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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by tepi on April 28, 2011, at 23:25:16
I keep going up on this med because I developed tolerance to it... I started with only 300mg /day
I am taking now 2000mg in the morning and 1200mg in the afternoon.
It seems this is not goona workwhat should I do ????
Social phobia I want to cure !
Posted by wilyee on April 29, 2011, at 1:44:10
In reply to High Neurontin (Gabapentin) dose, posted by tepi on April 28, 2011, at 23:25:16
Are you using a benzo with it?It might be my own response but klonopin seems to have a synegy with gabpeitin ,alone gabpeitin sucked but in combo its a great combo
Posted by B2chica on April 29, 2011, at 9:55:56
In reply to High Neurontin (Gabapentin) dose, posted by tepi on April 28, 2011, at 23:25:16
i too started with 300mg a day and now i average 1500 a day. i went up pretty quickly. just doesnt seem to cut it on the bad days. but i have to watch it cuz at the higher doses i get really red eyes and they start to hurt a bit, like pressure. once i thought i was getting glaucoma...
so i understand. and i have yet to find what works. pdoc ended up putting me on smallest dose of AP to help...it does but but neither alone i need to combine...and even then on the really bad days it doesnt help...
if you find the magic pill, let me know and i'll follow you down the rabbit hole.
:)b2c.
>
> I keep going up on this med because I developed tolerance to it... I started with only 300mg /day
> I am taking now 2000mg in the morning and 1200mg in the afternoon.
> It seems this is not goona work
>
> what should I do ????
>
> Social phobia I want to cure !
Posted by Phillipa on April 29, 2011, at 10:55:20
In reply to Re: High Neurontin (Gabapentin) dose » tepi, posted by B2chica on April 29, 2011, at 9:55:56
Tepi wasn't nardil helping and you went off it? Phillipa
Posted by iforgotmypassword on April 29, 2011, at 15:48:42
In reply to Re: High Neurontin (Gabapentin) dose, posted by Phillipa on April 29, 2011, at 10:55:20
i tried gabapentin at relatively low doses and gave up on it after i started drunkenly saying really inappropriate things. i know there is some paradoxical high-dose/low-dose stuff with gabapentin, do the cognitive s/e's go away with high dose, or does one even experience cognitive enhancement?
i seem to remember an article saying that gabapentin and memantine would be an interesting combination worth investigating. i'm not sure if it mean that it would beat back tolerance, but i remember memantine was at the very least potentiator of lorazepam, so maybe it would affect gaba-ergic tolerance as well.
Posted by floatingbridge on April 29, 2011, at 23:47:50
In reply to High Neurontin (Gabapentin) dose, posted by tepi on April 28, 2011, at 23:25:16
tepi, I wish I had some information for you. I haven't tried it. What is the dosage ceiling? Are you doing monotherapy with neurontin?
Sorry it's so rough right now.
Posted by desolationrower on April 30, 2011, at 3:55:52
In reply to Re: High Neurontin (Gabapentin) dose » tepi, posted by floatingbridge on April 29, 2011, at 23:47:50
I think there is a saturation point for the absorbtion of gapapentin and i think it might be alterable with other things take with it. pregabalin is similar but has a higher ceiling.
-d/r
Posted by SLS on April 30, 2011, at 6:36:57
In reply to High Neurontin (Gabapentin) dose, posted by tepi on April 28, 2011, at 23:25:16
>
> I keep going up on this med because I developed tolerance to it... I started with only 300mg /day
> I am taking now 2000mg in the morning and 1200mg in the afternoon.
> It seems this is not goona work
>
> what should I do ????
>
> Social phobia I want to cure !Gabapentin has been thought to treat social phobia for quite awhile. More recently, it has been studied systematically using double-blind investigations.
http://www.ncbi.nlm.nih.gov/pubmed/10440462
I would look towards an SRI like paroxetine or venlafaxine, or a MAOI - Nardil specifically. You can then add gabapentin as an augmenter if these drugs fail to produce a robust therapeutic effect.
I may be wrong, but I have been under the impression that paroxetine is more effective than the other SSRIs. If side effects are deemed unacceptable, my guess is that any other SSRI would substitute for paroxetine, with the possible exception of fluoxetine (it can be anxiogenic). Paroxetine might be the most offensive regarding weight gain and sexual dysfunction. However, I did not experience these things when I tried it. Escitalopram might make a good substitute.
