Another silly Neurontin/gabapentin thread - Social Anxiety Forum
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post #1 of 50 (permalink) Old 10-17-2006, 06:03 AM Thread Starter
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Another silly Neurontin/gabapentin thread


My psychiatrist gave me a list of medications on our last appointment that he wants me to research and consider. On the list is Lamictal, Trileptal, Depakote, and Neurontin. They're all anticonvulsants and/or mood stabilizers. I think the mood stabilizer property is what my psychiatrist is looking for. I've heard Lamictal is good at that, but it's a little pricey. The same goes for Trileptal. I've read that Depakote makes people nauseous and has some of the other unpleasant effects of the valproates, so I don't particularly want to delve into all that.

So that leaves me with Neurontin. It is the only one available in generic form (which is a plus), but from some of the threads I've read here at SAS, it sucks and is worthless (though, a very few people seem to have had success with it). Who here is or has taken it? What were your experiences with it like? I've read that it is good for all sorts of things, from pain management to anxiety relief to mood stablization. Is that true? From what I've gathered, it's not actually metabolized by the body, so how does it have any effect whatsoever?

(Neurontin's younger brother, Lyrica, interests me, but it too is a bit pricey.)

Any information you can give about Neurontin will be appreciated. Thanks!

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #2 of 50 (permalink) Old 10-17-2006, 07:10 AM
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It helped me sleep a little when I first started it but thats all I can say because other than that I couldn't even tell I was taking it.
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post #3 of 50 (permalink) Old 10-17-2006, 08:40 PM
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Make pubmed your friend.

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post #4 of 50 (permalink) Old 10-18-2006, 05:57 AM Thread Starter
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PubMed is nice and all, but I'd rather read personal accounts before I read case studies.

So with that said...Keep the replies coming, people!

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #5 of 50 (permalink) Old 10-18-2006, 09:49 AM
 
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I've never taken it, but my dad used to.

He used to call it Neu-ROTTEN because all it did was eat money.
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post #6 of 50 (permalink) Old 10-18-2006, 12:59 PM
 
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The thing that gets me about this drug is that it is not metabolized. Drug goes in one end and comes out the other unmodified. So for those it does work on, how in the hell does it actually work? There are studies showing it's effectiveness as an anticonvulsant and analgesic, as well as it's well known sedative effects, but no one knows how it actually gets anywhere in the body.

Thankfully, it does help my insomnia and with my insurance coverage it's a minimal cost per month, but I sure would like to know what it actually does.
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post #7 of 50 (permalink) Old 10-19-2006, 02:35 PM
 
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It looks like it is going to get approval for SA. It is in like phase III trials.
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post #8 of 50 (permalink) Old 10-19-2006, 10:22 PM
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Quote:
Originally Posted by Pistachio
The thing that gets me about this drug is that it is not metabolized. Drug goes in one end and comes out the other unmodified. So for those it does work on, how in the hell does it actually work? There are studies showing it's effectiveness as an anticonvulsant and analgesic, as well as it's well known sedative effects, but no one knows how it actually gets anywhere in the body.

Thankfully, it does help my insomnia and with my insurance coverage it's a minimal cost per month, but I sure would like to know what it actually does.
It is a sort of amino acid. It is absorbed in the gut. It just isnt' filtered by the liver or kidneys... it either goes through the BBB or it gets peed out. I think. Does someone know more? (Please say yes.)

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #9 of 50 (permalink) Old 10-20-2006, 05:58 AM Thread Starter
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Maybe we should look into how Lyrica works in order to take a guess at how Neurontin works. I assume more is known about Lyrica and its method of action since it's a scheduled substance. I'm probably wrong, though.

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #10 of 50 (permalink) Old 10-20-2006, 04:43 PM
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Quote:
Originally Posted by korey
PubMed is nice and all, but I'd rather read personal accounts before I read case studies.
Your original question was in regards to efficacy. Efficacy is something that is established through empirical study, not anecdotes.

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #11 of 50 (permalink) Old 10-21-2006, 05:32 AM
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Quote:
Originally Posted by Caedmon
Efficacy is something that is established through empirical study, not anecdotes.
Paxil has empirical studies that the FDA found impressive enough to approve it for treatment of SA. Xanax lacks so much study and lacks FDA approval for SA. Which works better for most people?

Asking real people in the real world what works means a bit more to me than what some study done in fantasy land says.
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post #12 of 50 (permalink) Old 10-22-2006, 11:03 PM
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http://en.wikipedia.org/wiki/Anecdotal_evidence

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post #13 of 50 (permalink) Old 10-23-2006, 06:18 AM Thread Starter
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Blah, I can make my own thread if I want ::tries to dance but collapses from being sleepy::

From what I've gathered by reading posts on SAS along with some stuff on PubMed, Neurontin's effectiveness is mainly individual. For some, it helps with a whole list of things, but for others, it does absolutely nothing. There are probably more of the latter, though.

I guess I'll just have to try it out for myself. Hopefully my psychiatrist will be able to tell me how it works in greater detail.

Feel free to continue replying to my original post, though. I do like to read about others' experiences with medications, both anecdotally and empirically (but anecdotally is just easier. Those case studies can be hard to interpret sometimes )

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #14 of 50 (permalink) Old 10-24-2006, 03:38 PM Thread Starter
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Are there any other GABA analogs that have mood stabilization properties (hopefully some that actually get metabolized )?

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #15 of 50 (permalink) Old 10-24-2006, 08:07 PM
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Depakote & its cousins.

