Misc Gabapentin: withdrawals? mechanism of action? benzo cross-tolerance/dependence?

[Swimmingdancer]

Sorry if there are threads on this already, but I couldn't find anything that fully/properly answers my questions. Feel free to point me to other relevant threads.

Is the mechanism(s) of action of gabapentin known/understood? I have done quite a bit of reading on it and there are studies saying it doesn't bind to GABA receptors, but it sure feels like it affects GABA in some way.

How common is physiological dependence and what are withdrawals (if any) like? Obviously this would vary a lot from person to person and depend on dosage and duration of use, but there have been a few very vocal people on here saying it cause severe incredibly long withdrawals, far worse than benzos, after only a short time of use, which contradicts everything my doctors believe about it and so I'm looking for a balance of different people's experiences with it to get a more general picture.

Is there cross-tolerance and cross-dependence from gabapentin and benzodiazepines?

*Also please note that while pregabalin is considered a pro-drug for gabapentin, I am more interested in people's experiences with normal therapeutic doses of gabapentin than high doses of pregabalin when it comes to withdrawals, as they would be more relevant to my situation. Also for those who were taking gabapentin to get off benzos or opioids what makes you believe that your withdrawals were solely the result of the gabapentin, (if you do believe that)?

 

[Jabberwocky]

I've always wondered this myself actually - is pregabalin simply a stronger more enchanced version of gabapentin?

I know that personally I found lyrica withdrawal worse than any other. It took me a year of slow tapering to come off it when id only used it for 6 months. According to Pfizer - lyrica acts by making more GABA availiable in the brain, but that's a load of bullshit. It has opiate like properties (feelings wise) and analgesic properties too, which benzos lack. It's just the start of benzos all over again but this time in my opinion it's even worse.

Sorry you noted you didn't want lyrica contributions.

 

[Swimmingdancer]

I've always wondered this myself actually - is pregabalin simply a stronger more enchanced version of gabapentin?

I know that personally I found lyrica withdrawal worse than any other. It took me a year of slow tapering to come off it when id only used it for 6 months. According to Pfizer - lyrica acts by making more GABA availiable in the brain, but that's a load of bullshit. It has opiate like properties (feelings wise) and analgesic properties too, which benzos lack. It's just the start of benzos all over again but this time in my opinion it's even worse.

Sorry you noted you didn't want lyrica contributions.

It's fine, I just wanted to differentiate between pregabalin and gabapentin because a lot of people who haven't even taken gabapentin have been saying "gabapentin withdrawals are hell" based solely on their experience with pregabalin. And perhaps that might be sort of like basing one's recommendations about codeine based on one's experiences with heroin. Pregabalin is a lot stronger and in general people seem to have much more likelihood of physical dependence/withdrawals with it. So I am open to comments/experiences with pregabalin but am much more interested to know about gabapentin. Does that make sense?

I know pregabalin is said to be a "pro-drug" for gabapentin and/or a "stronger version of gabapentin" (whatever that really even means), but we don't really understand how either of these drugs even work and there are some substantial differences between them.

For one, pregabalin is rapidly absorbed at a BA of ~90% in the stomach, with peak blood levels occurring within 1 hr, whereas gabapentin is slowly absorbed, with a lower BA that gets lower the more of it you take, from the small intestine, with peak blood levels occurring in ~4 hrs.

I don't see how pregabalin can be a pro-drug for gabapentin, since it undergoes little metabolism, with 98% of remaining unchanged.

Both gabapentin and pregabalin have been found in recent studies to bind to a subunit of the voltage-dependent calcium channel in the CNS, but I'm not really sure exactly what that does and it is suggested that this is unlikely to account for the majority of their effects, especially the effects felt when you first start taking one of these drugs (as opposed to taking them frequently longer-term).

Unlike benzos, which bind to GABA-A, GABA-B, and benzodiazepine receptors, I've read studies (including Pfizer's own studies) that found that pregabalin and gabapentin neither bind directly to these receptors, nor augment GABA-A currents or affect GABA metabolism. But as I said, it sure feels like gabapentin is affecting GABA in some way.

