116 replies to this topic

[DoneWithCrap]

From what I have found when I search this forum, gabapentin has a very short half life. That is what worries me the most. My prescriber claims that I will be taking a very small dose.
My question is two fold... Will it help at this dose and will I have more or fewer side effects if I take it?

[FiveNotions]

Renee, just my opinion, but I think this shit would be pouring gasoline on a fire ... tons of online forum comments from people who report getting migraines for the first time when starting gabapentin, many who say their migraines got a lot worse ...

 

Another issue I saw commented on ... people having trouble with the generic gabapentin, after switching from the brand Neurontin ....

 

Also, I've found a couple of the early research articles about the initial studies of Neurontin (it hadn't gone to generic gabapentin yet) to treat migraines ... I'm digging further, but it looks like Pfizer, the developer/mfg of Neurontin funded a couple of the studies .... then used the study evidence to promote sales/use of it for off-label rx for migraines ...

 

I think you may be rushing for a magic pill a bit too soon ... can't we see if there are other causes of / solutions for the migraines? Not to mention, perhaps your too rapid crapalta tapering is causing / worsening them?

[FiveNotions]

Results fudged in Pfizer-funded studies of its new epilepsy drug [Neurontin], analysis finds
http://www.cleveland...unded_stud.html

Reporting and other biases in studies of Neurontin for migraine, psychiatric/bipolar disorders,nociceptive pain, and neuropathic pain [U of California San Francisco, PhD thesis, 2008. The author did a pretty comprehensive "study of the studies."
http://dida.library....du/pdf/oxx18r10

Page 19: "With respect to Pfizer-supported studies of Neurontin in the areas of migraine, bipolar disorders, and pain, there is extensive evidence of reporting bias. Those that I observed, most of them many times over, included failure to publish negative results; selective outcome reporting where a secondary outcome or newly defined outcome was reported because the desired findings were not obtained for the primary outcome; selective analyses where, for example, patients were inappropriately excluded from or included in the analyses; multiple publication of desirable results; hiding of negative results in abstracts, letters to the editor, or other “grey literature”; and differential citation of Pfizer results to highlight actual or claimed positive findings. In addition, I observed extensive evidence of “reframing” or “spin” to make negative results appear positive. This was often accomplished by a “ghost author” working with a commercial company hired to accomplish Pfizer’s marketing goals related to its “publication strategy” (ie, the plan to successfully market Neurontin through selective publication of study results). There is also evidence that many of the studies were biased in their design, rendering their scientific value questionable."

US Circuit Court of Appeals, First Circuit
IN RE: NEURONTIN MARKETING AND SALES PRACTICES LITIGATION [April 2013]
http://media.ca1.usc...1-1904P-01A.pdf
Note: This decision from the Appeals Court upheld what the jury and the district found as to facts presented, and it upheld the district court's ruling against Pfizer and the other companies.

Page 9: "Both the jury and the district court found that Parke-Davis, Warner-Lambert, and Pfizer had "engaged in the fraudulent marketing of Neurontin" for the treatment of bipolar disorder, beginning in July 1998 . . . for the treatment of neuropathic pain, beginning in November 1997 . . . for the treatment of migraines, beginning in April 1999 . . . for doses greater than 1800 mg/day, beginning in November 1997 . . . This fraudulent marketing included, but was not limited to three strategies, each of which included subcomponents: (1) direct marketing (or "detailing") to doctors, which misrepresented Neurontin's effectiveness for off-label indications; (2) sponsoring misleading informational supplements and continuing medical education ("CME") programs; and (3) suppressing negative
information about Neurontin while publishing articles in medical journals that reported positive information about Neurontin's offlabel effectiveness."

[DoneWithCrap]

Thank you FN. I will not even fill the script.
Today I feel like I'm in cold turkey withdrawal. Brain zaps, nausia and vomitting, photo and phono phobic even more than usual.

I wonder if reusing gel caps that I had emptied other stuff out of my have damaged the capsules which would be like taking the beads without a gel cap?

