Misc Gabapentin suddenly stopped working?

[Swimmingdancer]

So I recently started taking gabapentin, and it was working quite well for my fibromyalgia and post-acute methadone withdrawal symptoms at first, but after about a week it very suddenly stopped doing anything perceptible. When I was first taking it even a low dose would give a noticeable improvement in pain and a perceptible feeling of being on a drug, now even if I take a much higher dose I feel nothing and my pain has gotten severe again. Does it just build tolerance extremely fast or what? Surely if it was just tolerance then a higher dose would still do something?

I really don't think it was just placebo effect when I first started it, as I am generally pretty resistant to placebo effect and like I said there was a noticeable drugged feeling initially as well. I've tried taking multiple lower doses throughout the day, taking it with food, etc. My pharmacist said it should get more effective for pain after about a week.

Could the fact that I was on methadone for a long time have something to do with it? I don't really understand how gabapentin works, maybe no one does? What I have read is that it was initially developed to mimic GABA, but is not actually believed to act on the GABA receptors, and its mechanism(s) of action is unknown or at least poorly understood? One doctor told me gabapentin was an NMDA antagonist, and apart from being an opioid methadone is an NMDA antagonist, so that's why I'm asking if there is possibly some connection with the methadone. Another source says it inhibits calcium channels.

 

[Nine North]

It could be a tolerance thing, gabapentin is notorious for how quickly your body assimilates it. IDK about the methadone interaction but a dr once told me Lyrica was designed especially to avoid that superfast assimilation, not if he was right about Lyrica's origins/design but maybe try pregabalin instead? I've taken both for nerve pain and definitely didn't assimilate Lyrica as fast as the gaba

 

[Swimmingdancer]

Well that's interesting, unfortunately I won't be able to try switching to pregabalin for a long time. Also it is way more expensive than gabapentin is for me.

When you developed a tolerance to gabapentin did you find taking higher doses to compensate, or were you like me and felt nothing even with higher doses?

 

[tricomb]

The only way I could feel 600mg pregabalin without thinking it was 100% placebo was if I took it every 3 days..... I have taken huge doses of it and still felt nada.

I have no idea how people with fibromyalgia and other nerve pain disorders get by using gabapentin or pregabalin.

Pregabalin seems to be snake oil if you ask me. And it's supposed to be the new-and-improved gabapentin, so I dunno mate, I wouldn't get your hopes up.

 

[Nine North]

Well that's interesting, unfortunately I won't be able to try switching to pregabalin for a long time. Also it is way more expensive than gabapentin is for me.

When you developed a tolerance to gabapentin did you find taking higher doses to compensate, or were you like me and felt nothing even with higher doses?

I hear you about the expense for pregabalin, I went back to the gabapentin cause of that, sucks that Lyrica is so pricey/big pharma are so greedy. And yeah, even when I tried considerably higher doses it really didn't stick, I felt it a tiny bit more but not nearly enough to make it worth it, and it was more of a fog than any pain relief anyway. It does still help me with pain but that's cause I take it as little as possible, saving it for the really bad days; personally found that not using it at times did mean my tolerance went down, have read from others that wasn't the case for them.

@tricomb yeah, there are still plenty of questions about pregabalin, the other thing that seems more common with Lyrica than gaba, at least from what I've read, is that some people report some nasty wds when going off it. IDK, Lyrica was too expensive for me to ever take it long enough to find out.

 

[Swimmingdancer]

The only way I could feel 600mg pregabalin without thinking it was 100% placebo was if I took it every 3 days..... I have taken huge doses of it and still felt nada.

I have no idea how people with fibromyalgia and other nerve pain disorders get by using gabapentin or pregabalin.

Pregabalin seems to be snake oil if you ask me. And it's supposed to be the new-and-improved gabapentin, so I dunno mate, I wouldn't get your hopes up.

Yeah, I rarely get my hopes up these days . Do you think both gabapentin and pregabalin are ineffective, or just pregabalin? They do seem to affect different people very differently (some people think they're wonder drugs, some people say they do nothing). And yeah, in general pregabalin is not THAT effective: one randomized controlled trial of pregabalin at a dose of 450 mg/day found that only 1 in 6 patients had a 50% or more reduction in fibromyalgia-related pain. I am trying really hard to get/stay off opioids (still using very low doses of oral opioids occasionally, not sure if that's actually doing anything to be honest), they no longer work for me anyway. Just experimenting with other drugs that have less dependence potential than opioids but my goal is to eventually be drug free. I need some help right now though, going through a really tough time. Exercise is actually proven to be far more effective than drugs for fibromyalgia but it's very difficult to motivate myself to get any exercise when I am so fatigued and in so much pain, and it's so dark and cold outside.

It does still help me with pain but that's cause I take it as little as possible, saving it for the really bad days; personally found that not using it at times did mean my tolerance went down, have read from others that wasn't the case for them.

Yeah, I think I will try that. Maybe higher doses are not necessarily better. And yeah, some of its effects for me is/was just making me feel calmer and care less about the pain - which is certainly helpful even if the pain is still there.

the other thing that seems more common with Lyrica than gaba, at least from what I've read, is that some people report some nasty wds when going off it. IDK, Lyrica was too expensive for me to ever take it long enough to find out.

True, that is a consideration for me. I have definitely heard more people complaining of horrible WDs from pregabalin than gabapentin. And I don't need that!