According to a review:

pregabalin decreases the release of various neurotransmitters which have been pathophysiolgically implicated in anxiety disorders including glutamate (Dooley et al 2000a), substance P (Fehrenbacher et al 2003; Geracioti et al 2006), and norepinephrine (Dooley et al 2000b; Strawn and Geracioti).

I wonder if that is the same for gabapentin? Will see what I can find...

If anyone knows more about how these drugs may work I'd love to hear it.

 

[Jabberwocky]

Well the decrease in glutamate could certainly attribute to the decrease in anxiety along with noradrenalin - as they are both anxiety provoking neurotransmitters.

1. Gabapentin crosses several membrane barriers in the body via a specific amino acid transporter (system L) and competes with leucine, isoleucine, valine and phenylalanine for transport. 2. Gabapentin increases the concentration and probably the rate of synthesis of GABA in brain, which may enhance non-vesicular GABA release during seizures. 3. Gabapentin binds with high affinity to a novel binding site in brain tissues that is associated with an auxiliary subunit of voltage-sensitive Ca2+ channels. Recent electrophysiology results suggest that gabapentin may modulate certain types of Ca2+ current. 4. Gabapentin reduces the release of several monoamine neurotransmitters. 5. Electrophysiology suggests that gabapentin inhibits voltage-activated Na+ channels, but other results contradict these findings. 6. Gabapentin increases serotonin concentrations in human whole blood, which may be relevant to neurobehavioral actions. 7. Gabapentin prevents neuronal death in several models including those designed to mimic amyotrophic lateral sclerosis (ALS). This may occur by inhibition of glutamate synthesis by branched-chain amino acid aminotransferase (BCAA-t).

Two secs phone about to run out of batteries. Wil follow up soon.

From: http://www.ncbi.nlm.nih.gov/m/pubmed/9551785/

 

[Swimmingdancer]

Well the decrease in glutamate could certainly attribute to the decrease in anxiety along with noradrenalin - as they are both anxiety provoking neurotransmitters.



Two secs phone about to run out of batteries. Wil follow up soon.

From: http://www.ncbi.nlm.nih.gov/m/pubmed/9551785/

Thanks! That is very interesting
It is from 15 years ago though, so it may be that some newer research is not included or even contradicts some of these hypotheses. That's one thing that's making it so hard for me to research this drug (let alone compare it to pregabalin pharmacologically), all the sources say different things. But that one is better than most I've read so far and it's nice to have a summary of the different theories. Really old sources tended to say it was a GABA analogue which bound to GABA receptors, without any real evidence of that.

*Also, my friend's doctor said it was a NMDA antagonist, any evidence that this is true?

 

[tweaker_X]

How common is physiological dependence and what are withdrawals (if any) like? Obviously this would vary a lot from person to person and depend on dosage and duration of use, but there have been a few very vocal people on here saying it cause severe incredibly long withdrawals, far worse than benzos, after only a short time of use, which contradicts everything my doctors believe about it and so I'm looking for a balance of different people's experiences with it to get a more general picture.

I sure hope this isn't true. I'm taking it for some rather nasty benzo withdrawals. It does help. Would suck to withdrawal worse later.

 

[Toz]

I sure hope this isn't true. I'm taking it for some rather nasty benzo withdrawals. It does help. Would suck to withdrawal worse later.

You might be in for a rude awakening when you stop taking it. It's in my oppinion much worse than benzo withdrawal (and then I have gone CT from 5mg clonazepam daily taken for years)

Found this thread, had more like this one saved in favorites after googling alot on withdrawals from gabapentin since I've been desperate to find out how in the world it can cause 7 months of withdrawal after using it for 4 weeks but hard drive crashed so don't have them saved anymore. It is about both pregabalin/gabapentin though.

http://sci.rutgers.edu/forum/showthread.php?t=60400&page=18

Even though I used gabapentin to get off opiates and had recently gotten off benzos, I know the withdrawal is from neither of those because it simply doesn't fit. Those don't cause vision problems/nerve pain. Besides, I tried resuming both with no success.

