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Old 04-18-2004, 06:47 AM   #1
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rhoff HB User
Question Alternatives to Neurontin

I am new to this board and longer term pain. I have a herniated
disc, impinging on my L3 nerve root, giving me some bad pain. This occured
in Jan of this year. I am currently seeing a pain mgmt dr and have spoken
to and searching for a neuro surgeon. My pain dr put me on oxycodone,
5 mg tabs prn and started me on neurontin. Ok with the oxy but at 300
mg of neurontin last week had hard time breating and heart beat felt
irregular along with dizziness and disorintation. Felt like my breathing or
heart was going to stop. My doctor said to start at 1oo mg a day at
night for 1 week, go to 200 (100 bid) next week. For the last
5 days on 100 mg of neurontin I still feel the same effects at a lesser
degree, extremely uncomfortable. Can anybody enlighten me to this
drug and it's effects? Can some people be allergic to neurontin? Are
there other alternatives to neuropathec pain other than addictive narcotics?
Any and all help would be greatly appreciated.

 
Old 04-18-2004, 07:11 AM   #2
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Re: Alternatives to Neurontin

Hi Rhof, Neurontin is actually an anti seizure med and isn't really considered addictive. If you are a seizure patient and stop taking your seizure meds you wold likely have a seizure but that doesn't really qualify as addictive unless you want to call insulin addictive too.

The use of meds for off label purposes is legal ,However there just isn't any clinical trials or FDA aproval for that specific use. Any of the Antiseizure meds can be ued for treatment of nerve pain "neuropathic pain". If you can't tolerate Neurontin any of the antiseizure meds like Toppamax, Lamyctil, Dilantin,Klonopin etc can be used for the treatment of neuropathic pain.

The antiseizure meds are actually the opiate phobic docs best tool, 10 years ago it was antidepressants and now it's anti seizure meds. The bottom line is neither class of meds, antiseizure or antidepressants have been proven to have any effect on pain. Docs like to use them because CP patients want something to relieve their pain so it's the next best thing to actual pain medication only these meds have very distinct side effects.

Because no clinical study has ever been performed on the effectiveness of Anti seizure meds on neuropathic pain It's just a matter of trial and error to find which med works the best with the least side effects if at all. Using meds for off label uses is common practice although it's not neccesarry for the doc to tell the patient this is not the FDA aproved use of the med he/she prescribes. You get to be a guinea pig like so many of the rest of us.

It doesn't sound like Neurontin is a med you handle well. 300mgs is a very small dose, some folks take as much as 3600 mgs per day. Is it that effective? I couldn't tell you. I have read posts where people believe it's a miracle drug or other meds in the same class are miracle drugs but again, no clinical data to back the miracle statement.
Good luck, Dave

Last edited by Shoreline; 04-18-2004 at 07:50 AM.

 
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Old 04-18-2004, 07:29 AM   #3
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Amazon1 HB User
Re: Alternatives to Neurontin

Hi rhoff...You need to tell your doctor about the reaction you are having to the Neurontin and don't accept any other medications that are similiar as they will have the same effect on you!

I was prescribed Neurontin several months ago when my doctor was searching for something else to give me other than my current opiod treatment. I had a bad reaction the first time I took it (disorientation, heavy heartbeat, dizzy and sleepy) and now have a full bottle that is absolutely useless to me...I refuse to take it again!

Good luck to you!
TC!
Amazon1

 
Old 04-18-2004, 12:05 PM   #4
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Mason HB User
Re: Alternatives to Neurontin

this is your best response to a question by the group, These people really value your judgment. Are you a doctor or just someone with a lot of years on the board?
I wrote on the use of meds. some time ago. As shorelne says, no one can say what med. will work and what won't work. Remember, meds. don't stop the pain, rather, they try to trick the brain by saying, hey, there is no pain.
In closing, try a med., give it some time, then go back to your dc and and tell him, NEXT.

 
Old 04-18-2004, 03:17 PM   #5
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callie3 HB User
Re: Alternatives to Neurontin

I couldn't take the neurontin due to the side affects so I went to Topamax and I have noticed a great difference in my nerve pain. The side affects are very different with Topamax and if you can stick them out for a few weeks(You have to start on a very low dose (25 mg is recommended and titrate up)I take 75 mg a day now, you may have better luck. I would say my nerve pain has been alleviated by about 75%. It doesn't work for everyone and not all can handle the side affects(memory loss,tingling hands and feet,lips and face)weight loss,(I've lost 35 lbs)disorientation. These go away after a couple of weeks which is why it is so important to start slow. It also makes soft drinks taste terrible at first it may be the answer.
Talk to your Dr about the different drugs available. I do know that most pain patients do not recieve relief from just the anti seizure meds alone.Most are on other meds for pain relief. The anti seizure drugs seem to help with nerve pain. I still take Duragesic for the back pain I suffer. Good Luck!