 

[BrokedownPalace]

I have been prescribed gabapentin (neurontin) since I was 17. I, too, have noticed the notorious tolerance issue after only a short time of using it. Nowadays, the only time I get any appreciable effect from it is if I abstain from taking it for a week +, and then take a moderate sized dose. After about three days of use my tolerance sky rockets and the drug is basically useless, anymore. Which is unfortunate, since I find it actually is an underrated compound, working pretty decently in regards to my nerve pain, and it also helps with anxiety. It is wonderful as well when used during opioid withdrawal. Pregabalin is far superior, and when I can see a doctor again I want to get on that instead of gabapentin.

 

[Nine North]

I have been prescribed gabapentin (neurontin) since I was 17. I, too, have noticed the notorious tolerance issue after only a short time of using it. Nowadays, the only time I get any appreciable effect from it is if I abstain from taking it for a week +, and then take a moderate sized dose. After about three days of use my tolerance sky rockets and the drug is basically useless, anymore. Which is unfortunate, since I find it actually is an underrated compound, working pretty decently in regards to my nerve pain, and it also helps with anxiety. It is wonderful as well when used during opioid withdrawal. Pregabalin is far superior, and when I can see a doctor again I want to get on that instead of gabapentin.

That's pretty much how I use it, not taking it at all as long as can deal with the pain, then going back to it with as low a dose as helps, skipping dosages/days, anything to keep the toleration down till have to take a full break again. And I agree these are interesting compounds, when gaba is working it's useful for a number of things, nerve pain, anxiety, opiate wds, and on the flip side it also works really well with opiates. It's just a shame about the assimilation cause when it's effective it's a good, non-narcotic, non-addictive med. I'd like to have a chance to try Lyrica longer than the brief 2-3 months had it before, though the potential addiction/withdrawal is definitely worrying.

Anyway hope maybe cutting back then re-trying the gaba helps you a bit Swimming, and you're right, its calming properties at least help with dealing with the pain even if doesn't relieve it directly. Nerve issues are just miserable in every way: difficult to understand, difficult to diagnose, difficult to treat, just difficult in every way, and every person has a unique situation, probably why the reaction to these meds is so idiosyncratic as well. Be nice if someone came up with a drug in the middle, gaba without the tolerance issues but Lyrica without the potential wds. Problem is even if they d it'll still cost a fortune.

 

[laCster]

Gabapentin tolerance grows faster than anytbi.g i have tried. If I take it two days in a row, the second day I doblnt feel shit. You not feeling neurontin could.be with its extremely variable bioavailability.

Do you stack your doses? To get the best effect take 100 mg gabapentin every 45-60mins

I switched to lyrica to not deal with that bullshit. I agree with bdp, prebabling and gabapentin are severely under rsted, but Pregabalin is 10 times more.effective than gabapentin


You could try gabapentin encarbiil which is xr gabapentin, but I really recoomend Pregabalin

 

[tricomb]

Stacking doses works with gabapentin?

It sure as hell does NOT work with pregabalin. That was one thing that I noticed about pregabalin. The only time it could give me placebo-like effects was when I bolus dose dumped it all at once, and everyone I've talked to, including people who actually can feel pregabalin, they all confirmed that redosing doesn't work for them either.

So yeah, I have my doubts about pregabalin, but I am not very experienced with gabapentin, so maybe it does stack in a way that pregabalin doesn't.

 

[glasgow]

I've heard gaba. sells inside, and they snort it ,so I've snorted 300 twice in half hour about to do another 300 in ten min i feel energetic got some get up and go and I need it to face the Xmas rush but ill check back in later let u guys know how it went, I'm a gabapebtin newcomer onlytaken 1nce before too drunk too notice

 

[Swimmingdancer]

Do you stack your doses? To get the best effect take 100 mg gabapentin every 45-60mins

Yeah, that's what I do, except during the night unless I wake up and think to take some or something (night is the hardest time for me unfortunately). Except my next script is for the 300mg capsule size so I won't be able to do that (unless the capsules can be opened and divided? I'm not sure if they have an enteric coating or something that makes it necessary to keep it in the capsule?)

Stacking doses works with gabapentin?

It sure as hell does NOT work with pregabalin. That was one thing that I noticed about pregabalin. The only time it could give me placebo-like effects was when I bolus dose dumped it all at once, and everyone I've talked to, including people who actually can feel pregabalin, they all confirmed that redosing doesn't work for them either.

So yeah, I have my doubts about pregabalin, but I am not very experienced with gabapentin, so maybe it does stack in a way that pregabalin doesn't.

Studies have shown that stacking doses is effective with gabapentin, but not with pregabalin. The bioavailability of gabapentin is not dose-proportional, it decreases as the dose increases. For example, 300 mg taken 3x/day per day has a BA ~60%, whereas for 1600mg 3x/day the BA is only ~27%. Pregabalin on the other hand is supposed to have a dose-proportional BA of around 90% (as with all BAs I'm sure in reality it can vary considerably from person to person though).

 

[Choosing_Positive]

Pegabalin works great...but you gotta find your dose. Try getting a few sample bottles (should be 75mg capsules) and titrating up to find your magic number. For me it was 550, but after a while I went down to 225, still with affective results.

Swimmingdancer, it's definitely worth a shot. It is different for everyone; some people it seems to do nothing, for others (like me) it is a godsend. Good luck friend...