Okay ..... I need some help here !! Dr. Earley put me on Neurontin. He said to start out taking 1 300mg capsule around 5 or 6, and increase it every other day to a max of six or less if working for the RLS as long as I am not having side effects. This might be a stupid question, but how do I space these out in the day ? I know I'm not suppose to take six pills at one time ..... and he didn't specify every four hours, etc. I'm still not sleeping, and my RLS is waking me up in the night and bothersome during the day.
Input appreciated by those in the know !!!!
Neurontin Dosage
Neurontin Dosage
Sue
Re: Neurontin Dosage
I just started gabapentin last week. I'm to take 100mg 3x a day and gradually increase to 300mg 3x a day. I haven't got past 100mg twice a day. It makes me very tired and appears to make my body ache and sore. My legs and arms feel heavy. I also haven't figured out how to space out to 3x a day. I wonder if anyone else has had the heavy limb feeling.
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ViewsAskew
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Re: Neurontin Dosage
Gabapentin made me VERY tired. It works well for many - they say that the majority of people feel less tired within a couple weeks and tolerate it well. One of the side effects to pay attention to is mood - it can cause suicidal behavior and ideation. If you notice ANY depressive symptoms, call your doctor immediately. The other important side effect is DRESS -if you notice any skin rashes, call your doctor immediately.
In terms of how to space the drugs, it may help to make a visual timeline of your symptoms. In most cases, excluding the really severe ones (less than 2% of us), people are only symptomatic in the evening hours. Could be, say, from 8 PM to 2 AM, or maybe 10 PM to 1 AM. If you'd been augmented, it's likely worse, but people go back to their prior level most times.
Once you know when your "active" hours are, try taking the med 1- 1.5 hours prior to when symptoms start. Since the dosage is up to 3x per day, we can assume a dose lasts about 8 hours. If your active hours period is 8 hours or less, 1 dose will likely be enough. Just take more at the same time if you're not getting coverage. Try 200 mg at 6 PM, for example. If that's not enough, make it 300 mg at 6 PM.
If your active hours period is between 8 and 16 hours, you'll likely need to split the meds between two doses, 8 hours apart. So, say, 4 PM and midnight. If your symptoms span the entire day, you may decide you only want two doses or you may decide you want the full 3 doses. Some of us suffer a few daytime symptoms in order to reduce the amount of medication taken. Some of us need that third dose because of work or other needs.
Another option is to consider gabapentin encarbil as you take one dose per day, no matter what. It supposedly works more efficiently in the body, so you need fewer mg of it. It's a lot more expensive, however, so in the US, it would depend on your insurance company and how much you have to pay.
In terms of how to space the drugs, it may help to make a visual timeline of your symptoms. In most cases, excluding the really severe ones (less than 2% of us), people are only symptomatic in the evening hours. Could be, say, from 8 PM to 2 AM, or maybe 10 PM to 1 AM. If you'd been augmented, it's likely worse, but people go back to their prior level most times.
Once you know when your "active" hours are, try taking the med 1- 1.5 hours prior to when symptoms start. Since the dosage is up to 3x per day, we can assume a dose lasts about 8 hours. If your active hours period is 8 hours or less, 1 dose will likely be enough. Just take more at the same time if you're not getting coverage. Try 200 mg at 6 PM, for example. If that's not enough, make it 300 mg at 6 PM.
If your active hours period is between 8 and 16 hours, you'll likely need to split the meds between two doses, 8 hours apart. So, say, 4 PM and midnight. If your symptoms span the entire day, you may decide you only want two doses or you may decide you want the full 3 doses. Some of us suffer a few daytime symptoms in order to reduce the amount of medication taken. Some of us need that third dose because of work or other needs.
Another option is to consider gabapentin encarbil as you take one dose per day, no matter what. It supposedly works more efficiently in the body, so you need fewer mg of it. It's a lot more expensive, however, so in the US, it would depend on your insurance company and how much you have to pay.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Re: Neurontin Dosage
Thank You so much ViewsAskew !!!! I knew you would come through for me !! I'm not sure how soon the side effects show up, but I can hardly get out of my own way !! I'm not just tired, I'm sleepy !!! I guess I should give it some time . Yes I definitely augmented on the Mirapex ... I suppose I will hang in there. I'm feeling really tired and agitated today. Its got to get better, yes ???
Hugs !!
Hugs !!
Sue
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ViewsAskew
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Re: Neurontin Dosage
It definitely has to get better 
. It took me many months to really feel free of the pramipexole. It got better slowly, not quickly.
