think of his schedule?


Comment:

   I think it would have some fraction of my geriatric patients semi
comatose or at least bedbound in rapid order.  Neurontin is not very
dangerous, but as with GHB, an overdose can be quite frightening for a
few hours-- especially for those watching.  Your first scale is more
reasonable, except that I suggest you advance at that rate only until
you begin to experience sleepiness, then hold at the previous dose a
few days before starting up again.  And always keep the bedtime dose
bigger, for obvious reasons.  How much bigger?  Enough to make you
sleepy.  Max dose at a time I think around 800, but I don't have a PDR
at hand.

   And, naturally, see a pain specialist.  These guys all have their
favorite regimen for using the stuff, and can give you may other tips
besides.