Neurontin, for nerve pain, does it affect arterial inflammation?

[Whittlesey]

Hello Everyone, I am wondering if anyone has any information or experiences with neurontin and the inflammation we are dealing with in GCA and PMR?

trying to do as much of the anti inflammatory daily living -- in dealing with this.

I found this on a site which seems ok. Doctors are responding to questions and their information is available. On our web pages, they usually separate sites that are trying to sell a product and sites that really deal with an issue. This site is not part of the sites, labelled "Advertisement". