Today we are talking about the medication Gabapentin. If you are currently taking it
or have recently been prescribed it by your doctor, you need to need to watch the video.
We are going to go over how to take it, what are the most common side effects as well as
what are the most concerning things that you need to be aware of if you are going to be
on it. Hi, I'm Dr. Erik Richardson a board certified
Family Practice physician. I'd like to welcome you to FamilyMed, a channel that focuses giving
you practical and accurate medical information to help you and your family. If you think
this would be something that is helpful to you make sure you subscribe, hit that notification
button and follow along with us. Today, we are going to be talking about gabapentin
or sometimes known as Neurontin. This is a medication that has been around since the
early 1990's and widely used as a generic medication since 2004. It was originally developed
as a medication to treat seizures but over time has been used for a lot of different
conditions. There are only two actual approved uses of this medication in the united states
and that is to treat seizures as well as treating something called post herpetic neuralgia-this
when you get chronic pain after having an outbreak of shingles.
But this is a medication that is used for a lot of different conditions that are considered
"off-label" or non-FDA approved conditions. Most commonly, we use this for different nerve
involved pains. These are things like diabetic neuropathy, this is a burning pain that diabetics
can get from uncontrolled diabetes. We use it for different kinds of back pain or any
other pain that likely involves the nerves. It's used a lot in fibromyalgia, Alcohol dependence,
Hiccups, Chronic itching, Restless Leg Syndrone, Anxiety disorders, Depression and even in
treating the symptoms of menopause. So as you can see, there are a lot of reasons
that your doctor may have recommended this medication. It can help with a lot of these
conditions, but just like any medication, it's going to help some and others not. The
good news is, that for most patients, they tend to tolerate the medication pretty well,
without any significant side effects. But remember I said most, there certainly are
patients who can have issues with the medication. We'll go over that in a minute.
Gabapentin comes in a tablet, capsule or liquid form. Capsules come in 100, 300 and 400mg,
Tablets come in 600 and 800 mg and the liquid comes in 250mg/5ml. It is usually given any
where from one to three times a day with the maximum recommend dose of 3600 mg a day. This
is the kind of medication that usually has to build up in your system so you usually
won't notice any effect right away. Usually we have a patient start out at once a day
and increase slowly to avoid side effects. We take the same approach as well when we
need to stop it. This isn't a medication that you want to stop all of a sudden after being
on it for a while. We have you slowly taper down off of it with avoid any withdrawl symptoms.
This is something that you definitely want to be working with your doctor on and following
their directions. Now the main thing that most of you are going
to be worried about with this medication is what are the side effects? Most people do
well with it but I certainly have patients who have had their problems with it as well.
Probably the most common side effect that I have patients complain of when taking this
medication is a foggy type feeling in the head. You can feel somewhat tired and drugged
and just not yourself. Usually I recommend to my patients that they start it at night.
In most people those symptoms tend to go away after a few days but not in everybody. Other
common and less serious side effects can be some fatigue, swelling in the ankles, tremor,
nausea, vomiting, dry mouth and mood changes. Just like the foggy feeling, these tend to
go away over time. By starting at a lower dose and slowly increasing it we can usually
avoid most of these problems. There are some concerning things though that
you need to watch out for. These certainly are not common, but they are possible. Less
common of the concerning side effects, are certain allergic reactions and skin eruptions
that can happen. You can get a condition called rhabdomyolysis where the muscles can break
down causing damage to the kidney. It can also make it so it's harder to breathe in
some people, so those who have issues with their breathing need to be extra careful if
they are going to be on it. We also recommend that you be careful if you are taking it with
other prescription pain medications because they also have the ability to decrease your
drive to breathe. When you combine them together it can be dangerous in some people.
One of the more common of the more serious conditions is the effect it can have on those
with underlying depression. We can see worsening depression and even suicidal thoughts in some
people, so it's very important that while taking it, you talk to loved ones and your
doctor if you start to feel anything like that.
You also need to be careful when coming off of the medication. As I mentioned before,
when coming off of the medication it is important that you taper down off of it slowly under
the direction and help of your doctor. Stopping it abruptly has been shown in some people
to cause withdrawal symptoms as well as even withdrawal seizures.
One of the more concerning things though that we have seen with this medication over the
past few years is that more and more people have been abusing it and have become addicted
to it. In several states in the United States it has become a controlled substance. We most
often see it in those who are already abusing prescription pain medications. This is especially
hard as gabapentin is something that many physicians try to use as an attempt to get
people of pain mediations. In a couple studies it showed that approximately one percent of
the general population of the united states and 22 percent of those in addiction treatment
facilities had a history of abusing gabapentin. It is something that you need to be careful
with and work closely with your doctor and talk to them about any concerns you may have
of addiction. If you already have a history of addictions then it may not be the best
options for you. Gabapentin can be a very helpful medication
in many different situations but unfortunately the risk of addiction and abuse isn't on the
radar of many who are prescribing it. Over the past few years with all the problems that
we have had with opioid addiction and abuse, as a profession we have turned more and more
to gabapentin to treat pain and other conditions. The unintended consequence has been to replace
a very addictive substance for another that although not as addictive, still is a medication
that can have the same problem. The biggest problem with discussing the serious
side effects is scaring you away from taking it. That isn't my intention either. This can
be a powerful tool in treating some very difficult and life altering conditions. The majority
of people do great on this medication and helps improve their quality of life in a dramatic
way. We are all different though so that's why it's important to be aware of issues that
can arise so you can make an educated decision with your doctor. This isn't an all encompassing
discussion of this medication either. There are certainly other things that your own doctor
may want to discuss with you but hopefully now you can feel a little more informed about
how this may affect you. Well, I hope you found this to be helpful,
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So until next time, this is FamilyMed with Dr. Richardson and remember to take care of
your body because it's the only one you have.