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  • BDD Moderators: Keif’ Richards

Paradoxical Reaction to Gabapentin

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Just saw your last edits. How are you? Are you ok? What are you doing with your gabapentin dosing now? I think if you're getting that bad of withdrawals that fast from the gabapentin it's best to taper your drugs one at a time. I sent you a PM. Hope you're feeling better, stay strong :)
 
Monday was a rough day. It wasn’t so much the usual withdrawal symptoms but the feeling like I was going to have a seizure. The rescue dose of 250mg gabapentin kicked in along with 1mg of alprazolam and I felt better but I was exhausted and scared. I tapered back up to 275mg TID on Tuesday and I felt a lot better.

I’m definitely staying with TID dosing and not even considering a multiple drug taper after Monday’s experience.

Loved your PM and am in the process of writing you back.

Thanks for hanging in there with me. This is one bumpy ride.
 
I have always been either too intense or too withdrawn for everybody else. I don’t care if I am alone anymore. I want off the drugs to “regulate my personality” and just want to be me. I did not go on all these drugs for mental health issues! It was all for migraines!

I'm so hypersensitive to everything now that I don't know how to live like this. I am so desperate for relief. I can’t go on like this.

Any suggestions or input would be most welcome and appreciated.
 
Here is the problem as I see it:

These are the only solid bioavailabilities I have been able to find for gabapentin.*
4,800mg TID has a BA of 27%
3,600mg TID has a BA of 33%
2,400mg TID has a BA of 34%
1,200mg TID has a BA of 47%
900mg TID has a BA of 60%
600mg TID has a BA of 40%
300mg TID has a BA of 60%
200mg TID has a BA of 40%
100mg TID has a BA of 70%

*See Swimmingdancer's correction below.

BA is potentiated by TID dosing and reduced by BID or SID dosing. Taking it with food increases the bioavailability by 14%. Antacids and magnesium decrease the bioavailability.

So with the unknown variables between the doses regarding BA it is impossible to construct a taper without just guessing. You could be decreasing your dose but increasing your BA, decreasing the dose by 10% in milligrams but a much higher or lower number in BA, or, getting nowhere.

Also, I was on 900mg SID and was told to taper TID for more stability due to the short half life. This could have actually raised the BA by 180mg per day. Additionally, having TID dosing could be more addicting than the SID dose as the tolerance could build up faster, making the withdrawal and the withdrawal symptoms even harder.

How in the world do you taper off this drug? This is crazy.
 
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I would try not to stress about it too much, your taper doesn't have to be perfect, and creating a taper plan is not an exact science. I would go with your previous idea of starting off with a rate of around 30% per cut, then decreasing it to 20% per cut, then 10% per cut as your dose gets lower. You don't really know how your brain and body are going to respond and it varies so much from person to person, so all you can really do is play it by ear and slow down or increase the holds if the withdrawals get too bad. If withdrawals are really bad you can just raise the dose back up to the previous dose and stabilize for a little while, then try to cut it by a smaller amount the next time. Good luck :)

Also the numbers you listed for the bioavailabilities for 600mg, 300mg, 200mg, and 100mg TID are not correct.
 
Then please feel free to correct me because those are the numbers I'm finding and I need the right answer please.:)

I think the problem is that some of those numbers did not actually come from TID dosing. (Also the BA you listed for 4,800mg TID was not correct either, probably a typo :) )

4,800mg TID or 1600mg in one dose has a BA of 27%
3,600mg TID or 1200mg in one dose has a BA of 33%
2,400mg TID or 800mg in one dose has a BA of 34%
1,200mg TID or 400mg in one dose has a BA of 47%
900mg TID or 300mg in one dose has a BA of 60%
300mg TID or 100mg in one dose has a BA of 70%

We don't have published BAs for less than 100mg per dose. My assumption is that it stays at around 70%-75% and doesn't increase much once the dose gets lower. The ER formulation has a reported BA of around 75%, so if you think of taking an ER pill as about the same as taking really tiny doses every hour, then that makes me think that with oral administration the maximum possible BA is ~75%.
 
Yes, that was a typo. Thanks.;)

I'm so glad you posted the correct numbers. Guess I'll have to do another spreadsheet, lol. Gives me something to do while I'm holding.8)
 
Sadly there is no way to come up with the perfect taper that will ensure no withdrawal symptoms while still tapering as quickly as possible :( It's so highly variable and often no matter what you do you're going to have some withdrawal symptoms. The key is keeping them to a manageable level that doesn't make you go crazy or give up, and learning how to mentally cope with some level of symptoms and the psychological difficulties in getting off a drug. But it's hard to predict in advance what that ideal taper will be for an individual, plus it fluctuates.
 
It has been suggested to me by several people that due to my hypersensitivity, it might be better if I cut by a few milligrams every day instead of doing the 10% for 10 days taper. I could keep going at a few milligrams every day or do holds if I needed to so I don’t get nailed by the cumulative effect.

This would, in theory, would eliminate the withdrawals I could feel for the first three or four days every time I cut by 10% after holding for 10 days and make the transition smoother instead of cyclic.
 
i have been on gabapentin since 2007. My dose started off at 300mg's twice a day and now i am prescribed 800mg's 4 times a day for a total of 3200mg's a day. I usually only take 2400mg's a day now though or sometimes less as i can get away with taking 800mg's in more divided doses by splitting the tablets in half. I had to taper down and for me it wasn't too bad as i had clonazepam as well as seroquel to calm me down.

I must say that cold turkey gabapentin wd's is one of the most painful withdrawals i have ever been through. My insurance decided to fuck me over and stop paying for my gabapentin for about 2 weeks so i was stuck with nothing as there is no way i could afford it. I had tremors, aches and pains all over, really bad sweats, headaches, severe restlessness, pupil dilation, restless leg syndrome that sometimes extended all over my body and extreme hypersensitivity to touch or any kind of pain. I remember one time when someone accidentally bumped into my arm and it sent a jolt of nerve pain up and down my arm that hurt like hell. And of course my nerve pain came back with a vengeance :! . My doctor added 10mg's of Valium to take as needed along with my clonazepam so that helped a good bit but it didn't take away all the wd's.

I would say taper very slowly especially since you seem to be very sensitive to gabapentin withdrawals. Tapering down by a few mg's a day wouldn't be too hard if you get the capsules because you could just empty out the beads a few at a time.
 
Hi. I was wondering about any updates on progress with gabapentin taper. I always want to post here but my mind is so foggy from gabapentin over the years. withdrawing from this is the first thing I want to get through before getting my life back together. I've gotten to the point where I can't even post in forums like this because I don't even have the energy. I've always liked lurking on blue light from time to time and noticed this post and another one about gabapentin withdrawal and thought it was perfect, as this is the reason I never even bothered to make an account. SWIM misses a day here and there of social and recreational dabbling, but this drug has put him on the shelf and turns him into a goddamn mess. We both have searched for answers for too long and have no support in this matter and get shit from friends thinking its all in the mind. I've withdrawn from alcohol, opiates, benzos and stimulants but cannot seem to beat this one. This drug has helped me to recover from alcohol' opiates and benzos for years but never thought I'd have a problem with this shit. I'm not using thee forums just for this problem....I just prefer blue light over other forums I see. Sorry for the rambling. Any thoughts?
 
As this is a bump of an older thread which is discouraged I'm going to go ahead and close it. Feel free to start a new thread with your questions.
 
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