 
Old 04-19-2004, 06:34 AM   #6
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khoff HB User
Re: Alternatives to Neurontin

Mr Hoff -

As others said, Topomax is an alternative to Neurontin and has worked for others who couldn't take the neurontin.
Also, this is from the back pain boards. It talks about tricyclics for pain, but also gabitril which I understand is a more pure form of GABA than neurontin:

04-19-2004, 11:38 AM
feelbad
Senior Member Join Date: Dec 2003
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Re: Survey on pain meds Shoreline - please comment!

--------------------------------------------------------------------------------

Hey Moonlight, tricyclic antidepressants are routinely Rxed for nerve pain.it does actually work for some people.the ADs are not just Rxed for depression.Elavil is the most popular AD rxed for people with nerve pain.

Mobity, I was on Neurontin for two and a half years up until I started seeing a good pain doc.After my last surgery, the Neurontin was really not working all that well.my pain doc switched me to Gabitril which is supposed to be a much purer and more effective source of GABA. it is one of the newer antiseizure meds.He might want to also give it a try,in place of the Neurontin.

I am kinda suprised at the dosing schedule for the oxycontin that your husband is currently on.most docs don't like to rx it any more than 3 times a day.that is a rather high amount to be taking that close together.I am currently taking 40mgs three times a day,and that really tends to space me out some.i would really be over the top with four times a day at that dosage.i think that between the neurontin the elavil and that dosage of OC, i would want to sleep through my day.I know that everyone is different but that would really kick my butt.

Also, shoreline is usually hangin out on the pain management board not the back board.don't know if he will see this.he might hang out here too.who knows. i really hope your hubby can find some relief soon. Marcia

 
Old 04-19-2004, 12:35 PM   #7
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Re: Alternatives to Neurontin

Hey Ken, Were you asking what I thought about dosing OxyC 4 times a day? IMO it's too frequently, Someone has turned a long acting med into a short and the overlap at every dose creates very high peaks, double what you would experince from the first dose of the day.

The first release of half it's contents occurs at 1.2 hours and the second release of the remaining contents is at 6 hours, IF your taking OxyC every 6 then you are basically doubling your dose and serum level for 4 out of every 6 hours. Some rollercoaster your on.If this is a headache regemin I would think you would have some serrious rebound as your level drops off to half of what should be sustained to prevent acute flair ups.

If you through BT meds into the scenario , it makes it really tough to establish a base line serum level. If you need double the serum level why not just double your dose and take it TID, this way you don't have the highs and lows.

Your doc would be somwhat protected from prosecution for deviating so greatly from what's considered the standards of care, proper prescribing and what the manufacturer considers safe. The doc is pretty much alone with his own ideas and thats not much of a defense when you trying to explain why X patient needs OxyC 4 times a day plus BT meds if you use them.

There is no logical reason for QID dosing of a med that last 8-12 hours. What your doing totally defeats any benefit of long acting meds. Your basically taking a very high dose of what you consider to be a short acting med. If that's the only way to get 80 mgs of oxy in ya every 4 hours and that's your goal , you will acomplish it this way. However your tolerance is twice what you think it is and BT meds would need to be twice as potent to be effective. It is a great way to sit back and watch your tolerance skyrocket. But to each his own.

Addicts would call this method of med taking stacking. The first dose didn't hurt you so a second dose, long before it wears off will give you great overlap and still be a little safer than taking a huge dose all at once.

It's really not the daily MG intake that would worry me, It's the way it's being taken and prescribed that I would be concerned about. One of these days a pharmacist that actually read the bulliten from Purdue that says do not fill any script for oxy if it's written for more than twice a day may be filling in and flat out refuse the script or tear it up thinking it's been alterred because it's such an uncommon way to dispense OxyC.

I think about my docs abilty to continue to practice and will he be there in 15 years when i need him. IF he's a soft touch and believes ludricrous statements like OxyC only last 6 hours for me ,when the seccond release hasn't even occured yet. He's setting himself up to be investigated and shut down. Good luck finding another doc to prescribe oxyC 4 times a day.

Ken your welcome to cut and paste this on back pain. It's just too hard to keep up with more than one forum right now. I'm sure I would have plenty to say but I would be on the computer long past my sitting ability, and my wifes tolerance.LOL
I'm looking at that post and I'll go look for a survey on pain meds on the back board.
Take care, Dave

 
Old 04-19-2004, 12:47 PM   #8
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khoff HB User
Re: Alternatives to Neurontin

Shore -

Sorry about the confusion. It wasn't my post about the oxy but someone elses. I tried to cut/paste from the back borad to answer rhoffs question on alternatives to neurontin. That user posted about the tricyclics and gabitril. I must have cut/paste too much. I am actually looking at methadone instead!

Ken

 
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