Gabapentin/Neurontin The Most Common off-Label Prescription in Psychiatry
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- čas přidán 7. 06. 2024
- Gabapentin is approved by the FDA for three specific indications to prevent and control partial seizures, relieve nerve pain following shingles (post herpetic neuralgia), and to treat moderate to severe restless leg syndrome. Unfortunately, less than 1% of the prescriptions written for gabapentin are for the above listed FDA approvals. In fact, much of the off-label prescribing of gabapentin is done for the treatment of psychiatric and substance use disorders.
Time Stamps
Introduction: 00:00 to 01:12
FDA approved indication and how we got here: 01:13 to 04:10
Mechanism of Action: 04:11 to 05:11
Why the increase in off-label prescribing: 05:12 to 08:34
Gabapentin For Anxiety: 08:35 to 11:38
Gabapentin for Bipolar Disorder: 11:39 to 13:23
Gabapentin for Alcohol/cannabis use disorder: 13:24 to 18:50
Gabapentin and chronic lower back pain: 18:51 to 19:57
Adverse Effects: 19:58 to 20:18
Dosing Gabapentin: 20:19 to 21:44
Conclusion: 21:45 to 23:46
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Gabapentin was the one and only thing that made the weeping stop, the volume go down, and for me to converse again. It was life saving. I tried them ALL.
This doc is giving patchy advice. He claimed that anticonvulsant dont work for mood disorders. Anticonvulsants were completely effective for my mood disorder.
It's good to hear that you had success, it's not that there is no evidence for the use of gabapentin in anxiety disorders, it's just not great evidence and it will work for some people. I appreciate the comment
@@ShrinksInSneakers Name a psych drug that effective for all across the board. You wont find one. Everyone is wired differently.
@@ShrinksInSneakers yea I know everyone is different. Hope everyone is able to find what they need!
I just started taking Gabapentin and it drastically helps me with my cyclothymia or bipolar disorder 3rd degree, bipolar disorder without the mania and hypomania.
It definitely helps stabilize my mood. In addition it seems to fight my generalized anxiety disorder, PTSD, and depression more so than any anxiolytic or SSRI I have ever tried.
I think this might be a lifechanging drug for me and my struggles against cyclothymia, GAD, PTSD, and major depression.
I work in home health, end of life(usually pallitive) care. I had a patient with severe MS that was on a super high dose of Gabapentin for about a decade. He was wheelchair bound, non weight bearing, doc said he was beginning end stage.
He got a new Dr from the VA who weaned him off almost ALL of his meds to start pallitive and the Gabapentin was at the root of his severe increase in symptoms. He was removed from end of life care and began PT to work on walking again. One of the craziest things I've ever witnessed in my career. He was 62.
Goes to tell you how much knowledge most do not know...
Very interesting
I wish I'd known your story while my sister was still alive. Maybe she could have gotten better treatment for her MS.
I am trying to tell my friend with MS that takes 4800mg a day is not good 😳
@@jeanierailsback3327 wow that's awful. That's such an insane dose.
Gabapentin, for me, was a nightmare. Doctor prescribed it to me for C3 bone spurs. It was wonderful, and took care of the pain. After awhile, I started to forget things. Simple stuff on where I placed my keys, forgetting to pick up this and that from the grocery store. Then I went to a teller machine and forgot my pin code. The icing on the cake was when I had a doctor appointment and completely forgot where he was located, I knew there was a damn problem! Doctor had me discontinue use, weaning me off gradually. My memory went to normal quite quickly. Never again!
Good to know.
How much were you taking?
Wow that is strange. Me and husband are both on this md. I take it for restless leg syndrome, and fibromyalgia. My husband uses it for nerve pain from injury and restless leg as well. This md is very effective for fibromyalgia and nerve pain
@@kathleengivant-taylor2277 It was awful, my physician explaining that memory loss can be a side effect, but never saw a reaction to it as bad as mine. When I got home from the doctor that day, I looked up memory loss caused by gabapentin and was very surprised. All is well now and glad that it is over. Consider myself lucky.
@@skykitchen867 wow. Iam sorry too hear u went Thur that. Glad ur ok now
Hi, thank you for your great videos! Two comments: 1) In the cited article (where a screenshot is included at approximately 3:00) it says Pfizer was fined $2.3 billion for Bextra (valdecoxib), not Neurontin (gabapentin). The fine for the latter was actually $430 million, which of course is also a substantial amount. 2) In general I am a little hesitant when my psychiatrist prescribes me off-label medication, but gabapentin 800 mg three times daily has really relieved uncomfortable akathisia which I have experienced as a side effect of some of the other medications I am taking. Keep up the good work!
Guanfacine off-label to treat anxiety can be quite nice, since its direct effect is calming the "fight or flight" anxiety and panic response. It's so relatively safe that it's even a first choice for pediatric patients.
(I had bad side effects and weight gain from Gabapentin, so my doctor switched me to something else.)
Well done. I am now thinking about what I am taking Gabapentin.
I am not a doctor but I found your presentation clear and informative. Thanks.
Thanks for your great videos, doctor❤❤
I love your videos. Also, I think you’re looking at yourself instead the lens when you’re filming. I do that all the time, which is how I recognize it. Thanks for sharing your expertise!
This md really helps my fibromyalgia greatly
Gabapentin has worked unbelievably well for me. About 5 years ago, my GAD started becoming bad. I got treatment with various meds and therapy. but it still gradually got worse. Then in the later part of 2022 I went into an absolute spiral into a full-blown mental health crisis. Had to take off work and wasn't sure if I'd ever be back. I went on gabapentin 2x300mg and felt much better in a matter of days. It's been several months now and I feel better than I have in many years. I'm not even sure what my exact diagnosis is since it's sort of like GAD but with panic and my psych suspects a little bipolar. For whatever reason, this is the med that makes things okay for me. Also helps with my chronic nighttime itching so I sleep better.
You months later and it’s still doing the same things for you?
@@frdm5774 Yes, I'm still happy with gabapentin. I'd say that the main benefit is that my brain is a lot less "noisy" now. Before, I had so many random thoughts, especially when I got stressed, that I couldn't even say what I was thinking. Now if I need to do something like run an errand, I don't overthink it with so many "what ifs" that it's paralyzing. I just go do it and deal with whatever comes up. I did have a hypomanic episode recently that got pretty bad, so I need a mood stabilizer as well (Lamotrigine or Seroquel) and the gab didn't help very much. I've had no issues with tolerance or addiction. I usually take one 300mg in the morning and night and more as needed. But if I forget to take it, there's no problem.
@@frdm5774 I wrote a long reply to this but now I don't see it. Yes, it's still working great for me. My brain's a lot less "noisy" now. Before my thoughts were so random I couldn't have told you what I was ever thinking. Now I have complete thoughts. I don't overthink simple tasks with so many "what ifs'. If I need to go do something I just deal with any problem as they come up. I had suicidal ideation almost every day from age 15 until I started on gab. It hasn't once entered my head since. I still have the occasional hypomanic episode and it doesn't do much for that. I've had no issues with tolerance or addiction. I take a 300mg in the morning and usually at night and more as needed. I can skip days with no problem.
I am a new Psych NP and see gabapentin prescribed for pain all the time! I will think twice before prescribing this. Love your videos!
As always the abuse or overprescription of something ruins it for the individuals who may actually need it and whom it may really help.
Thank you appreciate the support
Please don’t let one CZcamsr decide for you. Do more research and then decide. Good points here though..
@@wendysherbert3257 I would never suggest a medication is right or wrong for anyone. as always my recommendation is each person should talk to their doctor and have a complete evaluation before making any decisions. Granted I am a board certified doctor and the goal here is to bring people evidence based information and interpretation of the literature which is often hard to understand without training. I appreciate the comment and support
Anything you prescribe can be addictive.
Gosh... people irk me with lack of COMMON SENSE.
and you're gonna be writing prescriptions.
Lol.
Great....
Very good Dr.
Excellent content!
Thank you for watching and being a part of the community
My doctor prescribed Gabapentin for pain management. Thanks for this info as I’m concerned, I’ve never taken this before.
I've been on gabapentin 4 about 5yrs, works very well 4 me.
It has helped me
Me too.
I am a psychiatrist too. I agree with most of what you say, and I understand why gabapentin is a "go to" medicine. I have found that a combination of gabapentin with baclofen works wonders in treating lower back pain but also in benzodiazepine use disorder or benzo withdrawal, or alcohol withdrawal if it is mild enough. The two pills together hit on all the different types of GABA receptors, and the baclofen is a little sedating to a patient without tolerance for it which can help with sleep disturbances associated with all forms of withdrawal. Just a thought and its a personal thing that I have tried and seems to be effective for people in mild to moderate distress. Of course in terms of alcohol or benzo detox, having a benzo like lorazepam ready, just in case is important. Sometimes I will add Keppra to the mix if I am worried about seizure.
I've been taking exactly that, gabapentin and baclofen for my four ruptured lumbar discs for about a month. Some days I find myself walking around so pain-free that I forget that I'm injured.
I am in the process of tapering off of 2 mg of Clonazepam (generic for Klonopin) I am now down to 1.5 mg a day. Do you think it would be safe for me to go down to 1 mg a day and then start taking 600 mgs of Gabapentin with some Baclofen?
@@BrianSmith-lo3mj I think that is EXACTLY the approach I would take, but not yet. You need to get lower on that dose first. Gaba and Baclofen are the 2 drugs I use the most when coming to the END of the taper and in the beginning when transitioning them from a shorter acting benzo (I.e. Xanax), to Valium or Klonopin, until they are comfortable with their equivelamt dose of the new longer acting med. Here is the thing; tapering, despite what people thing will begin to get harder as you go lower and lower.
Let me first give you the speech that I am not your doctor, nor do I know anything about you or any other conditions you may have, so this would be my standard in a healthy, normal, mam or woman below 65 and nonpregnant woman. First I get them on a long acting benzo that is the equivalent of what they were taking in the other drug. In this case clonazepam is a fairly long half-life drug, so step one is done. Now, I would prescribe 1 mg tablets (for now), because you can pretty easily break them into 4's, making 0.25 doses. If you have been at 1.5 a day for 2 weeks (without cheating at all), and you are comfortable, decrease by 0.25 and hold there for 2 weeks or until comfortable, then again. If that works out you will be at 1 mg a day. Now, I would prescribe the gabapentin. First off, I would be prescribing as much as 1,600 mg a day. (90- 400 mg capsules, up to 4 times daily as needed, for a month supply). That should make you plenty comfortable enough until you are down to 0.5 mg a day. Now, if you feel good....great, if not, I would add in the baclofen at 10 mg, Up to 3 times daily as needed. Now going from 0.5 to nothing is the most miserable and I think part of it is psychosomatic because this shit starts getting real when you realize you are going from "some drugs" to "no drugs". From 0.5, you may be able to jump down to 0.25, or you may need to start slowing down more. (For example 0.4, 0.3, 0.25, 0.20, etc.). I know this takes a long time and is frustrating but the thing to understand is if you go too fast, one bad day and you are going to say " fuck it" and take 2 mg, and that will disrupt the whole flow of the taper. So it is important to do it right. My longest patient took over 4 years, and there were a lot that were between 3 and 4. So, now, I realize you can only break a pill so small, so at some point you will need to drop to the 0.5 tablets so split 4 ways will be 0.125 mg a piece. If you must, you can even crush them, measure weight and dissolve in water and drink.
Once you are at the 0.5 stage, risk of death is over and the risk of seizures is next to nothing, but you aren't quite out yet. Once you are comfortable on 0.125 a day for 2 weeks, now you can start doing it every OTHER day if you need, then every 3rd day, or just stop at that point if you feel ready and rely only on the gabapentin and baclofen. Add in OTC stuff if necessary like benadryl, melatonin, exercise, sleep well (if you can). Do not take any Z-Drugs to sleep (Ambient, Sonata, etc), as they are virtually benzos themselves except for a tiny molecular difference. After 7-14 days free of clonazepam, now you can start coming off the baclofen first, then the gabapentin. You may feel that a little, but it will be a day at the spa compared to benzo detox. Good luck and hope this helped. One thing I can't stress enough is don't push yourself too fast (unless you have a medical reason, or you are facing imminent jail, or whatever) because it will catch up, cause a backslide or a "fuck it". NEVER REVERSE for any reason. Do it once, do it right, and put those things in the rearview mirror.
The blood pressure medication Clonidine can be quite useful at mitigating benzo or opioid withdrawals.
This class of medication (Clonidine/Guanfacine) specifically target the sympathetic nervous system (fight or flight response) to calm it, so they're gaining popularity as off-label treatments for anxiety, sleep disorders, and other issues. They're FDA approved as non-stimulant ADHD medications.
I take pregabalin I can only take it at night. Daytime use just makes me sleep. It also causes ticks. I just keep taking it in the hope it is doing something. I have Neuromuscular Scoliosis and a lot of problems involving all three levels each having a pinched nerve to start . Since I have the scoliosis I thought maybe its doing something beneficial but you couldn’t prove it by me. Thanks for all the knowledge it helps; I like to do research and listen to webinars.
Wow, this is great information. I'm a psych advance practice nurse treating children and adolescents. I've never prescribed gabapentin for my kiddos- but I have been prescribed it to grade 2 spondylolisthesis of L4 and L5 secondary to Herrington rod stabilization of a L1 fracture 35 years ago. It works ok, not fabulous. Reduced the amount of pain meds I take. But I agree it's decent but not great for pain. Would love to find something more effective.
I know that this doctor claims otherwise, but anticonvulsants cleared ALL my mood disorder issues. So they do work for mood disorders and bipolar disorder.
Thank you for sharing.I was prescribed gapapenden for Red Scalp Syndrome.Its itching/ burning of your scalp with no rash.I was also told this condition comes from my severe anxiety and ocd.I did not opt to take it because i did not like all the cons i read about it.Iam looking for a safe SSRI to take while taking the blood thinner Eliquis and iam having trouble with getting something i feel is safe.I will be seeing my cardiologist in a few weeks but i do not feel she will know enough about SSRIs to help me. I had been on Prozac over 20 yrs ago for a clinical depression and severe anxiety and it was a God scent, but now iam on this blood thinner and this is a stumbling block for me.Maybe i will have to come off my blood thinner since my BP and vitals , and lifestyle is a whole lot better.
Very good mood stabilizer for me. Actually one of the most prescribed medications
It's highly prescribed but the truth is this medication failed in randomized controlled trials to work as a mood stabilizer. It's a common misconception that the entire class of anticonvulsant medications are mood stabilizers most are not. Hope this helps
@@ShrinksInSneakers it's helped me severely with my anxiety and mood. I was capable of being off benzodiazepines.
@@benjaminharding6386better for mood, Def better than being hooked on Benzo's
My doc gave me this for nerve pain in my back. After using it I started getting intense feelings of hate for my wife and kids. I threw that shit away.
Do you have a video on lithium ? Is it good ?
another great video. i dont understand why you have such little subscribers. you are a wealth of information. can you do a video on the difference between SSRI and SNRI's? i have tried many ssris and none have "worked" i have always wanted to know the difference and why a doctor would prescribe one over the other? and what is most common etc. thanks doc!
In short the main difference is SNRI work as both norepinephrine and serotinin while SSRIs are only serotonin reuptake inhibitors. As a whole the research tells us that SNRIs are slightly more effective than SSRIs (effect size of 0.33 Vs 0.36) if someone has failed an SSRI trial many doctors will consider a trial of SNRI at that point. Hope this helps and you can help me out by subscribing to the channel and spreading the word about what we are doing here.
@@ShrinksInSneakers thanks for your reply doc. Really appreciated. Im subbed and have shared your videos to a few friends. Keep them coming! :)
@@harness84_29 thank you appreciate it
Perhaps you're like me, and your depression responds to dopamine, rather than serotonin. This would move into the realm of Wellbutrin, Mirapex, Amantadine, etc.
Super cool video! Such a common drug so I feel this is so high yield to out out so that we can all understand more about it.
I would love to see you do a playlist for substance abuse disorder playlist sometime. I am specifically curious about how you approach methamphetamine abuse.
