Scrofula
Bluelight Crew
Well, some good news, maybe: gabapentin (hereafter GBP) and her quirky kinetics.
So you take 7.2 grams GBP every twelve hours. Well, there's a well-known issue of diminishing returns for this drug--the more you eat, the less (per dose) you actually get into your blood. If you take a 400mg dose, 188mg gets into your blood (47% ). But an 800mg dose only gives you 272mg (34% ) (these are real data from the FDA monograph).
The trend continues, but no one's looked at even half your dose. Well, math does exist, and people who know how to use it estimate that the most you can absorb in a 24 hour period is 5 grams. This is from the appropriately named journal Seizure who list references that suggest 6 grams is a more likely cutoff. That's 6 grams divided, too, so really 3 grams at a time, twice a day.
The implication is that you could, right now, cut your use in half and never notice a thing. You've been essentially shitting out half your pills. But you're also taking 3X the max daily dose, and 4x the max single dose, so we can't even use their math to estimate (their number are still in the linear range). Not to mention how your guts have adapted. So maybe slightly less than half was shit out?
All else being equal, I would tell you to cut in half right now, and taper down to levels at least found in LD50 calculations.
But, you claim an inheritable seizure disorder in your family, and are taking a seizure-risk drug of unspecified quantity, and a short-acting benzodiazepine. This paper tested "high" dose GBP's effects on anti-seizure meds, but tramadol and benzos weren't included. GBP is not metabolized, you just piss it out, so I wouldn't worry about interference from your liver. But who knows what impact an extra half-ounce of drug going through your kidneys has on the other drugs you take. Their concentrations may be higher than normal, and cutting your GBP means you'd also lower their concentrations. Maybe just for the benzo, putting you at risk of seizure.
So, you obviously need to tread very lightly, and discomfort from a gabapentin withdrawal should be the least of your worries, before you go status epilepticus on some country road.
I think you need blood work to monitor your GBP to safely taper off it completely. And after that stop the tramadol if you're a seizure risk to begin with.
So you take 7.2 grams GBP every twelve hours. Well, there's a well-known issue of diminishing returns for this drug--the more you eat, the less (per dose) you actually get into your blood. If you take a 400mg dose, 188mg gets into your blood (47% ). But an 800mg dose only gives you 272mg (34% ) (these are real data from the FDA monograph).
The trend continues, but no one's looked at even half your dose. Well, math does exist, and people who know how to use it estimate that the most you can absorb in a 24 hour period is 5 grams. This is from the appropriately named journal Seizure who list references that suggest 6 grams is a more likely cutoff. That's 6 grams divided, too, so really 3 grams at a time, twice a day.
The implication is that you could, right now, cut your use in half and never notice a thing. You've been essentially shitting out half your pills. But you're also taking 3X the max daily dose, and 4x the max single dose, so we can't even use their math to estimate (their number are still in the linear range). Not to mention how your guts have adapted. So maybe slightly less than half was shit out?
All else being equal, I would tell you to cut in half right now, and taper down to levels at least found in LD50 calculations.
But, you claim an inheritable seizure disorder in your family, and are taking a seizure-risk drug of unspecified quantity, and a short-acting benzodiazepine. This paper tested "high" dose GBP's effects on anti-seizure meds, but tramadol and benzos weren't included. GBP is not metabolized, you just piss it out, so I wouldn't worry about interference from your liver. But who knows what impact an extra half-ounce of drug going through your kidneys has on the other drugs you take. Their concentrations may be higher than normal, and cutting your GBP means you'd also lower their concentrations. Maybe just for the benzo, putting you at risk of seizure.
So, you obviously need to tread very lightly, and discomfort from a gabapentin withdrawal should be the least of your worries, before you go status epilepticus on some country road.
I think you need blood work to monitor your GBP to safely taper off it completely. And after that stop the tramadol if you're a seizure risk to begin with.