Edit: I find studies about this drug so conflicting, first I find some that says it's a gaba analogue, then it says it has no binding affinity for gaba receptor sites and then I find some other that just says it's mechanism of action for reducing pain is simply unknown. Cmon what's it gonna be really?

 

[AlphaMethylPhenyl]

Unfortunately Gabapentin/Pregabalin is not well-studied enough to definitively say how it really works

Anecdotal evidence is probably your best bet if you want to profile it

I can tell you there is cross-tolerance between bzdps and gabapentin/pregabalin

The two drugs are making a comeback in psychiatric literature on two fronts: being given to a wide variety of drug addicts with mental disorders which works to both alleviate their disorder (mostly ones related to mood) and decrease cravings, as well as being substituted for bzdps; now the logic I've heard behind this is that they don't build tolerance as fast and don't cause as severe of a withdrawal but again look to studies with I'd say n>50 (or better yet find a good meta-analysis) if you want real information because frankly compared to other drugs we don't know how they work.

 

[paranoid android]

Here's my experience with gabapentin.

I have been on gabapentin now since about 2006 and the only breaks Ive had is when i was on lyrica instead because i was getting sample packs from my doctor or the few times i ran out or my insurance decided to fuck with me. Currently i am prescribed the rather ridiculous dose of 800mg's 4 times a day but i usually only take half that dose which means i have loads of those horse pills left over. A few years ago my insurance suddenly decided to stop paying for my gabapentin and since i could not afford it and my doc did not have any samples of pregabalin i went into withdrawal. It felt like a combination of benzo and opiate withdrawal. Well more like alcohol withdrawal in terms of the physical pain it caused. Every touch felt painful and even the slightest smack on my arm would send a shock of nerve pain right through it. Every nerve fiber in my body felt like it was on edge and along with this my trigeminal neuralgia pain flared up, i got tremors, dizziness, sweating, insomnia, restless leg syndrome. twitches, sensitivity to light and migraines as well.

I was on 4-6mg's of clonazepam a day and it did seem to numb the withdrawals a good bit but my doctor was nice enough to add 20mg's of Valium to my benzo dose to help stop the tremors and this helped alot. I would also add that gabapentin withdrawals seem to last for ages despite it's very short method of action. I had to go without gabapentin for 2 weeks and i was in withdrawal for 2 weeks so i have no idea how long it actually lasts. I would rank it as being more painful then benzo withdrawals. I have only had to come off clonazepam once and i had to make 20mg's of clonazepam last me about 10 days when i was taking 6mg's a day on average. I had been on benzos everyday at this point for maybe 4 years at 4-6mg's of clonazepam a day. I would rather go through that then the gabapentin withdrawal quite frankly

 

[Swimmingdancer]

Unfortunately Gabapentin/Pregabalin is not well-studied enough to definitively say how it really works

Anecdotal evidence is probably your best bet if you want to profile it

I can tell you there is cross-tolerance between bzdps and gabapentin/pregabalin

The two drugs are making a comeback in psychiatric literature on two fronts: being given to a wide variety of drug addicts with mental disorders which works to both alleviate their disorder (mostly ones related to mood) and decrease cravings, as well as being substituted for bzdps; now the logic I've heard behind this is that they don't build tolerance as fast and don't cause as severe of a withdrawal but again look to studies with I'd say n>50 (or better yet find a good meta-analysis) if you want real information because frankly compared to other drugs we don't know how they work.

Yeah that's what I figured and I'm very interested in people's experiences with gabapentin for that reason. One doctor I talked to even said it does not cause any physical dependence whatsoever so I feel I can't really rely on the info from doctors about it.

Every nerve fiber in my body felt like it was on edge and along with this my trigeminal neuralgia pain flared up, i got tremors, dizziness, sweating, insomnia, restless leg syndrome. twitches, sensitivity to light and migraines as well.

