Gabpentin withdrawal time table?

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johnmarg
Posts: 9
Joined: Wed Jul 27, 2016 11:58 pm

Gabpentin withdrawal time table?

Postby johnmarg » Wed Apr 03, 2019 2:13 pm

Does anyone know how to stop gabapentin slowly? I take 600 mg per night.

stjohnh
Posts: 855
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Gabpentin withdrawal time table?

Postby stjohnh » Wed Apr 03, 2019 2:41 pm

You shouldn't need to. Just stop it. Remember gabapentin alone usually helps only folks with mild RLS. Your RLS likely has progressed (unless you have had an IV Iron infusion) and will require other therapy (dopamine agonists, IV Iron or opioids). If the gabapentin had been working well previously, but not so much now, one possibility to discuss with your doc is to keep taking the gabapentin but add a tiny (1/2 of 0.125 mg tablet) dose of Mirapex.

Another, and likely the best option, is to discuss IV Iron with your doctor. Print a copy of the paper at the link at the end and take it to your doc.

RLS is caused by BID (Brain Iron Deficiency). Many people with RLS can have their symptoms markedly reduced or even eliminated with IV Iron treatments. This is the only treatment that gets at the basis for RLS (low brain iron). It has almost no side effects. The International Restless Legs Study Group has elevated IV Iron treatment to first line therapy. This means that IV Iron is one of the first treatments doctors should try, not one of the last (as has been done for many years). If you can get your doc to prescribe IV Iron treatment, that is the way you should go. Unfortunately this is fairly new information and most docs, even those that frequently treat RLS, are not aware of it. Note that the blood tests doctors usually do (ferritin test) to check for low iron only check for low BLOOD iron, there is no test available for checking for low BRAIN iron. Oral iron usually doesn't provide a high enough blood level increase to help, folks need IV Iron infusions. Here is a link to the recommendations:
https://www.sciencedirect.com/science/a ... via%3Dihub
Blessings,
Holland

johnmarg
Posts: 9
Joined: Wed Jul 27, 2016 11:58 pm

Re: Gabpentin withdrawal time table?

Postby johnmarg » Wed Apr 03, 2019 4:27 pm

thanks St. John. I already had tests and have no iron deficiency. I have severe RLS, Every night leg twitching when I awaken during the night. Your suggestion of the small dose of mirapex is a good one. I really dont want to go to the next level of meds. The Gab. worked for the first 2 years but it a little less effective now. I also take ambian occasionally when I am really sleep deprived. I would take it every night and not even need anything else, but my Dr. says it can cause memory problems. If I could sleep 8 hours straight, I wouldnt need anything, but I wake up hourly. I am wired weird. Take care.

QyX
Posts: 443
Joined: Wed Mar 13, 2013 12:53 pm
Location: Berlin / Germany

Re: Gabpentin withdrawal time table?

Postby QyX » Thu Apr 04, 2019 4:03 am

600 mg Gabapentin per night is not that much. There is a lot of room to increase the dose depending on how well you are tolerating the Gabapentin. In Germany daily doses up to 3.600 mg are approved.

So before adding a 2nd drug you can simply try increasing the dose. Of course you should talk to your doctor about it first and not try it on your own.

Most likely you would tolerate an increase of the dosage until you reach a point where you get more and more side effects.

If you want to stop Gabapentin, you can just reduce the dosage over a period over 2 to 4 weeks. While most people have no trouble stopping Gabapentin fast, some people have issues.

Brynmr
Posts: 44
Joined: Sat Jul 21, 2018 3:15 pm

Re: Gabpentin withdrawal time table?

Postby Brynmr » Tue Apr 09, 2019 1:51 am

Try increasing the dose. I started out at 300 mg of gabapentin a night but gradually increased to 1200 - 1500 mg a night. 95% of the time I sleep very well.

leggo_my_legs
Posts: 332
Joined: Sun Oct 16, 2016 12:29 am

Re: Gabpentin withdrawal time table?

Postby leggo_my_legs » Wed Apr 10, 2019 2:49 am

It is not safe to stop gabapentin cold turkey no matter why you were taking it! For advice go to the facebook group Gabapentin Withdrawal Support. Great group.

badnights
Moderator
Posts: 5218
Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: Gabpentin withdrawal time table?

Postby badnights » Sat Apr 13, 2019 6:07 pm

I already had tests and have no iron deficiency. I have severe RLS, Every night leg twitching when I awaken during the night. Your suggestion of the small dose of mirapex is a good one. I really dont want to go to the next level of meds. The Gab. worked for the first 2 years but it a little less effective now. I also take ambian occasionally when I am really sleep deprived. I would take it every night and not even need anything else, but my Dr. says it can cause memory problems. If I could sleep 8 hours straight, I wouldnt need anything, but I wake up hourly. I am wired weird. Take care.
You're not wired any wierder than the rest of us here :) It's all part of the WED/RLS: the godawful twitching and the accompanying insomnia, so even if the twitching is under control, you never seem to get a good, sound sleep.

I am concerned that you said you "had tests and have no iron deficiency". Many standard iron panels don't test for ferritin. If they do, the lab might say "normal" for ferritin levels over 20 ng/ml. The problem is that WED/RLS patients need a level of over 75 and preferably over 100. We have a brain iron deficiency, probably caused by malfunctions in the way iron crosses the blood-brain barrier. We can have lots of iron in the rest of our body and still be deficient in parts of our brain. Low iron stores anywhere in the body can be reflected in low ferritin levels in the blood, so that's why we get the ferritin test. For most of the population, a level of 20 or 30 is not a sign of any problem, but for WED/RLSers it is much too low. So get the actual number for your serum ferritin level. If it is below 100, consider supplementing with oral iron.

Taking iron reduces my symptoms and I'm fairly confident of that statement, since I've stopped and re-started a number of times over the years, intentionally and unintentionally, with consistent results. It takes 2-4 weeks for the symptoms to worsen when I stop or get better when I start again.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.


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