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How Effective Is Gabapentin for Neuropathic Pain?

B. Chisholm
B. Chisholm

Gabapentin for neuropathic pain has been found to be very effective when used correctly. Neuropathic pain refers to nerve pain and can be highly debilitating and affect the sufferer’s quality of life significantly. It occurs most commonly in patients with diabetes and after a herpes infection such as shingles. Gabapentin for neuropathic pain is available in most countries by prescription only and may be known by different trade names in different countries, according to manufacturer.

Neuropathic pain, often referred to as postherpetic neuralgia when occurring after a herpes zoster (shingles) infection, occurs due to damage caused to the nerves during the infection. This may result in various symptoms including burning pain, sensitivity to light touch or clothes, itching or numbness and may last for months to years. Treatment is often difficult and may include the use of analgesics, tricyclic antidepressants and antiepileptic drugs, like gabapentin.

Nausea and vomiting are possible side effects of gabapentin.
Nausea and vomiting are possible side effects of gabapentin.

Gabapentin is most commonly used to treat some types of epilepsy. It is not fully understood how gabapentin for neuropathic pain works but many studies have shown it to be effective for this indication. Due to the difficulty often experienced in trying to control neuropathic pain, the treating doctor may try different medications from different classes until pain control is achieved. In some cases this may entail the use of numerous medications together.

Neuropathic pain is common after a herpes infection like shingles.
Neuropathic pain is common after a herpes infection like shingles.

When using gabapentin, the doctor will usually start at a low dose and increase the dose slowly over a number of days, monitoring their response to the drug and tolerance of potential adverse effects. Side effects of gabapentin may include sleepiness, dizziness, headache, nausea and vomiting. It is recommended that driving and the operation of heavy machinery is avoided until the maintenance dose is established, and the patient’s response is known.

The prescribed dose of gabapentin for neuropathic pain should not be exceeded without a doctor's approval.
The prescribed dose of gabapentin for neuropathic pain should not be exceeded without a doctor's approval.

The prescribed dose and dosage interval of gabapentin for neuropathic pain should not be exceeded without discussion with the prescribing doctor. Depending on the severity of the pain and the person’s response, therapy with gabapentin may be long term. The drug should not be stopped suddenly, but rather withdrawn slowly with tapering doses, under supervision of the doctor.

Sleepiness is a common side effect of gabapentin.
Sleepiness is a common side effect of gabapentin.

Other medications, including homeopathic, over-the-counter and complementary medications should be discussed with the prescribing doctor before starting gabapentin for neuropathic pain as interactions may occur with other drugs. Underlying clinical conditions should also be disclosed as it may be contraindicated in people with some medical conditions. Pregnancy, desired pregnancy and lactation should also be discussed.

Discussion Comments

anon995348

Gabapentin is worthless. All one has to do is read the studies by Pfizer for post-herpetic-neuralgia pain pre-FDA approval for that use. Controlled bias, no confounders, and three subsequent studies produce "results favorable over 50 percent of patients," all at differing doses per study. Imagine that. A drug with varying doses, all with the same wonderful results in 50 percent of patients.

If you don't know how to read a clinic trial study, then learn how. You'll learn where to spot the bias, lack of controls, errors etc. They don't even know "how" it works, but have no problem promoting its use to doctors and patients, much like its predecessor which was under scrutiny and nearly bankrupt because they were promoting it for off-label uses not clinically trialed and approved by the FDA.

Sadly, the real pain control is denied by physicians to patients who really need it (for chronic and acute pain conditions). And let's not get into the serious side effects of both dosing and withdrawal periods from gabapentin and Lyrica (basically the same drug with Lyrica's additional ingredient).

anon963443

That is a lie and an insult. I have had such drastic neuropathic pain and I've eaten gabapentin in all types of regimens.

That clause "when used effectively" is bull. For severe pain, none of the neuropathic agents come close to narcotics. They remain the most effective.

Gabapentin helps with the girdle sensation around the midrift in some cases but has done nothing for the fire burning sensation for years now, and Lyrica and Baclofen cause problem areas to get worse.

Take this crap off the market, stop readjusting the formula every seven years and giving it a different name so you can get around copyright law, and stand trial for crimes against humanity.

fBoyle

@turquoise-- Gabapentin definitely works for neuropathic pain. Of course, everyone will respond to it a little differently. If the pain is severe, your doctor can prescribe it along with another pain reliever. This is often done with good results. But don't mix drugs on your own because there could be negative interactions. Your doctor will need to decide what to prescribe and in what doses.

I was on gabapentin for a short time for nerve pain after an injury. It worked for me. The only downside was withdrawal. The withdrawal symptoms were unpleasant.

SarahGen

@turquoise-- I'm on gabapentin for neuropthic pain and it's very effective. I think it's effective for nerve pain in general. It does take some time to get to the right dose though.

My doctor started me at 300mg/day. Now I'm up to 1200mg/day and I have no pain whatsoever. My dose was increased slowly over many months. This is how gabapentin is generally used for neuropathic pain. Doctors start with a low dose and keep increasing it until the patient is comfortable and mostly pain-free. This can't be done without the supervision of a doctor though. Gabapentin has side effects and there needs to be some time in between dose increases so that the body adjusts.

I think you should give it a try.

turquoise

I've tried several different drugs for neuropathic pain with little success. My doctor wants me to try gabapentin but I'm not sure about it. This is an off-label use of the drug so I don't think it will work for me.

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    • Nausea and vomiting are possible side effects of gabapentin.
      By: Alliance
      Nausea and vomiting are possible side effects of gabapentin.
    • Neuropathic pain is common after a herpes infection like shingles.
      By: librakv
      Neuropathic pain is common after a herpes infection like shingles.
    • The prescribed dose of gabapentin for neuropathic pain should not be exceeded without a doctor's approval.
      By: nyul
      The prescribed dose of gabapentin for neuropathic pain should not be exceeded without a doctor's approval.
    • Sleepiness is a common side effect of gabapentin.
      By: Alliance
      Sleepiness is a common side effect of gabapentin.
    • Gabapentin use may cause side effects like dizziness and headaches.
      By: WavebreakMediaMicro
      Gabapentin use may cause side effects like dizziness and headaches.
    • Pregnant women should consult with a doctor prior to taking gabapentin.
      By: Andres Rodriguez
      Pregnant women should consult with a doctor prior to taking gabapentin.
    • Depending on the severity of the pain and the patient's response, therapy with gabapentin may be long-term.
      By: WavebreakMediaMicro
      Depending on the severity of the pain and the patient's response, therapy with gabapentin may be long-term.