This is how I feel all the time already (long before I started taking gabapentin), so it would be really hard for me to tell if I get withdrawal symptoms when I don't take the gabapentin or simply the return of my regular symptoms. I don't feel any worse if I don't take it than I did before I started taking it though, so I don't think I'm physically dependent on it at this point. However I've only been taking it for a few months and only in moderate doses, usually only once a day now.

Even though I used gabapentin to get off opiates and had recently gotten off benzos, I know the withdrawal is from neither of those because it simply doesn't fit. Those don't cause vision problems/nerve pain.

They can actually. And one can develop opioid-induced hyperalgesia and allodynia etc which doesn't really improve from resuming the opioid. What drug(s) specifically were you using the gabapentin to get off?

 

[pasha]

The withdrawals from gabapentin and pregabalin are the first withdrawals and worst withdrawals I've ever been through. They don't feel anything like benzodiazepine withdrawals or opioid withdrawals so it's very easy to differentiate the two.

For a kick off, the acute phase can last several weeks to months, with no evidence of a let up between day to day. Benzodiazepine withdrawal is very severe for a long period of time, where as pregabalin/gabapentin withdrawal is moderate-severe but for a much longer time. Unlike benzodiazepine withdrawal where one is restless, it makes me absolutely catatonic, where the only thing you can do is lay still. Your hands and feet feel like they are molten rocks with a resemblance to neuropathy a condition which it treats. The muscle rigidity, nausea, anxiety, paresthesia and depression are unrivaled. The psychosis is by no means pronounced, but it's there, and very discomforting. The biggest problem I find with this withdrawal is that nothing seems to touch it, not benzodiazepines, not opioids, and only barbiturates to a limited extent. The only thing that provides the greatest relief is cannabis.

There have also been reports of seizures and epilepsy when they were not there prior to treatment using these drugs.

I know many people who have suffered horrible withdrawal symptoms from this drug without prior use of any gabaergics, and others who have absolutely no problem stopping it even with prior gabaergic abuse. I've attempted to speak to several neurologists, and create some theories about what the mechanics behind its withdrawal are, all seem to agree while it is reported very often, the reason is unknown, and that many other AED share similar withdrawals but not as severe therefore I have not been able to form any solid thesis. Just hearing about lamitogrine withdrawal stories was enough to make me cringe.

I honestly say this with no exaggeration, but I would rather go through opioid withdrawal 100 times over then go through pregabalin/gabapentin withdrawals, the depression sticks with you for an endless period of time. I have to say though that it doesn't surprise me all that much that a drug which is basically the gold standard for every type of withdrawal there is, can carry such devastating withdrawal symptoms. Which is why I would recommend anyone who intends to get on this drug to leave it, in order to preserve the aid it provides in withdrawal from other drugs.

http://www.ncbi.nlm.nih.gov/pubmed/15898970
http://www.wisegeek.com/what-is-gabapentin-withdrawal.htm
http://www.benzosupport.org/neurontin_and_withdrawal.htm
http://www.ncbi.nlm.nih.gov/pubmed/20484214
http://www.theannals.com/content/early/2011/06/10/aph.1Q057
http://journals.lww.com/clinicalneu.../07000/Gabapentin_Withdrawal_Syndrome.11.aspx (locked)
http://article.psychiatrist.com/dao_1-login.asp?ID=10002997&RSID=91075939966014 (locked)
http://www.ncbi.nlm.nih.gov/pubmed/12507063
http://ajp.psychiatryonline.org/article.aspx?articleID=102360
http://www.ncbi.nlm.nih.gov/pubmed/15991228

 

[Swimmingdancer]

Yikes you guys are scaring me. Chromophobia how long did you take it for and in what dose? And can you describe the muscle rigidity a bit more? Like was it painful extremely tight muscles, or?

 

[DickTate]

This thread is as interesting as it is scary. I was prescribed Gabapentin for chronic back pain because "it is not addictive like benzos & opioids".

Luckily I am not taking it regularly but since I'm gonna stop the opis next week I want to use it as a wd-aid but now I don't know if that is smart.
However, next appointment I will ask my doctor about this. I think it is irresponsibly that these medications are prescribed so laissez-faire style.