I did buy a 1000 pack of empty gel caps and wii only use these from here on. Hopefully this will take that factor out of the equation.
I counted out my beads for the next 3 weeks decreasing 1 bead every 3 days. If I don't feel any better in a few days, I think I will go even slower.

I really hate this whole thing. I want it to be over as soon as I can but finally realize that it is not working the way I have been doing it.

Thank you all for your support. I should think about finding a psychitrist. The prescriber I see is a LPN. She said I should not be looking to this forum for advise because you are not doctors. I had to bite my young as to not say " Neither are you"!

[DoneWithCrap]

If the brain zaps are mild seizures, wouldn't an anti seizure med help with them?

That is why I asked if I could go back on the Topamax in the first place.

Just wondering...

[FiveNotions]

Renee, I've got to rely on FH, TM and the other bead counters for solid advice on this ... but here's my thought ... sounds like you've put yourself into a hard withdrawal phase, given the symptoms you're having. My suggestion would be that you need to up your crapalta dose to the last point where you felt stable and stay there for a while.

 

Once stable, start with the strict bead counting approach, using fresh/empty gel caps ... and go even slower than you have been.

 

I remember from when you first posted ... you had a long list of other meds you were on ... are you still taking all of those?

 

You must go slow with the Cymbalta tapering ... you are very very fragile and cannot afford to throw yourself into a tailspin ... nor do you want to add on more / new drugs to your already long list

 

The brain zaps are not minor seizures .... who in the world told you that? (Was it the "Licensed Practical Nitwit you just saw? ) They're the result of too rapid a drop in serotonin level in the brain ... they should minimize/go away if you go up on your dose... get stable and then slowly count down...

 

Also, are you taking omega 3 and chelated magnesium? Both help with zaps, especially the omega 3. (And, be sure to check the info FH posted just the other day about what other meds magnesium interacts with .. see the "Cymbalta in the news" forum ...)

[DoneWithCrap]

The problem is that I haven't been stable in many months, FN.
Even before I started tapering, I would accidentally miss doses. I wouldn't notice that I forgot to take my morning meds until the next day when I would have withdrawal symptoms. I don't even know what "stable" feels like.

[FiveNotions]

Oh my... what can you do to be sure you take your meds every single day? I'm not sure you should even be trying to taper off the Cymbalta if you weren't / aren't stable on the other stuff ....?? Are you still forgetting the others? Are you forgetting to take the Cymbalta?

You're really causing yourself a lot of unnecessary ... and possibly dangerous ... problems by missing med doses ... those you listed early on are not "just aspirin" to take "as needed" ...

You've got me worried here, dear one!
 

[thismoment]

ReneeRJ

 

Indeed you are in cold-turkey withdrawal. If I were in your shoes (I'm getting a peculiar visual on that one), I'd go back up to 20 mg and wean down from there over about 3 months.  Put the symptoms in charge: if you have difficult symptoms you're going too fast-- plain and simple.

 

Have a benzodiazepine standing by as-needed for anxiety, and you might just see your headaches diminish.

 

Take care.

[DoneWithCrap]

I have set my phone alarm to remind me to take my meds, eat breakfast and sleep. I don't know when I started using the alarm for this but I have only missed my morning meds once since then. Night time meds= sleep which causes anxiety for me but I have only missed them a few times.

I reduced my trazidone to 25mg and have kept at that since I started tapering (I think)
I upped my clonazepam to .75mg when I reduced the trazodone, but I'm upping that to 1mg starting tonight (yes I need to up it. It is not working anymore)
I think everything else is the same except for the acid reducer in the morning. New insurance wouldn't pay for it.

[FiveNotions]

Well, now I'm wondering about the Trazodone ... that's got a stiff withdrawal as well ... one withdrawal at a time is enuf ... what dose of Trazodone were you on before you came down to 25 mg.?

 

How long have you been on the clonazepam? You may be "pooped out" on it and need to switch to another one...

 

If by acid reducer you mean something for acid reflux, Prilosec is an OTC med that fixes it right up ... the generic is omeprazole, which even my Medicaid insurance covers ... it's lots cheaper than the Prilosec, amazingly ... Also, ACV fixes my acid reflux, so I don't need to omeprazole any more ... doesn't work for everyone tho' ... might be worth a try ...