Keep up the great work Dr. R. You are super cool 💪
No problem glad it was helpful
I misused Gabapentin for about 3 -4 months w/o medical supervision. As a person with debilitating social anxiety and depression I can say that no other medicine/substance has been as effective in treating these symptoms by my estimation. Admittedly, that was my own subjective opinion, but it left me very hopeful that my conditions are treatable. Ive never been at liberty to explore these notions with a professional but would truly enjoy that.
Please note: you do build up a tolerance to Gabapentin over time. It will stop working, and as you increase the dose, you increase the side effects. Eventually you will max out and end up worse off than you started.
I’m not a doctor, but a person with real life experience. Do the best you can for yourself by finding and addressing the root cause instead.
Bum hip surgery and lower back pain almost 24/7…gabapentin made me stupid. Literally. Backed into a BMW, knocked telly off while dusting, lost two sets of keys, ran into a sign, etc. Discovered aleve and Tylenol work best. Thx for sharing info
I. Walked to the bathroom in middle of night left leg went through door and right hit wall banged my head.Santa clause in a pill ceos pharmacitical companies must laugh at docs gullibility
Thanks
No problem glad it helped
Dr. Rossi. I've gone to hell and back by tapering years of high doses of benzodiazapines. I want to also wein the Gabapentin next. Will this Withdrawal be just as difficult?
Are there any low risk pain relief medications with high success rates that you could recommend?
I've been described Gabapentin for pain and numbness in my feet and extremities due to Relapsing Remitting Multiple Sclerosis.
Question, what is your feeling about gabapentin for treatment of fibromyalgia?
My Cleveland Clinic Psychiatrist added Lamictal to my Cymbalta and Wellbutrin. It made quite a difference.
Lamictal can be quite nice. It's the only anticonvulsant that isn't well know to cause grogginess, brain fog, and the rest of the issues common with those kinds of drugs. It's a good one.
Hey doc, have you ever heard of phenibut? If so whats your opinion on it? Do you think it around be used in the United States?
Highly addictive
Zero effects. Did absolutely nothing on me.
What about "Beer's Criteria" ???
I was prescribed gabapentin . I was on 600 mg a day for about 10 years. The first year I was hypomanic and felt fantastic After that I basically stayed on it to treat severe anxiety since I’ve had since grade 6. I liked it. My psychiatrist believed it was not working anymore and suggested I come off it. Mistake … in my experience, it’s a very effective drug for mood and anxiety. I’m going to see her next week and I will discuss going back on it and see what she thinks. I don’t think she’s a fan of it. But I’m going to talk about gabapentin anyway. Hope this helps someone
Like we said in he video there is some evidence for its use in anxiety specifically social anxiety and panic disorder. With such limited evidence it would be difficult to offer this as a first line treatment. Things like cognitive behavioral therapy and other FDA approved medications for anxiety remain first line. For people who have exercised all other available options, gabapentin can be considered but as I said pregabalin has more evidence in GAD. Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here
😊
@@ShrinksInSneakers All health care professionals need to realize, "limited data does not = an ineffective treatment, nor should it be viewed with excessive suspicion."
As far as anticonvulsants not working for bipolar and as a mood stabilizer. YES THEY DO!
Anticonvulsants cleared *ALL* my mood disorder issues.
I could finally think clearly with no intrusive/self replicating thoughts or emotions. Everything became balanced, the negativity was gone and it made me the prosocial person that I had always sought to manifest but couldnt.
Please stop telling people that anticonvulsants dont treat mood disorders and bipolar disorder because they do treat those disorders.
@@stephencarlsbad I'm not saying that anticonvulsants do not work, certain ones clearly do work well depakote for example and lamotrigine. The point is that it's not a class effect, not ALL anticonvulsants are mood stabilizers. It's very hard to communicate these things in the context of a video or a single point. I stand by my statement that gabapentin would not be a first or second line option for the treatment of bipolar disorder and you would find very few doctors who would say otherwise. Hope this helps clear things up
@@ShrinksInSneakers You're right. It's very difficult to communicate context particularly without full clarification.
The use of the word "class" is somewhat bare and unfortunately, misleading because the lay person wont typically understand your meaning. And simply put, CZcams is a layperson forum. For every 1000 views you might be receiving 1 or 2 professional doctors who understand precisely what you mean.
For the rest of the viewers, almost none will recognize the distinction made with the use of the word class as in "class of drug."
Had you used "class of drug", I would have made the distinction in meaning, however, the bare use of the word "class" caused it to slip past especially since an emotionally emphatic point was being made after the brief use of "class".
This puts the responsibility onto you to clarify the meaning. Without clarification, your statement's main takeaway is most often, "You can't rely on anticonvulsant as effective mood stabilizers" because of the understanding with the reference to class of drug.
So you definitely know what you mean, but WE dont know what you mean.
So aside from that, I agree, and you make an excellent point that Gabapentin is not likely a good stand-alone choice for treating mood dysregulation for most people.
Gabapentin makes me very happy im able to enjoy the moment and talk to people. It does give me anxiety when i do not take it. Im worried about how much this medication stresses the kidneys. Does it relax muscles because it blocks calcium channels and calcium helps conract muscles?
Initially prescribed this for Fibromyalgia 300 mg 3x a day. Coming off was rough. Fast forward several years, I developed a severe case of Shingles with the neuropathy you spoke of in your intro……900 mg 3 x a day. Also was on antidepressants and anxiety meds with pain meds. This was effective, however unfortunately I was unable to wean off ( forgot to refill timely, pharmacy out of meds, weekend etc). I literally felt like a lightning electrical storm in my brain. Fast forward to a year ago, and had neuropathy due to pretty back to back surgeries (laparoscopic so insertion sites were reused). Surgeon rx ( unaware of past use) me a small dose. I took the absolute bare minimum one time a day ( it was liquid form so I cut the dose in half). Fortunately it alleviated that neuropathy pain and I was able to use it short form with minimum adverse side effects. Such an interesting video! Glad to have found this video and channel. Love the layman way you have communicated to your listeners who aren’t as well versed as others in the medical arena.