Also I am interested in why some people seem to be not affected by Gabapentin/Pregabalin-Withdrawl even after prolonged use and higher doses...

 

[pasha]

Yikes you guys are scaring me. Chromophobia how long did you take it for and in what dose? And can you describe the muscle rigidity a bit more? Like was it painful extremely tight muscles, or?

I used to take them intermittently when I was young, usually at doses of 3000 milligrams pregabalin, sometimes more, sometimes less. It was OTC where I used to live (until 2012 when it became scheduled due to emergency room visits from withdrawal and kidney failure) so practically everyone used to take it. Sometimes I would take 10 grams pregabalin in a night, others used to do 15-20 grams easily. There are many generic kinds that come in 16 pill blister packets of 300 milligrams pregabalin capsules now which wasn't the case before, which led to an incline in its abuse because of the price dropping significantly. I left it for a year and then fractured my shoulder during a rugby match at school, so I was prescribed 75 milligrams twice daily and I stuck to that for about 6 months. I had never done benzodiazepines at the time and was not addicted to any drugs. When I stopped all hell broke loose, it was simply inhumane. The doctors at that time, (which really hasn't changed that much) didn't know anything about pregabalin/gabapentin withdrawals.


After these drugs became highly controlled narcotics, people who where addicted would buy a tablet, for the same price you would buy a gram of cocaine (not sure if this qualifies as price discussion). They would trade an arm and a leg for them if you had a prescription.

The muscle rigidity is exactly like that of spasticity, which is pretty painful, another condition which these drugs treat. They do so by decreasing neuronal excitation which hypertonia is associated with.

Another thing that happens a lot with people during withdrawal and use is diplopia, or double vision which sticks to people for life even at therapeutic doses.

Doctors unfortunately refuse to acknowledge these facts, because pfizer remains the most fraudulent company when it comes to advertising gabapentin/pregablin, since they are the most illegally promoted drugs for off/on-label purposes by hiding the negative side-effects.

A federal judge has ruled that Pfizer violated the California Unfair Competition Law by illegally promoting the Neurontin epilepsy drug. The finding stems from the same case in which a federal jury last March decided the drugmaker violated federal racketeering law for the same practices and must pay $142 million in damages – under federal RICO law, the original $47 million penalty is tripled.

In a lawsuit, Kaiser Foundation Hospitals and the Kaiser Foundation Health Plan, which are based in California, had charged Pfizer with illegally promoting Neurontin for unapproved uses, such as for treating migraine headaches, pain and bipolar disorder (background here and here).

In her ruling, US District Court Judge Patti Saris determined that Pfizer fraudulently marketed Neurontin by making material misrepresentations in advertising supplements and direct communications, and by showing positive info while suppressing negative evidence. She also wrote that “Kaiser has proven that there is little or no scientifically accepted evidence that Neurontin is effective for the treatment of bipolar disorder, neuropathic pain, nociceptive pain, migraine, or doses greater than 1800 mg/day.”

Six years ago, Pfizer agreed to pay $430 million in penalties and pleaded guilty to criminal charges of illegally marketing Neurontin, which was one of the meds that were obtained as part of its 2000 acquisition of Warner Lambert. In making its appeal, Pfizer contended the federal judge improperly allowed details of that case and settlement to be considered by the Boston jury.

This is just the one charge and for gabapentin, the amounts they've had to pay for pregabalin are in the billions. For the amount of money they net annually from these drugs, and being the biggest pharmaceutical company in the world, this is just spare change.

Edit:

What's interesting for me is one of the professors discussing gabapentin withdrawal made a rough estimate for benzodiazepine-gabapentin equipotency at 1000 milligrams/5 milligrams clonazepam. If that's remotely true then coming off a 3,600 milligram habit of gabapentin, could be likened to coming off a 12.5 milligram clonazepam habit.

