Gabapenton and Previous History of Benzo Addiction

[Moreaux]

TLDR at bottom.

I'm torn as to where to stick this post and was considering the Mental Health forum, but I want the scientific answer and not personal experience on this. I have done copious research on this issue for the past week but am not satisfied with what I have read so I am hoping you guys can help me.

I am looking at getting a script for gabapentin to counteract the speedy effects of Wellbutrin XL. I started Wellbutrin three weeks ago and slowly increased my dose to 300mg as I do have a low siezure threshold and wanted to take it slow. It has been a struggle as Wellbutrin keeps me amped up and I am consistently only sleeping two or three hours a night. I do take 1.5mg of melatonin but that doesn't bring me down. I have also tried taking Indural (propranolol) 40mg before bed, and cannot increase the dose as I have my blood pressure is consistently low 90s/ high 50s low 60s. I know the propranolol will help reduce the norepinephrine piece of the Wellbutrin, but it's not reducing it enough.

As prior to Wellbutrin I was not taking any medication outside of melatonin, though I do have propranolol and trazodone on standby, and the trazodone is not an option because of seizures. I am thinking about getting a script for a sleep aid, but here is my situation. From 2000 - 2010 I was on Xanax "as needed" and became addicted. I never got high off of it or intentionally abused it but I used it daily, sometimes multiple times a day. I was also a hard alcoholic, and went to rehab in 2010 where I was cut off both cold turkey. I had extreme excitotoxicity from benzo withdrawal and it has taken me years to recover.

My research has shown that gabapentin does not kindle (want verification on this part), and it is a GABA-B where as Benzos, alcohol, and Nonbenzos are GABA-A. I would like to know if it would be safe for me to try gabapentin once a day, every other day, to alleviate the side effects of the Wellbutrin? My options are limited as antihistamines often used for sleep also have speedy effects on me, and I am a recovering addict so Phenibut and most other sleep aids are off the table. I have past experience with GHB and while I found it relaxing, it did not trigger my addict brain to want more which is why I am looking at gabapentin.
Gabapenton is also an attractive option for me as it will help with the constant energy which turns into ambiguous anxiety from the Wellbutrin, and I'm also hoping it counteracts the low siezure threshold from the Wellbutrin as I really am on the edge and don't want to start up traditional antisiezure meds again.

Getting off of Wellbutrin in the near future is not an option as I desparately need to quit smoking, and Chantix makes me suicidal and I lack the self control to just quit (very embarrassed by this). Sorry for the long post, just wanted to explain the specifics and my intentions. Any insight would be greatly appreciated! I also open to other prescriptions that may facilitate this endeavor - I am not married to gabapentin.

TLDR: Former benzo addict, quit benzos in 2010 - horrible withdrawal, would like to take gabapentin to counter speedy effects and low siezure threshold from Wellbutrin without it kindling with the benzos. Plan to use it every other day, once during the day.

 

[Solipsis]

No gabapentin is not a GABA-B agonist, it is a VDCC blocker like other gabapentinoids. This results in a few things like some excitatory neurotransmitter actions being attenuated, so yes it might counter some speedy effects of wellbutrin but I couldn't say if it's really a wise decision to do that. (It also shifts your body's GABA/glutamate balance a bit in the direction of GABA - which of course itself does act on GABA receptors). When you try if a medication like wellbutrin is right for you you normally weigh whether the pro's are worth the cons. If you have really great benefit from it then perhaps it is worth countering with another medication, but it is well worth considering the downsides of all the interactions, having to eventually withdraw from them, etc... and if this is really better than just trying another SNRI or SDRI. I understand if you need it to quit smoking, but just realize that it can be complicated to decide what can help you sleep and especially how long you can take it.

Fortunately gabapentin and pregabalin work rather quickly so you won't have to take weeks to find out if the combination is better for you...

As for 'kindling' if you call that sedative withdrawals: no, as it is not a GABAergic the withdrawals from gabapentin or pregabalin are not quite similar to those from alcohol or benzos. Not everyone gets them, it can depend on individuals, the dosage, probably whether other medications are involved or other factors. I've recently been withdrawing from pregabalin after 2 years - at anxiolytic doses, not anticonvulsant - and while it is not unmanageable or dangerous as I found benzos to be, it was still at times horrible for me. I lose the benefit they always give me and get the opposite in return... I can't really afford that so it really messed with my life, but I am coming out the other end.

Phenibut actually also acts as gabapentinoids do (VDCC blocking) so if that is off the table it is hard to understand why gabapentin or pregabalin are not. Also it is not regular to take gabapentin every other day... you would have to experiment but it would not be usual if it works. Then again: you don't need a good night's sleep desperately every night but you do need one every 2 or 3 nights.

I find the related pregabalin nice for sleep as it doesn't really sedate me and makes my sleep better but I don't wake up groggy but rather alright from it. However with other compounds involved it can be different.

So: it's not a bad idea, and especially not to take for a trial run (although maybe if you wanna try it take it every day for a few days to get a more consistent effect so that you can tell)... but it is not exactly the medication that you think it is.

 

[Moreaux]

Thank you so much for the information. Most of the literature I read on the internet associated gabapentin with GABA-B and the VDCC piece was not emphasized. I'm certain the resources I was looking at were substandard and overly simplified because I am not a scientist and only know the very basics regarding pharmacology, mechanisms of action, etc., which is why I posed the question here.

The info you provided allowed me to better understand how gabapentin works, and it's very enticing on many levels, particularly with anxiety, GABA, effects on glutamate. The piece about it preventing the formation of new synapses certainly makes gabapentin and pregabalin no longer options as I do want to recover more from Xanax withdrawal, and I suspect once I start gabapentin it would most likely be difficult to stop as it would bring my energy and anxiety levels down some. I don't want to regress in the healing process...my cognitive level and memory are about 80% of what they were before I began Xanax.

Regarding Phenibut, I think that may be too addictive and I don't want to risk an addiction, particularly with a substance that has no limits in procurement lol. I have read several Phenibut threads on this site and tolerance seems to build quickly and several users report being addicted.

I thank you again for your input! Kindest regards!

Moreaux

 

[aced126]

Maybe switch to an instant release formulation of bupropion? Almost all the sleep promoting agents I know of modulate in some way the GABA system, and most lead to dependence and possibly addiction. Even the newest of drugs which act on completely different neural circuits involved in sleep (e.g suvorexant, orexin receptor 1 and 2 antagonist) still have dependence liability. And quitting smoking is probably not a good reason to warrant getting dependent on another GABAergic.