Edited to add: This was a very effective medication in helping fibromyalgia ( chronic lower pain back) at the time, as well as neuropathy in LOW LOW short term use. Coming off cold turkey is horrendous ( imo and experience). Cymbalta is my perfect medication for fibromyalgia as well as depression. The gaba made me gain weight but did help to sleep when taken at night but not a medication I ever want to take again. I have been to many lectures about this medication ( heavy on Evidence Based Medicine) when I worked in the academic medical arena. Good lecture Dr. sneaker 😀
@@jenniferstepps I must be taking a very low dose, because I regularly come off it for a break because after being on it a while I start "feeling stupid" like forgetful and confused about things, and I dont have any withdrawal symptoms. The only symptom I have is that my neuropathy comes back and so my feet burn and sting..
@@jeffchastain2977 wow that sounds amazing! I wish that was all I had. It is a fantastic medication for what it’s typically prescribed for. Glad you have great results.
For fibromyalgia, you MUST go on a low tyramine diet.
High tyramine levels along with poor tyramine clearance as we age are the drivers behind idiopathic chronic pain and inflammation aka fibromyalgia.
To treat this they give patients prednisone which... "Blocks tyramines from interacting with muscle receptors."
Lower tyramines, exercise regularly to help the liver function better and you will cure your fibromyalgia on your own.
@@stephencarlsbad Thank you for the information. I had weight loss surgery so I have to already be careful of what I can and can’t digest (dietary and medicinal)- I’m also a kidney stone prone person so I stay clear of oxilates 95% of the time……I do enjoy peanut butter which is high in oxilates but also in protein which is vital for weight loss ( exact opposite for non patients…they get protein to add)
I’ve been prescribed gabapentin for fibromyalgia
My quality of life has improved since adding this medication to my day. I do take it 3x daily which was hard to remember a lunch pill at first!
works great for my RLS
You know it can also cause RLS?
Anouther bonus of gabapentin is it works great on tooth pain I discovered one time while waiting to get in with dentist for treatment because I was already prescribed it and taking it and noticed the pain in my tooth went down a whole alot better then the opioid pain reliever I take regular basis as chronic pain patient
I was prescribed Gabapentin for cannabis use disorder almost two years ago. At first, it helped with the withdrawal symptoms and stabilized my mood. I am now dealing with severe depression and remain on Gabapentin and two SSRI's. I'm wondering if it is time to get off Gapapentin and find something else that may help with my resistant depression and low mood. I'm wondering if Gabapentin is making things worse? Maybe better might be something like Abilify, that is approved for mood disorder and depression?
Best wishes on getting off gabapentin. It's the worst drug to take. It kills your brain snaps. The VA gave it to me and when I was on it , it made me gain so much weight. The withdrawals are way bad with brain snaps and fog. I quit all meds and went to thc/cbd
I’ve been on 2 mg of Abilify for 10 years. No depression 👍🏻and increased energy
I would say once someone is free of cannabis withdrawal symptoms and cannabis use disorder is well treated its best to taper off gabapentin (this should be done by your doctor as stated by another comment here to avoid withdrawal). I have a whole video on treatment resistant depression, a 5 step process check it out in the video playlist. What we know from the reproach is that augmentation with medications like abilify is more likely to result in remission of depressive symptoms than switching medications or augmenting with another antidepressant. This has become my preferred strategy. Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here
Get back on Nature's Medicine 🍁 Best Wishes
Two SSRI medications? Have you ever experienced Serotonin Syndrome?
also for Fibromyalgia
I like pregabalin better for fibromyalgia and it has approval for use in that disorder
I was prescribed gabapentin for chronic physical pain but I'm afraid to take due to potential side effects such as memory problems.
I tried Lamictal and Gabepenton and caused me a lot of pain like electricity vibrating sensation in my spine and back and my nervous system causing me a whole lot of anxiety and pain. I feel like I can't function. I can't work and I just lay in bed all day. I lay in pain with anxiety. I been off of it for almost a week now. I went from a Betty Boop personality to Eore from winnie the pooh. Just very sad and scared for my life. I just don't know what to do? My brain hurts. I just pray God heals me! I wanted to know will I ever go back to normal? I am a Licensed massage therapist and haven't been able to work for almost 3 months now and I was in Nursing school and haven't been able to go to class. I am just a mess! Is there any Good Advice you Recommend?
Are you okay, Katherine? No one has replied to you yet, and I just wanted to reach out to check on you and see how things are for you two months later.
Have they tried you on Tizanidine for your pain and anxiety? This class of drug calms the body's "fight or flight" response, and Tizanidine is also a muscle relaxant.
I really get so FN tired of people talking about the abuse of medication that has been on the market for decades and helps far, far more than it's ever harmed. Even opiates help people such as myself with chronic pain. The doctor, the lawyer, the law makers have hurt far more people tinkering with people's lives adding stigma, hurdles, and laws to keep people from things that always and I mean ALWAYS find a way to do and get what they want. Let's see, has drug law saved lives? Well, over 110,000 deaths last year. Not gabapentin. Gun law, that working out? Don't think so. These people including doctors all pick low hanging fruit every single time. As long as I can go home and leave these hard decisions to someone else that's what I do! That's the mentality on both sides. Crooks don't care about law either.