 

[tweaker_X]

Holy shit! Sounds massively shitty to say the least. I've been on 300mgs of gabapenting 3x per day for 2.5 months. It does help. You guys are making me consider getting a script for valium or mailordering it at least. The benzo withdrawals (6mgs of xanas daily) destroyed my world and landed me on the street. I'm just now starting to feel better after 6 months clean from benzos. I seriously cant imagine anything worse.

 

[Swimmingdancer]

so I was prescribed 75 milligrams twice daily

Is that a typo? You were only taking 75mg BID when you quit and had horrible withdrawals???

 

[pasha]

^ No, I corrected the post, I was talking about pregabalin. I realized it may have been confusing given the high doses mentioned in the beginning. Gabapentin doesn't come in anything less than 300 milligrams I don't think, nonetheless once I was through with the pregabalin I tried using gabapentin on a year long taper after dozens of failed attempts to quit, but it made no difference what so ever. When I finally did manage to quit it once it was with the aid of phenobarbital. Unfortunately though I had to get back on it again after repeated GHB withdrawals years later, and since then it's been a cat and mouse game.

There are really no cravings like opioids for me, just the feeling that something is neurologically wrong with you, and as soon as you take them it gets fixed. So I was consistently stuck thinking I was the problem, I had the works done, EEG, MRI, CT, you name it, but everything came back normal except slight abnormalities in EEG readings. It wasn't until years later when reports of withdrawal began to emerge I discovered that the drug wasn't helping with an underlying disorder, it was the cause of it.

Gabapentin withdrawal case reports:

The Problem

Many of the patients at your long-term psychiatric treatment center (also known as a state prison) receive treatment with gabapentin for chronic pain or seizure disorders. Some inmates may well be using their gabapentin prescriptions for recreational purposes or for bartering. You are aware of previous reports of gabapentin abuse in prison populations (Am. J. Addict. 2004;13:321–3). In either case, you wonder about the risk for some type of withdrawal should a vulnerable inmate/patient be shaken down for his gabapentin.

The Question

What types of withdrawal phenomena can occur with abrupt cessation of gabapentin?

The Analysis

We performed a Medline search combining “gabapentin” and “withdrawal.”

The Evidence

Gabapentin enhances GABAergic transmission possibly via agonist action at the γ-aminobutyric acid type B receptor (Mol. Pharmacol. 2001;59:144–52), although the precise mechanism of action is unknown.

One early case report described a 48-year-old female with a 20-year history of bipolar disorder (J. Clin. Psychopharmacol. 1999;19:188–9). She was treated with gabapentin 500 mg/day for approximately 4 weeks for hypomania, at which point she became depressed. (Other primary mood stabilizers caused side effects.) The gabapentin was tapered off, and within 48 hours of the last dose she became catatonic. After several days, she was successfully treated with lorazepam. The authors considered withdrawal from gabapentin to be the cause of the catatonia because the patient had never before experienced such a state.

Another investigator described three case reports of gabapentin withdrawal (Clin. Neuropharmacol. 2001;24:245–6). The first case was that of a 29-year-old male treated with gabapentin 4,800 mg/day over 6 weeks for bipolar disorder. (Other mood stabilizers were intolerable.) He ran out of tablets and had no access to a refill. Within 1 day of the last dose, he experienced anxiety, diaphoresis, and palpitations. By day 3, he was confused and his spouse brought him to the emergency department. He was tachycardic, tachypneic, and hypertensive. Physical exam, blood counts, chemistry panel, urinalysis, urine drug screen, and head CT were all normal or negative. Gabapentin was reinitiated, and the patient began showing recovery within hours.

The second case was that of a 36-year-old male treated with gabapentin 3,600 mg/day over 2 months for bipolar disorder and chronic back pain. For financial reasons, he abruptly discontinued gabapentin. He presented in a very similar fashion to the first case; the work-up was negative except for asterixis, myoclonus, and the presence of agitation. Gabapentin was initiated again, along with a single dose of lorazepam (2 mg IM). He began recovery within hours.