 

Renee, have you ever done a list of all your meds, in chronological order beginning with the first one you were on? List the names, dates you started and stopped (to the extent you can remember), and what condition they were for?

 

I can't help but wonder if some of the stuff you've been put on was to treat the side effects of the earlier meds ... there must be a logical way to sort out all the stuff you're taking, and figure out possible ways to simplify this ... ???

[DoneWithCrap]

Thanks TM.
I will fill more gel caps to add more for each day.
It is hard for me to listen to my body because I have an autoimmune desease. My rhumitologist thinks it is mixed connective tissue dissorder for the blood work he has done. I guess I have been missing the cues of withdrawal symptoms and blaming my symptoms on MCD. I'm not all that in tune with my body. Never have been. I can dissociate pain of any type away. I have been diagnosed with DID but I think that is an exaggeration lol. There are only a few of us controlling my body and I'm just along for the ride. The more grounded I get, the harder it is to block out the pain. My therapist says this is an improvement. I have my doubts.

I'm feeling kind of confused and foolish right now. Don't worry though, with my poor memory, I will forget what an ass I am in no time

[FiveNotions]

Hey, feeling confused is why most of us ended up here ... confusion, and asking questions, learning and sharing with friends is the start of clarity ....as for feeling foolish ... I can't imagine why ... everything you've discussed here today has been sensible ... good questions, excellent observations about yourself and these meds ... now, if you turn up here naked, with your underpants on your head, wearing a Halloween mask ... okay, maybe I'd think "foolish" ... or, then again, I might just join you!

[DoneWithCrap]

The acid reducer was omeprazole. Fallon community health insurance won't cover it because it is available OTC. I tried ACV. It is like drinking a Summers Eve lol and is hard for me to swallow. I did drink it twice since I bought it. The first time in cold water then I put it in apple cider. It was easier to drink in the cider but still not very pleasent.

As for my history of meds goes, I have been on tons of different crap starting in my 20s. No way I can remember what I have been on or not. Never took an MAOI. That much I know for sure but I have been on many different antidepressants and antipsychotic meds. I'm sure I have been prescribed more meds to counteract the side effects. That is how I got up to 14+ Rx at one point.

I wish I could go inpatient and get off everything. Then put back on only the things I need. Hard to admit that I would ever go back inpatient after all the hard core hospital time I have had in my past, but if there was a doctor out there who believed in me, I would.

[DoneWithCrap]

Lol Thank you FN. I guess I feel less foolish. FYI my underwear would never wind up on my head lol. They are the sacred protector of my underworld

Oops. I shared too much lol

[fishinghat]

You got the names right FN. Gabapentin has been linked to pancreatic and liver cancer by the FDA. They put out a warning about 5 years ago and my dr called me into his office right away to let me know to get off it. There are only a few drs left here that will still prescribe it and they run screenings every 6 months for liver and pancreatic function.

[FiveNotions]

Renee, I found what seems to be a very informative thread on Trazodone ... on http://survivingantidepressants.org/

http://survivinganti...zodone-desyrel/

How long have you been on it, and for what condition? Have you had any of its side-effects and been put on other meds to treat the S/Es?

[DoneWithCrap]

Thanks FH
Time to find a real psychitrist

[fishinghat]

The current FDA black box warning is below.

 

 

WARNING: ADDICTION, ABUSE, and MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION, ACCIDENTAL INGESTION; and NEONATAL OPIOID WITHDRAWAL SYNDROME
See full prescribing information for complete boxed warning.

• MS CONTIN exposes users to risks of addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk before prescribing, and monitor regularly for development of these behaviors and conditions. (5.1)
• Serious, life-threatening or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Instruct patients to swallow MS CONTIN tablets whole to avoid exposure to a potentially fatal dose of morphine. (5.2)
• Accidental ingestion of MS CONTIN, especially in children, can result in fatal overdose of morphine. (5.2)
• Prolonged use of MS CONTIN during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. (5.3)

http://dailymed.nlm....75-37B2E9FF65F6

 

Link to complete FDA info. I really suggest you read this.