Seek counseling before you explode.
@@rahrahrobbbieee Seek experience and understanding before commenting.
Isn’t there a gabapentin that is OTC.?
I just switched to Oxcarbazamine when I saw they were going to control/ schedule Gabapentin, at least in my state. I get too fucking pissed trying to get treatment and receiving abuse because of personal bias against addicts. Been through it enough, the Oxcarbazamine actually is working better anyway. less pain and less seizures.
I totally know what you mean. I have been on Oxycontin(low dosage) for 15 years because of a bad accident injury of my spine that even the surgeon that operated on me gave me a 50/50 prognosis of ever walking normally again. I take gabapentin with that for diabetic neuropathy and it made it so I could lower my dosage on my Oxycontin. But now I take 2 "drugs of abuse" so the pharmacists are going be even more judgemental. Another drug that I have to hide in my safe, and not talk about.
Was on gabapentin for Rheumatoid and Fibromyalgia. My memory was screwy, I became clumsy and stumbled. The third day I fell sprained both wrists, ribs, arms, knees. I am still in bed wrapped in Ace bandages. Then I read the withdrawal symptoms. Horrifying for many. Sooo.. no more gabapentin. Marijuana works for many in reducing pain. Going for my medical marijuana prescription. Pain is awful.
Also, wide awake on gaba. Awful drug for.me.😢😢😢
I use gaba for severe painful fibromyalgia in my arms(from fingers to shoulders especially in tendons & ligaments which on occasion makes my arms useless)I need 3600mg per 24 hrs. Drawbacks- huge weight gain.
I take 3 300mg 3 times a day for nerve pain and back pain.
How should you wean off so much gabapentin ? I have it for degenerative arthritis plus an opiate
You must wean off slowly under a doctor's supervision.
I know many people who were prescribed Lyrical for withdrawal from opioids. Withdrawal is very painful and causes anxiety although it does seem to help. On the other hand many abuse it.
I think there are better options for opioid withdrawal. I always go back to the evidence based treatment for opioid use disorder but I agree opioid withdrawal can be vey difficult to get through. I do want to point out I have used his medication in alcohol use disorder so it's not a blanket statement that everyone abuses gabapentin or Lyrica.
@@ShrinksInSneakers Absolutely, not every does. I was stating in my first hand knowledge that it is abused by quite a few in the street but not as many in a controlled setting like detox or rehab. Quite a few stated they were prescribed Lyrica for anxiety and that it did help in that respect.
The blood pressure and ADHD medication Clonidine is the gold standard for opioid withdrawal, but perhaps you're taking a different class of blood pressure medication and your doctor didn't want to have them combined in your system.
@@Dulcimerist Funny you mention this, after I finally came off the Lyrica, I was prescribed Clonidine for as needed use.
It just works.
One week of gabapentin for my restless legs ( 300 mg) and my depression and anger have new highs. Withdrawal symptoms when missed one dose. Never going to take this stuff again. I have atypical response to antidepressants. Wishing psychiatry was a science instead of a endless experiment in the dark with my brain as tge target.
Yep. I now have guinea pig brain syndrome. Doctors should experiment on themselves.
Restless legs are tough to treat. The blood pressure medication Clonidine can help with that in some people, plus it can reduce night sweats and hot flashes.
I take its sister drug, Guanfacine, plus Cabergoline to treat my restless legs.
@@Dulcimerist thanks for the suggestion I've never heard of it before
Overdoses due to opioids are amplified by concurrent use of gabapentin. If you’re using it to treat cns depressant use disorder, be cautious.
When one has pain, his body is telling him something is wrong and attention is needed.
To mask the pain is beyond idiotic. It's like having "check engine light" brightly lit on the dash of your car and you go ahead and disconnect the wire to it. I have bad case of neuropathy and chose to live in pain until the root cause is found. Interestingly enough, I am building up tolerance to pain. No Gabapantin or Lyrica for me. Side effects scare the daylights out of me.
This is scary I’ve been on gabapantin 1800 mg gabapantin , 600 mg tridural, opioids three times a day , two flex Eric,blood pressure meds, diabetes ; zopliclone and the list goes on been on all this 12 years and I’m 49
Holy snikey! Who's your doctor? Wild......
@@jasonthomas7414it’s not a good thing 😊
Have a friend with MS and she takes 4800 mg a day…. Is this perhaps too much? 😳
Gabapentin was effective in removing nerve pain ,sciatica and arthritis. However I felt a little disoriented and to curtail use.
I am currently using 900mg a day for sciatica pain.. How many months were you on it and did you have to taper off?
@@bktrinity1 I was on it two times. The first time I felt dizzy and confused. That lasted three weeks then the following year I was on it for about six months with great effect. I stopped because I was concerned about developing dementia, so I stopped and I believe I just went off it in one day. My sciatica is so painful right now I was actually thinking about asking my doctor for some gabapentin for short time use. It comes and goes I really don’t have many episodes of sciatica. Right now my pain relief medicines aren’t helping. Good luck.
Titanizine works best for my pain,chronic pain!!!!
Tinazidine is super good! I take its sister drug, Guanfacine, for other health issues.
I am reminded as I see the 'FDA approved' shown so proudly, that does not have the same power or validity anymore. Shame. Loads of shame tho.
No kidding. They've lost all credibility. Big Pharma, too.
Caution should be taken with this advice...
The only thing that fixed my mood swings, severe irritability, ADHD focus issues and quasi-anti-social personality disorder was anticonvulsants.
Below is a short list of anticonvulsants that fixed all my problems with mood instability and anxiety.