I believe 3600 mg of gabapentin is the upper bound above which no added benefit can be gained. Gabapentin is saturable with logorithmic dose curve. It is all excreted in the urine without being metabolized. Pregabalin is much more bioavailable as the dosage increases.
http://www.ncbi.nlm.nih.gov/pubmed/20818832
- Scott
Posted by tepi on April 30, 2011, at 11:56:44
In reply to Re: High Neurontin (Gabapentin) dose, posted by Phillipa on April 29, 2011, at 10:55:20
> Tepi wasn't nardil helping and you went off it? Phillipa
Yes Phillipa , I left Nardil almost 9 months ago..
Posted by tepi on April 30, 2011, at 12:04:47
In reply to Re: High Neurontin (Gabapentin) dose » tepi, posted by SLS on April 30, 2011, at 6:36:57
No more trials ... I think I cant go on on it.
I couldnt keep the same effect during all the days and I feel bad nowLyrica the same???? I want something else
Can I stop taking neurontin rigth awaysThank you for all your previous posts
Posted by floatingbridge on April 30, 2011, at 12:46:16
In reply to Ok I want to stop it , can I change to lyrica ?, posted by tepi on April 30, 2011, at 12:04:47
Wait till others answer. Here's my opinion about lyrica in the meantime
It is probably different (stronger but 'different'). In CA it is a scheduled drug.
I trialed it recently for pain. It was a great 'disinhibitor'. I also slurred my speech and withdrew because of rage episodes. I also lost a great deal of
cognitive ability.Guess I'm saying it could have potential,
but I'd use caution with dosing. But I'm giving you a very subjective view. To me, It was too strong, but granted, I didn't
need xanax while on it.You have a good doc to work with?
Take good care tepi. Hugs to you, if you don't mind.
fb
Posted by sigismund on May 1, 2011, at 2:03:58
In reply to Ok I want to stop it , can I change to lyrica ?, posted by tepi on April 30, 2011, at 12:04:47
>Can I stop taking neurontin rigth aways
Maybe better to taper it, Tep.
See how you feel as you reduce.
Posted by mtdewcmu on May 7, 2011, at 10:56:36
In reply to Re: High Neurontin (Gabapentin) dose » tepi, posted by SLS on April 30, 2011, at 6:36:57
> I may be wrong, but I have been under the impression that paroxetine is more effective than the other SSRIs. If side effects are deemed unacceptable, my guess is that any other SSRI would substitute for paroxetine, with the possible exception of fluoxetine (it can be anxiogenic). Paroxetine might be the most offensive regarding weight gain and sexual dysfunction. However, I did not experience these things when I tried it. Escitalopram might make a good substitute.
>My personal experience with Paxil, FWIW, leads me to consider it a mediocre drug. It caused a lot of GI side effects (although I might additionally have some kind of bowel problem independent of meds) and sweating (which hasn't gone away since stopping, but seemed even more troublesome on Paxil). One of the most uncomfortable feelings is to be sweating profusely while you are cold, and the sweat makes you colder. Every med has its haters, but I believe Paxil is known to have especially bad physical side effects.
Paxil controlled my symptoms decently at a minimum of 20mg, and it may have had additive anti-anxiety effects as the dose increased further, but I tried to minimize it in an attempt to control side effects.
I would without hesitation recommend trying Lexapro first, as it seems to be the bridge between the sedating and activating SSRIs that nearly everyone can tolerate. Celexa is also a good one if you need cheap.
Posted by mtdewcmu on May 7, 2011, at 11:03:05
In reply to Re: Ok I want to stop it , can I change to lyrica ?, posted by sigismund on May 1, 2011, at 2:03:58
> >Can I stop taking neurontin rigth aways
>
> Maybe better to taper it, Tep.
>
> See how you feel as you reduce.It would probably be wise not to stop suddenly. Rxlist.com says something about withdrawal precipitating seizures in epileptic patients. That may have no importance if you don't have epilepsy, but it's better to be safe than sorry.
This is the end of the thread.
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