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burpee 06-04-2008 11:33 AM

Gabapentin - how did you determine effective dose?
I damaged a sciatic nerve due to a back injury. I started Gabapentin a month ago. At first I took a single 300mg capsule at night.

After a few days - I kind of thought it was helping. At the time, my foot/ankle was very sensitive to anything touching it at night.

Now, it's four weeks later, and I wonder whether I am just getting better or whether I could take additional Gabapentin to eliminate pain I experience when I wear shoes or walk.

I've never found any clear information on establishing an upper dose. I don't experience any side effects, except maybe dry mouth?

How did you know you were taking enough? How did you know you took too much? Too little?


cmpgirl 06-04-2008 12:39 PM

Re: Gabapentin - how did you determine effective dose?
Burpee, I only took gabapentin (neurontin) for about 6 months because it did little for my pain and I had other side effects. But not all meds work the same for all people, so if you are getting relief, that's great.

As far as how you know what is enough or not, it really depends on your pain levels. What you can or can't live with. I know it can be dosed at much higher levels than you take, but it may not be necessary if you are getting adequate pain coverage.

Does it allow you to function well on a day to day basis, at your current dose? If so, then you should be fine. There may come a day when you build a bit of tolerance and may need an increase, but I wouldn't worry about that unless it happens.

I hope this helps. Take care, CMP/MM

stymie82 06-04-2008 03:42 PM

Re: Gabapentin - how did you determine effective dose?
Burpee, I have nerve damage in both legs and feet due to arachnoiditis. My doc prescribed Neurontin, and it has been effective in covering the pain. I started out taking a single 300 mg. dose at night. My doc told me to keep going up until I stopped receiving more benefit from it. He switched me to 800 mg pills and I now take 4 per day-3200mg per day total. I can immediately tell if I am behind in my dose. 3600 mg/day is the upper limit for the drug. Hope it works out well for you. I don't have any side effects. Fortunately, I have a cast iron stomach for meds, at least so far. :cool:

burpee 06-04-2008 04:31 PM

Re: Gabapentin - how did you determine effective dose?
Yes, thanks Stymie, I would guess that "trial and error" must be the only way to determine dosage. I've looked all over and there isn't any "official" prescribing guidelines - I guess, that goes with the fact that Gabapentin isn't FDA approved for pain relief.

Perhaps I'll check in again after I increase the dose.

Shoreline 06-04-2008 08:45 PM

Re: Gabapentin - how did you determine effective dose?
Hey Burp, It really os trial and eror, They keep increasing the dose untill you reach a limit to what you can tolerate. I tolerated it well although Iknew it made me sleepy /tired, But when I went from 1500 mgs to 1800 mgs, it flat out kncoked me out and it just didn't provide the relief if the only way to do it is la-la land.

Side efects really determine the range for most drugs. There is no thing as an max dose other than toxicity and I've never seen anyone reach a max dose. I've seen as high as 3600 mgs. I think you will really know and the only wauy to know is to keep going untill you do, otherwise you can't say if double or trippple would have been the effective dose unless you know you couldn't tolerate it.
Expect lots of increases and allowing time can help, but you will reach a point that you don't want to spend years waiting to come out of a zombie state. Even if you reach a dose that helps but isn't quite what you hoped for. Not givig something a fair shot is really the bigest shame. Giving up at 600 mgs a day simplly because you expected more relief from 600 mgs will always leave you wondering would 1200 have helped if you stop for a reason other than side effects.

You have the choice of staying on a tolerable dose and using it as an adjunct or you move on to the next anticonvulsive, Newer doesn't mean it's better so you try the oldies like dilantin and tegretol. All the anticonvulsants have been used as off label treatment meds for nerve pain and One manufacturer actually did a clinical trial to earn the right to claim to be the only FDA aproved anticonvulsant for nerve pain. They wouldn't have done it if they diodn't know this class worked and those that were already being used off label , didn't need the FDA aproval for docs and patients to understand it works. Mnay people still use some very old meds because they wiork better for them. We are all diferent so you bank the info from your trial and move on or make it part of you treatmant plan and look for other modalities whether it's adding a different class of med, Like antidepressants, Or NMDA receptor blockers, opitaes, etc etc,

I use stuff I learned in 93, 98, 2000 and combine it with my present medication and treatmwen plan to improve the quality of my life. It's what works for me. After 15 years of my own clinical trials of dozens of meds, I know what works for me and what meds I can tolerate and function on. Do look into and be aware that dry mouth and dental issues are a real problem with CP patients, There are ways to help if you wanted to start a new topic or search the key words for previous threads.

Good luck, Dave

burpee 06-11-2008 04:34 AM

Re: Gabapentin - how did you determine effective dose?
[QUOTE]After 15 years of my own clinical trials of dozens of meds, I know what works for me and what meds I can tolerate and function on.[/QUOTE]Thanks for the note - I'm continuing to fine tune a dose. Haven't "zonked out" yet.

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