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My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #16 of 50 (permalink) Old 10-24-2006, 10:59 PM Thread Starter
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What about primidone, phenytoin, topiramate, etc? I've also read about baclofen, a GABA analog that is used as a muscle relaxant. I wonder if it has any mood stabilization effects...

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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post #17 of 50 (permalink) Old 10-25-2006, 11:21 AM
 
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From : http://www.mcmanweb.com/article-236.htm
Quote:
Glutamate and GABA represent the yin-yang of the neurotransmitters, Darryle Schoepp PhD of Eli Lilly explained in a session at the 2003 American Psychiatric Association annual meeting, both present in nearly all synaptic function all over the brain, with the former acting in an excitatory capacity and the latter in an inhibitory role. The mood stabilizers are thought to act on one or the other or both.

There are two types of glutamate receptors, ionotropic (iGluR), including NMDA, kainate, and AMPA receptors; and metabotropic (mGluR), which mediate numerous chemical actions. When the NMDA receptor is working right, glutamate and glycine bind to the receptor, which opens up its corresponding ion channel and permits calcium entry into the neuron. This in turn promotes intracellular signaling essential to plasticity and survival.

Husseini Manji MD, Chief of the Laboratory of Molecular Pathophysiology at the NIMH, at the same APA session, reported what can go wrong: In response to stress and mood episodes, glutamate reuptake in the synapse is compromised, resulting in increased calcium influx through the NMDA receptors and ion channels into the neuron and the activation of certain calcium-dependent enzymes that can result in cell atrophy and death. In some patients, Dr Manji observed, their mood disorder may be fundamentally atrophic rather than symptomatic.

In an article in the May 2003 Biological Psychiatry, Dr Manji et al listed a number of experimental drugs that target the NMDA receptors. One small study found that the anesthetic, ketamine, an “NMDA receptor antagonist,” resulted in rapid improvement in depressed patients. The anticonvulsant felbamate, and a drug used in Germany to treat memory loss, memantine, are also being investigated for treating depression.

Meanwhile, over at the AMPA receptors, which are tied to MAP kinase and other processes, “AMPA receptor potentiators” (ARPs) may modulate these receptors and enhance MAP kinase activation. Several compounds are being investigated.

The mood stabilizer, Lamictal, with demonstrated efficacy for bipolar depression, is an antiglutamate agent. A drug currently on the market to treat ALS, riluzole, inhibits glutamate. A pilot study at the NIMH is underway to investigate its antidepressant effects.

GABA is formed in the brain from glutamate, glucose, and glutamine, and binds to one of two receptors on the postsynaptic neuron. GABA A receptors regulate excitability and anxiety, panic, and stress, and are the targets of benzodiazepines such as Ativan, barbiturates, and alcohol. Depressed individuals have decreased GABA in their cerebral spinal fluid and plasma.

Gerard Sanacora MD, PhD of Yale has used magnetic resonance spectroscopy to measure GABA in the brain, finding that those with melancholic depression show low GABA concentrations in the occipital cortex, while the depletion is not as pronounced for those with atypical depression, indicating a diagnostic potential for subtypes of depression (March, 2003 American Journal of Psychiatry). Before and after scans of eight patients who had ECT found a doubling of GABA, and similar scans of patients on SSRIs showed a slow rise in GABA levels in nine of 11 of them.

Julia Ross of Mood Cure fame refers to GABA as "our natural valium," and recommends it to her clients for calming down. However, as this neurotransmitter does not easily cross the blood-brain barrier, you may wind up instead with very expensive urine.
Even if it's processed in the gut, Gabapentine still has trouble crossing the blood brain barrier. As a matter of fact you might be better off working on increasing the levels of it's precursors rather than taking GABA straight.
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post #18 of 50 (permalink) Old 10-25-2006, 02:44 PM
 
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Quote:
Originally Posted by korey
What about primidone, phenytoin, topiramate, etc? I've also read about baclofen, a GABA analog that is used as a muscle relaxant. I wonder if it has any mood stabilization effects...
Those are some serious drugs there. Lots of side effects and interactions. I'd definitely get a psychs opinion on them. All of them seem to interact badly with CNS depressants (including benzos).

From Drugs.com:
Primidoneis an anti-siezure medication and interacts with a host of other medication.

Phenytoin another anti-siezure medicine with muscle relaxant and nerve pain relief components. But it also puts you at high risk of gum disease strangely enough.

Topiramate Very Increased risk of kidney stones.

Baclofen Don't take with any AD. Serious sedation may occur.

None of them appear on the controlled substances list unless by some other name. I haven't seen anything that suggests they have mood stabilization properties other than the sedative/hypnotic effect. Sorry, no personal experience with them.
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post #19 of 50 (permalink) Old 10-25-2006, 05:56 PM
 
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I don't like Neurontin


I was just taken off Neurontin because of the side effects it was having on me....iching, fuzzy headed, feeling terrible and anxiety...
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post #20 of 50 (permalink) Old 10-25-2006, 07:38 PM Thread Starter
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Well darnit

I guess I'll have to start considering the valproates again...

Rx:
Wellbutrin SR 300mg, Eskalith CR 900mg, Luvox 100mg

Things I have tried:
Lexapro, Zoloft, Celexa, Prozac, Paxil, Effexor XR, Remeron, Wellbutrin SR, Eskalith CR, Topamax, Valium, Xanax, Ativan, Ambien, Restoril, Desyrel, Ritalin, Adderall, Dexedrine, Inderal, Lopressor, Thorazine, Lamictal, Abilify, Depakote, Geodon, Seroquel, doxepin, chloral hydrate
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