[FiveNotions]

Renee, if you want to go into the hospital to get all this sorted out, there must be a place covered by your insurance and a doc who will support you in doing so. If you need help finding a facility, and a doc who will help you, just PM me with where you live, I'll try to find this information for you.

Can you afford the Prilosec? I think Target and CVS sell their own version of it, which is cheaper ...

[FiveNotions]

First things first, tho', Renee ... I sort of got us side-tracked here ... back to the Cymbalta ... can you get yourself back up a dose level and stay there until you feel better?

We also need to think about whether it's the Cymbalta you should be trying to get off of first ... FH? TM? Thoughts ... trazodone? Cymbalta? Or nothing and just get more stable for a while?

[DoneWithCrap]

I never took the trazodone the same way twice. I admit that I am a terrible patient when it comes to taking my meds. I don't know how to look through my old posts but I did post a while back about my plan to reduce the trazodone to half a tab a night instead of the 1.5 tabs as prescribed which I wasn't taking consistently. I pop so many pills (all prescribed) that I didn't even think of things like withdrawal or interactions. For me, everything I was prescribed was PRN and I had no idea of the danger I was causing myself.

[FiveNotions]

Oy... "everything is PRN" ... double Oy ... sure am glad you told us this ... it ties into everything else you're dealing with

 

But please tell us you're not still PRNing, are you? If so, stop that immediately !

 

Renee, it's time to step up to the plate and act responsibly ... take responsibility ... for each and every one of your meds ... no telling how much of your current illness you've brought on yourself ... we can't help you got off this shit unless you get on it, at your proper dosage and proper dosing schedule ...

 

If you can't do this for yourself, do it for Benzo the Wonder Dog ... he needs you healthy to keep making him that homemade doggie chow!

[fishinghat]

"I went to my psych prescriber on Thursday and she thinks I'm tapering too fast. I agree since I'm having so many symptoms. I'm at 32 beads down from 320 in a 60mg cap which puts me at 6mg. I had planed to remove a bead a day an be done in 31 days but now I'm going to only drop a bead every 3 days." day plan.

 

First of all if you are that far down then just stick with the 1 bead every 3

 

"From what I have found when I search this forum, gabapentin has a very short half life. That is what worries me the most. My prescriber claims that I will be taking a very small dose.
My question is two fold... Will it help at this dose and will I have more or fewer side effects if I take it?"

 

What dose did he/she prescribe?  As mentioned above it has been linked to pancreatic and liver cancer. It also has no withdrawal. I dropped mine cold turkey with no problem.

 

Even before I started tapering, I would accidentally miss doses. I wouldn't notice that I forgot to take my morning meds until the next day when I would have withdrawal symptoms. I don't even know what "stable" feels like.          

 

"The problem is that I haven't been stable in many months, FN."

 

I think in order to get stable Renee you may have go back up on your dosage. You have a couple choices

1) Stay at your 1 bead every 3 days level until you feel better then continue dropping

2) Just go ahead and finish up at 1 bead every 3 days. 

 

I think option 1 is unworkable as it may take you a couple of months to settle down. I think you should proceed with option 2 and if thewithdrawal gets too bad go backto your dr for something to help (benzo, clonidine or hydroxyzine).

 

 

"I reduced my trazidone to 25mg and have kept at that since I started tapering (I think)
I upped my clonazepam to .75mg when I reduced the trazodone, but I'm upping that to 1mg starting tonight (yes I need to up it. It is not working anymore)
I think everything else is the same except for the acid reducer in the morning. New insurance wouldn't pay for it. "         

 

You are putting your body through way too much at once. Stop screwing with the trazadone. Take it at the prescribed time every day and at the prescribed dose. You need to worry about that later. If you have built up tolerance to the clonazepam (which is likely) then increasing it by 0.25 mg will do little for you but it won't hurt you either.I have been on clonazepam and all my increases in dose where 1 mg each time just to get an effect. Something to consider. The dr can switch you over to oxazepam (another benzo) which you body should not be tolerant to. It has a very long half life and is easier to come off of than clonazepam. It will help with the withdrawal as well.