. It took me many months to really feel free of the pramipexole. It got better slowly, not quickly.Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Re: Neurontin Dosage
Neurontin made me sick and I had severe constipation.
Re: Neurontin Dosage / Anxiety Input
Good Day Fellow Sufferers !!!!!
So its been four weeks since I started the Gabapentin, I started out at 300mg in the evening, which was working well, but I was very restless at night in my sleep so Dr. Earley increased it to 300mg in the evening and 300mg one hour before bed. So far so good.....the daytime sleepiness has gone away and haven't noticed any other side effects (no weight gain, no constipation). I take Miralex every morning to ward off any constipation issues. I have noticed though that my anxiety level is increased since being off the Clonopin and Mirapex; although I am sleeping, I'm having trouble getting to sleep and sleeping all night. What does everyone take, if anything, for sleep and anxiety that is safe for us? I go see my Primary Care Doctor today, I printed out the Treatment Information from Dr. B's RLS Support Website. I have been going to the VA (Veterans Admin) for my healthcare, but that changes April 1 to Blue Cross, so I will be seeing a Neurologist here in town, we'll see what his willingness is to work with Dr. Earley and become schooled on WED/RLS (Thank Goodness !!! They screwed up my Iron Infusion and gave me Sucrose instead of Dextran, which is what Dr. Earley ordered!!! He was NOT happy about this, nor was I !!) He suggested, and I agreed that waiting until after April 1st for the correct infusion would be a good choice !!! Eeeeek.....
Anywayyyyssss .......... if I can get this sleep thing figured out and get my anxiety under control I will be in pretty good shape. Hey, I am having an MRA in late April to figure out this possible Aneurysm and its going to take 90 minutes. Any suggestions on how I am going to lay in an MRI for that long??
Hope that everyone is well and looking forward to Spring !!
Hugs!!!
So its been four weeks since I started the Gabapentin, I started out at 300mg in the evening, which was working well, but I was very restless at night in my sleep so Dr. Earley increased it to 300mg in the evening and 300mg one hour before bed. So far so good.....the daytime sleepiness has gone away and haven't noticed any other side effects (no weight gain, no constipation). I take Miralex every morning to ward off any constipation issues. I have noticed though that my anxiety level is increased since being off the Clonopin and Mirapex; although I am sleeping, I'm having trouble getting to sleep and sleeping all night. What does everyone take, if anything, for sleep and anxiety that is safe for us? I go see my Primary Care Doctor today, I printed out the Treatment Information from Dr. B's RLS Support Website. I have been going to the VA (Veterans Admin) for my healthcare, but that changes April 1 to Blue Cross, so I will be seeing a Neurologist here in town, we'll see what his willingness is to work with Dr. Earley and become schooled on WED/RLS (Thank Goodness !!! They screwed up my Iron Infusion and gave me Sucrose instead of Dextran, which is what Dr. Earley ordered!!! He was NOT happy about this, nor was I !!) He suggested, and I agreed that waiting until after April 1st for the correct infusion would be a good choice !!! Eeeeek.....
Anywayyyyssss .......... if I can get this sleep thing figured out and get my anxiety under control I will be in pretty good shape. Hey, I am having an MRA in late April to figure out this possible Aneurysm and its going to take 90 minutes. Any suggestions on how I am going to lay in an MRI for that long??
Hope that everyone is well and looking forward to Spring !!
Hugs!!!
Sue
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Rustsmith
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Re: Neurontin Dosage
Sue, I just started with gabapentin last night. I have been taking either topiramate or zonisamide for migraine prevention for several years. I had to get off of topiramate last year due to the impact is was having on my ability to recall names. The zonisamide was sort of working, but I decided to ask my neurologist to switch to gabapentin to treat both my migraines and my WED. She was willing to switch for the migraines by was very skeptical about its effect on WED even after I pointed out the FDA approval of Horizant and that gabapentin was one of the recommended drugs in by the Foundation's experts. In about a week I will be up to 600 mg, like you.
Anyway, she has also been providing me with a scrip for Lunesta to help me with sleep issues. I don't take it all the time, but my severe WED symptoms seem to coincide with the Spring and Fall pollen seasons, so I have been hitting it pretty regularly of late. Lunesta doesn't work when I have an untreated WED episode, but it works fine with the less severe episodes that occasionally breakthrough the gabapentin and pramipexole treatments.
I have tried several of the Z-drugs for sleep and like Lunesta best. The worst side effect seems to be a metallic taste in your mouth first thing in the morning. That is much better than the scary amnesia episode that I had with Ambien. As for the latest drug, Sonata did not have much of an effect on me on the one instance I took it. I was given a double dose during a sleep test and never did really get much sleep.