Depakote
Lithium
Lamictal
Buspar is an anxiolytic and also removed most of my anxiety and stabilized my mood.
The problem is that I react to all of them ie neuropathy.
Gabapentin is the only one that I dont react to so Im trying it now.
I would be careful basing any medical decision off a single persons personal experience. I appreciate people sharing experiences with treatment and it does have value but we need to look at the entire evidence base and apply it to the situation.
@@ShrinksInSneakers
I would be careful basing any medical decision off a doc that relies on the "lack of studies" instead of clinical evidence and hands on experience which this doc is lacking, compared to most, clearing.
A legit doctor wont write off therapies by conflating the lack of studies as being a lack of evidence of therapeutic effectiveness. A great number of studies are poorly done and are flat out wrong or fraudulent.
And whats your pettiness/warning?
I'm not advising anyone to take anything, so save it!😅
Im just sharing my experience.
Didn't they just watch your video and therefore are "informed"? Lol.
So we give you legit criticism that you shouldnt be taking personally and you retaliate out of, what? Ego and spite?
Not a good look for your image.
Your information, btw, is not only wrong but very misleading.
I dont see your channel going anywhere with his kind of attitude.
Sorry.
They don’t want to prescribe opiates …so now they’re prescribing this… that’s what happened…. end of story
I have to say I would concur with that statement and they really need to find something that actually works for folks because truth is opiates are the only thing that really works for people with real pain issues and it's unfortunate I understand that there have been some problems with opiates however what I've seen is that they are the only thing that actually brings some relief and comfort since the doctors won't operate to fix the issue for there pain
Poison
Is does not work for pain,i take it,but i dont drink,i was up all night last night,plus i raje trazadone100 mg
You need o smoke a little weed.
Gabapentin doesn't help my pain. Trazodone doesn't help my sleep problems. Tramadol helps maybe 10%. Maybe.
I want to issue a stern WARNING for this med. There’s a support group for survivors of Gabapentin &Pregab on FB with 15k members, all witnessing to horrible side effects, severe withdrawals when trying to come off it, resulting in years of micro tapering involving all sorts of difficulties.
The tricky lure of this med is that it helps really well in the beginning for a wide range of symptoms, but _a couple years_ in, the side effects start to creep in, and for many people those are devastatingly debilitating. The list of side effects listed in the support group as reported by the users are PAGES LONG. This substance should be controlled, if not banned. Cease prescribing it full stop.
Didn't help. I was put on it for back pain and gad
. The fatigue is a shocker. I am weaning. Off it.
Yeah my vet wants to put my dog on it too....
I’ve only been “forced” by PTs to take Gabapentin. The quacks prescribed me 8600 mg a day. Thankfully I am terrified of all meds & do research b4 taking anything or I’d likely need kidney transplant.
My mother in law abuses hers daily and gets high off it and falls down all the time it’s so crazy.. we can’t get her to get off them and she lyes to drs and they keep giving her more and more it’s sad cause she’s gonna die from this!!!!!!!!!
Originally for seizures
now they hand it out like candy for what ever ails you. Esp for
shingles. NO it does not work! I have yet to meet someone who has been on it with any positive reactions.
It’s a pharma kickback
for the Drs.
Doesn't help me either
Santa clause in a pill,big pharma must laugh at docs gullibility
I told my neurologist I did not want gabapentin. He wrote me an order for a medical marijuana doctor. I thought that was a bit funny.
Sounds like it, appreciate the comment
does the medical marijuana help?
@@lulzak2591 certain types (indica/CBD), to a certain degree, does help, but I can’t expect to go drive around, take care of my young child, or do higher-level thinking, like my job in finance. It’s a double-edged sword, in that respect, but seems to be safer than gabapentin, opioids, or benzos.
Higher dose Gabapentin (1,200mg and above per day) is good for social anxiety disorder but makes you really out of it and takes awhile to kick in. It’s a shame that providers prescribe it for daily use. Especially with Lyrica, taking these gabapentinoids every day will lead to a tolerance and dependence on the medication. The pt will have to take it just to feel normal and if they discontinue it the process can be very rough. This is avoided by limiting the frequency of dosing for these medications.
The risk for withdrawal symptoms can be mitigated with an appropriate tapper and avoiding abrupt discontinuation. While there is some risk for abuse it's usually when much higher doses are used, and the risk is much less than medications like benzodiazepines for example. Although GABA is in the name this medication has no activity at GABA A or B receptors and does not function in the same manner as benzodiazepines Hope this clears some of those points up
1800mg per day for pain. Does nothing
My Father was put on this garbage and suddenly he was pulling at the air, hallucinating and drooling. The MD argued that it was NOT the gabapentin. Why? It was terrible. When he stopped taking it he went back to ''normal''. He had severe back pain.
The MD gave it to my friends Mother and it was the cause of many of her troubles. This is terrible. Don't listen, just keep prescribing it.
It makes me hyper
Ive been on gabapentin for fibro for years and i new it wasnt doing anything for pain . Fibro and RA is what i am prescribed gabapentin for.
I use this for diabetic neuropathy in my feet. I have to give myself a "medication vacation" because after a while it makes my memory bad and makes me confused. So I take a few weeks off. When I am off it, I dont sleep very well because of the pain in my feet. It makes me angry that some people who misuse it, or mis-prescribe it make it hard for others by forcing the government to go apeshit about a medication that they have decided is a fun drug of abuse.