 

"The acid reducer was omeprazole. Fallon community health insurance won't cover it because it is available OTC. I tried ACV. It is like drinking a Summers Eve lol and is hard for me to swallow. I did drink it twice since I bought it. The first time in cold water then I put it in apple cider. It was easier to drink in the cider but still not very pleasent."

 

Omeprazole is available over the counter and is not expensive. If I remember right it should not be taken with an ssri/snri but I may be wrong. I will ckeck on that. Also I have never tried drinking Summers Eve. That is an interesting approach to curing a psych problem. lol

 

More to follow.
 

[DoneWithCrap]

Thank you FH.
I am crazy but I have never tried drinking Summers Eve either lol. It was just the first thought that came to my mind when I tried drinking the ACV. (You see. I'm a little twisted in the head too ) lol

[fishinghat]

Just as I remembered. The recommended acid reducer to be used is Zantac.

 

 

"Serious - Use AlternativePossible serious or life-threatening interaction. Monitor closely. Use alternatives if available.

duloxetine oral will decrease the level or effect of omeprazole oral by affecting hepatic enzyme CYP1A2 metabolism."

 

What this means is it is very damaging to kidneys.

 

Renee Please follow FN's post of 5:55 concerning "everything is PRN". It is very dangerous to take your meds that way.

[FiveNotions]

FH, I'm reading that people do have withdrawal issues with gabapentin...?

[FiveNotions]

Great to know that about the omeprazole, FH ... I developed acid reflux while on the Cymbalta, and my doc promptly put me on the stuff ... is their no end to their (docs) asshattery?

[fishinghat]

FH, I'm reading that people do have withdrawal issues with gabapentin...?

This is from the manufacturer. I too found a lot of personal references to withdrawal on forums but very little in any official documents. Will keep looking, Also some cancer info here.

 

Withdrawal Precipitated Seizure, Status Epilepticus

 

Antiepileptic drugs should not be abruptly discontinued because of the possibility of increasing seizure frequency.

In the placebo-controlled studies in patients >12 years of age, the incidence of status epilepticus in patients receiving Gabapentin was 0.6% (3 of 543) vs. 0.5% in patients receiving placebo (2 of 378). Among the 2074 patients >12 years of age treated with Gabapentin across all studies (controlled and uncontrolled), 31 (1.5%) had status epilepticus. Of these, 14 patients had no prior history of status epilepticus either before treatment or while on other medications. Because adequate historical data are not available, it is impossible to say whether or not treatment with Gabapentin is associated with a higher or lower rate of status epilepticus than would be expected to occur in a similar population not treated with Gabapentin.

 

Tumorigenic Potential

 

In standard preclinical in vivo lifetime carcinogenicity studies, an unexpectedly high incidence of pancreatic acinar adenocarcinomas was identified in male, but not female, rats. (See PRECAUTIONS, Carcinogenesis, Mutagenesis, Impairment of Fertility.) The clinical significance of this finding is unknown. Clinical experience during Gabapentin's premarketing development provides no direct means to assess its potential for inducing tumors in humans.

In clinical studies in adjunctive therapy in epilepsy comprising 2085 patient-years of exposure in patients >12 years of age, new tumors were reported in 10 patients (2 breast, 3 brain, 2 lung, 1 adrenal, 1 non-Hodgkin's lymphoma, 1 endometrial carcinoma in situ), and preexisting tumors worsened in 11 patients (9 brain, 1 breast, 1 prostate) during or up to 2 years following discontinuation of Gabapentin. Without knowledge of the background incidence and recurrence in a similar population not treated with Gabapentin, it is impossible to know whether the incidence seen in this cohort is or is not affected by treatment.

[DoneWithCrap]

I was taking omeprazole in the morning with breakfast before our new insurance denied it. I did buy it OTC and take the Rx dose until I ran out and kept forgetting to buy more. I was and still am taking Ranitidine 300mg (Zantac) before bed.

This is one time my forgetfulness has helped me.

As far as taking all my meds as PRN, I haven't done that since I joined this forum. Thanks for setting me straight in that one