Anyway, she has also been providing me with a scrip for Lunesta to help me with sleep issues. I don't take it all the time, but my severe WED symptoms seem to coincide with the Spring and Fall pollen seasons, so I have been hitting it pretty regularly of late. Lunesta doesn't work when I have an untreated WED episode, but it works fine with the less severe episodes that occasionally breakthrough the gabapentin and pramipexole treatments.
I have tried several of the Z-drugs for sleep and like Lunesta best. The worst side effect seems to be a metallic taste in your mouth first thing in the morning. That is much better than the scary amnesia episode that I had with Ambien. As for the latest drug, Sonata did not have much of an effect on me on the one instance I took it. I was given a double dose during a sleep test and never did really get much sleep.
Steve
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
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ViewsAskew
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Re: Neurontin Dosage
Well, good news, Sue!
I take it you don't want to go back to clonazepam or a similar drug, such as lorazepam? A dear friend takes lorazepam as needed - says she couldn't live without it. Sometimes we have to do things we don't really like. Half life of lorazepam is much shorter. And if you didn't need it every day, you might find you don't have to deal with dependence. And, it could help with the sleeplessness.
The old school AD trazedone doesn't worsen WED for many and it definitely can contribute to sleepiness and mood stability. It's inexpensive, too.
I take it you don't want to go back to clonazepam or a similar drug, such as lorazepam? A dear friend takes lorazepam as needed - says she couldn't live without it. Sometimes we have to do things we don't really like. Half life of lorazepam is much shorter. And if you didn't need it every day, you might find you don't have to deal with dependence. And, it could help with the sleeplessness.
The old school AD trazedone doesn't worsen WED for many and it definitely can contribute to sleepiness and mood stability. It's inexpensive, too
.Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
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Rustsmith
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Re: Neurontin Dosage
For now I am going to stick with the newer, more expensive, Lunesta simply because I have a good track record with it and my insurance hasn't balked yet (but the copay is significant). In the BAD old days when my WED had gone from mild to severe and my doctor had no idea what was causing my symptoms (strange that she claimed to have mild WED herself yesterday), we worked through most of the old benzo drugs. Since my WED was going full scale, all the benzos did was make me groggy and stagger like a drunk. I was still wide awake, but now even more miserable.
However, now that I have the ADs to reduce the WED symptoms, I would be willing to go back and give them a try. My doctor was talking about supplementing the gabapentin with trazedone, but as I mentioned in a note to WildOne, my confidence in this particular doctor is waning.
However, now that I have the ADs to reduce the WED symptoms, I would be willing to go back and give them a try. My doctor was talking about supplementing the gabapentin with trazedone, but as I mentioned in a note to WildOne, my confidence in this particular doctor is waning.
Steve
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
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badnights
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Re: Neurontin Dosage
Hi skn
Gabapentin itself might be causing the anxiety, it can cause mood-related side effects. Keep an eye on the anxiety and consider that possibility if it gets worse.
Being unable to sleep even in the absence of sensory and motor symptoms is too common
I take zopiclone, which I like a lot, it's gentle and I can ignore it if I choose to, but there is a period of time after I take it when, if I don't go to bed, I don't remember what I was doing afterwards. Other than that, no bad side effects for me. But it won't help with your anxiety. As Ann said, some of the benzo's are better for that.
For your MRI, ask the doctor who prescribed the MRI, or your GP or both, for a medication to get you through that. Start your asking soon, so that everyone involved can research a good solution I have two solutions in mind, either Sinemet (levo-carbidopa) or an opioid. If your augmenation on Mirapex was recent, it might be best to avoid the Sinemet. ALthough just the once might be fine.
I am horrified for you about the sucrose-dextran mixup. I have to wonder if the doctor didn't just ignore the dextran instruction because he was more familiar with sucrose? whtever the reason , it makes me angry. Why do people have to mess with our lives?
Gabapentin itself might be causing the anxiety, it can cause mood-related side effects. Keep an eye on the anxiety and consider that possibility if it gets worse.
Being unable to sleep even in the absence of sensory and motor symptoms is too common
I take zopiclone, which I like a lot, it's gentle and I can ignore it if I choose to, but there is a period of time after I take it when, if I don't go to bed, I don't remember what I was doing afterwards. Other than that, no bad side effects for me. But it won't help with your anxiety. As Ann said, some of the benzo's are better for that. For your MRI, ask the doctor who prescribed the MRI, or your GP or both, for a medication to get you through that. Start your asking soon, so that everyone involved can research a good solution
I have two solutions in mind, either Sinemet (levo-carbidopa) or an opioid. If your augmenation on Mirapex was recent, it might be best to avoid the Sinemet. ALthough just the once might be fine.I am horrified for you about the sucrose-dextran mixup. I have to wonder if the doctor didn't just ignore the dextran instruction because he was more familiar with sucrose? whtever the reason , it makes me angry. Why do people have to mess with our lives?