The third patient, a 28-year-old male treated with gabapentin 2,400 mg/day over 6 months for migraine headaches, left town without his tablets. Within 48 hours, he presented with irritability, diaphoresis, and a headache. Physical examination was normal. Symptoms resolved upon reinitiation of gabapentin.

A separate case report described a 34-year-old male with lumbar disk disease who was treated with gabapentin 8,000 mg/day for 9 months (J. Toxicol. Clin. Toxicol. 2002; 40:925–8). He ran out of tablets and was unable to obtain a refill. After 2 days, he presented to the emergency department in status epilepticus. He had no prior history of seizure disorder and was not receiving other medications. Medical evaluation for other causes of seizure was ruled out. He was restarted on gabapentin (at a lower dose) and did well.

Other investigators described two cases of gabapentin withdrawal (J. Clin. Psychiatry 2007;68:483–4). The first patient was a 33-year-old man with a history of alcohol dependence and alcohol withdrawal delirium tremens. Multiple reliable sources indicated that he was using only cannabis, and laboratory studies were consistent with collateral sources. He received gabapentin 3,600 mg/day for alcohol cravings; 3 days after running out of tablets, he presented with confusion, diaphoresis, disorientation, agitation, tachycardia, hyperreflexia, and tremulousness. He was treated with lorazepam 6 mg/day and haloperidol 10 mg/day for 1 day without benefit. Gabapentin was restarted at 1,800 mg/day with resolution of his difficulties.

In the second case, a 63-year-old male was prescribed gabapentin 1,800 mg/day for chronic back pain. (He was actually taking more.) For various reasons, gabapentin was abruptly discontinued; 3 days later, he was hallucinating, tachycardic, febrile, diaphoretic, tremulous, and agitated. Over the next 2 days, he received 48 mg of lorazepam with limited improvement. On day 6, gabapentin 1,200 mg/day was restarted with rapid recovery.

The Conclusion

The database for gabapentin withdrawal is in the early phase of development and is entirely based on case reports, but cases of gabapentin withdrawal have included catatonia, seizure, and delirium tremens-like withdrawals, which is consistent with the presumed mechanism of action.

http://psych.imng.com/fileadmin/content_pdf/cpn/archive_pdf/vol36iss7/70473_main.pdf
http://www.ncbi.nlm.nih.gov/pubmed/21652784

 

[Swimmingdancer]

Thanks for all the info

So to be clear Chromophobia, you experienced withdrawals from pregabalin, not gabapentin, is that correct?

 

[queenbee2]

I would like to just add my quick two cents:

I have taken Gabapentin off and on for over 4 years for nerve damage/pain from a thoracotomy. I take 300mg 2x per day. I stop taking it for weeks at a time sometimes and have never experienced anything even resembling withdrawals. I am not on a very high dosage because if I take more, I start to experience odd side effects like double vision and edema in my legs.

 

[pasha]

Thanks for all the info

So to be clear Chromophobia, you experienced withdrawals from pregabalin, not gabapentin, is that correct?

I've been through withdrawal from both, but in the beginning only pregabalin. They have a cross-tolerance, and they work fine for each others withdrawals, given that you take an equipotent dose.

I also wanted to note, that when I was scouring through studies about withdrawal, I found a user of another forum who made an interesting observation. That if in fact these drugs work through GAD, this mechanism has the capability of becoming down-regulated.

I would like to just add my quick two cents:

I have taken Gabapentin off and on for over 4 years for nerve damage/pain from a thoracotomy. I take 300mg 2x per day. I stop taking it for weeks at a time sometimes and have never experienced anything even resembling withdrawals. I am not on a very high dosage because if I take more, I start to experience odd side effects like double vision and edema in my legs.

As I mentioned before edema and diplopia (double vision), and photophobia even (sensitivity to light) are very common symptoms of use and sometimes linger afterwards. There have been rare reports of patients developing permanent diplopia from pregabalin/gabapentin use, even birth defects in children, but the edema will surely disappear after a certain period of time.

It's also very possible that you don't get withdrawals from gabapentin and pregabalin.