I take it & never ever did it make me high. I don't know why
Gabapentin can be very scary if used wrongly. In small tiny doses it can save someone from severe debilitating upwards spiral aka manic episodes, and/or nervous breakdowns or nervous system distress. I’m thankful for the medicine but I only used it when I couldn’t cope. I would never recommend this drug long term or in high doses over 100 mg. 🙏🏼♥️
Lyrica is the same m
And it's more additive than Percocet.
Makes me twitch when taking in the a.m. otherwise I couldn’t differentiate any effects or difference.
@@samanthahonaker1315 It makes me super hungry too
Yes it’s very similar
U know what is weriod iam more awake and function better after taking my dose of hydrocodone then my dose of gabapentin .
Why is there any proof that anything works off label....more guess work from many in the profession
Any off label prescription should be prosecuted
I took 100mg of gabapentin for nerve damage. Why does it make me drowsy?
Sedation is a potential side effect. This is due to the effects on GABA neurons. It increases synthesis of GABA which is the main inhibitory neurotransmitter in the brain. Hope this helps
@@ShrinksInSneakers thank you.
Terrible poison
I have to take 1000 milligrams of Tylenol, 500 napraxon,900 gabipentin,2mg xanax and then i was giving savella, one pill i was wide awake at 3 am
You are not going to be around much longer...unless you change your ways.
I'm very healthy , thank you, I had 2 major back injuries, I don't take all that now, the Dr. Switched me apon my request
Pregabalin in very effective for cannabis use disorder.
Because there are no options for the treatment of cannabis use disorder gabapentin remains an option but like I said in the video I would not universally recommend it to all patients and more randomized controlled trials should be done to confirm the early positive results. If you haven't subscribed to the channel please do and spread the word about what we are doing here.
It worked for me and several of my friends. All of us were heavy smokers since a very young age. Pregabs stop the cold sweats the nightmares the loss of appetite the low mood and the hypomania that comes with weed withdrawal like no other drug did. I have experienced it first hand and recommend it to all my friends who struggle to quit too. The stuff just works Doc.
@@Hamza23792 It sounds good and I'm certainly not opposed to using it in these cases
@@ShrinksInSneakers glad to hear that; it can help so many people who struggle with cannabis addiction. Give a try with patients who are serious about quitting and whom you trust the feedbacks, I would love to hear some success stories from you in your channel. Keep up the good work Doc. Your work is appreciated.
@@Hamza23792 I'll keep working to find new innovative things, I appreciate the support
Nope does not work!!!
Not for me either
Does absolutely nothing
I had a doctor make a joke about giving patients Neurontin when there wasn't anything wrong with them and they were just a hypochondriac who wanted a script for something to treat their imaginary problems lol.
I would not recommend that but to the main point of the video there are not many good psychotic reasons to use gabapentin.
Sounds like a great doc! 😑
What's the deal.
It soothes my autism.
You folks bug off.
On an individual basis this medication may have a benefit depending on the symptoms targeted. I'm not suggesting that this medication is never usefully, it's more to caution the overuse and point out that most of it is off label prescribing based on limited evidence. Hope this helps
@@ShrinksInSneakers But does that mean the Government should make it a controlled substance? As a patient under pain care for a back injury and diabetic neuropathy, this dismays me. Why make it harder for the people who benefit from this drug because some doctors mis-prescribe it, and some irresponsible people decide to abuse it. I understand the restrictions on opioids and opiates, but I would hazard a guess that not many people have died of a Neurontin overdose.
Gabapentin is addicting though
It's not. There are always going to be people who will try to abuse ahything and everything, even benadryl, but neurontin is not addictive.
I would say it's addictive in the way benzodiazepines are for example. There is risk for abuse but it does not effect GABA A or B receptors and does not function the way benzodiazepines do. It can be abused but this is generally when doses are well in excess of what is normally prescribed. I've seen people abuse Zyprexa and Seroquel but I would call them addictive
@@ShrinksInSneakers and Wellbutrin too has been abused.
@@ShrinksInSneakers I'm actually I recovered heroin addict. I'm still on methadone.
My story goes back to when all started in college with oxycontin. I'm 39 now.
I went through the oxy phase, which stopped in 2009/2010 due to abuse, then the heroin and into the fetynol stage the as t we're in right now.
If you'd ever like to know more I have a wealth of knowledge and am also trying to learn more now as I'm getting into the addiction field.
@@benjaminharding6386 yes it has, I've seen people have seizures when abused and end up in the ICU
Revelation 9:20 The rest of mankind, who were not killed by these PLAGUES, did NOT REPENT of the works of their hands, so as not to worship demons, and the idols of gold and of silver and of brass and of stone and of wood, which can neither see nor hear nor walk; 21 and they did NOT REPENT of their murders nor of their SORCERIES (in Greek= PHARMAKIA) nor of their immorality nor of their thefts.
Cool
not the place for this. dont do that to us
You do not manage alcohol withdrawal with gabapentin. You can use it to prevent alcohol withdrawal seizures but the standard of care is absolutely not to use it to manage a detox.
And the notion that anti epileptics are not effective for bipolar disorder is absolutely false. Gabapentin is a horrible mood stabalizer. Depakote lamictal tegretol and less often oxcarbazine (trileptal) are live saving for pts with bipolar disorder. You love lithium and i agree it can be very helpful. The only non epiletic mood stabilizer… over time is nephro toxic and long term kidney damage always happens … they have to be switched to another agent . I use gabapentin for anxiety disorders. If you are arguing your use of a med based on what peers would do you are not going to use pregabalin which is not commonly used for anxiety i ln the usa. Until that happens im not using it sorry . How long you been doing this? You seem like a newbie