Beth - Wishing you a restful sleep tonight
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churchmouse56
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Re: Neurontin Dosage
Hi Everyone,
I take 200 mg of Neurontin every night, along with a 50 mg Tramadol and it works well for me. The meds also help with my herniated disk. I am on the small side, so I guess that is why the smaller dose is all I need. I have been taking this combination for about 2 years with no serious side affects. My doc switched me to 300 mg of N during an episode with my back, and I could definitely tell the difference. I was groggy in the mornings as well as sleepy throughout the day. Be blessed!
I take 200 mg of Neurontin every night, along with a 50 mg Tramadol and it works well for me. The meds also help with my herniated disk. I am on the small side, so I guess that is why the smaller dose is all I need. I have been taking this combination for about 2 years with no serious side affects. My doc switched me to 300 mg of N during an episode with my back, and I could definitely tell the difference. I was groggy in the mornings as well as sleepy throughout the day. Be blessed!
Re: Neurontin Dosage
Update.......I had my follow-up MRI and everything came out normal !! Yay....huge relief. I took a Gabapentin an hour before and had no problems, the Tech was very helpful in that if I needed to move just let her know. She did the MRI in segments, so if I needed to move I could !!! I had my Iron Infusion last Friday, we will see what my levels are in six weeks...its a 50/50 crapshoot on that!!
My Primary Care Doc put me on Lexapro for my anxiety.....I have had no WED/RLS issues with it and I feel much better. Still not sleeping through the night, but I am working with Dr. Earley on my sleep pattern. Because the Clonopin and Mirapex were controlling that, now that I am no longer on those meds, my body is reverting back to its "normal" sleep pattern and forcing it to change with the Melatonin and Ambien will not work. We will see in two weeks, if adjusting my bedtime and wake up time doesn't work, what Dr. Earley has planned.....I was pretty impressed in that when I emailed him with my sleep issues, he called me !!! I love him !!!!
Hugs and hope everyone is doing as well as can be expected !!! (P.S.: I haven't received any updates regarding the Clinical Trial)
My Primary Care Doc put me on Lexapro for my anxiety.....I have had no WED/RLS issues with it and I feel much better. Still not sleeping through the night, but I am working with Dr. Earley on my sleep pattern. Because the Clonopin and Mirapex were controlling that, now that I am no longer on those meds, my body is reverting back to its "normal" sleep pattern and forcing it to change with the Melatonin and Ambien will not work. We will see in two weeks, if adjusting my bedtime and wake up time doesn't work, what Dr. Earley has planned.....I was pretty impressed in that when I emailed him with my sleep issues, he called me !!! I love him !!!!
Hugs and hope everyone is doing as well as can be expected !!! (P.S.: I haven't received any updates regarding the Clinical Trial)
Sue
Re: Neurontin Dosage
I realize that gabapentin can cause depression and suicidal thoughts (in rare cases), but I thought it induced a calming effect.
I used gabapentin for a while, it worked well and there was not a lot of side effects. I like Lunesta so much better because there are even fewer side effects (like NONE) and I didn't need to increase it so rapidly like the other drugs unless I was dealing with a lot of anxiety. When I wake up I didn't feel tired with Lunesta. And if I realize I'm not sleeping in the wee hours I can pop a Lunesta and not worry about being a zombie the next day. I guess you can say Lunesta is my favorite med!
I used gabapentin for a while, it worked well and there was not a lot of side effects. I like Lunesta so much better because there are even fewer side effects (like NONE) and I didn't need to increase it so rapidly like the other drugs unless I was dealing with a lot of anxiety. When I wake up I didn't feel tired with Lunesta. And if I realize I'm not sleeping in the wee hours I can pop a Lunesta and not worry about being a zombie the next day. I guess you can say Lunesta is my favorite med!
Re: Neurontin Dosage
I wasn't having any depression or suicidal thoughts, it was the anxiety, which was over the top !!! I was on Clonopin for a long time which controlled it. So far adjusting my sleep pattern hasn't helped, still waking up. Maybe the whole Glutamate thing has merit; because when I wake up, my body feels like its ready to be up for the day!! Are you no longer taking gabapentin? If not, why did you stop?
Sue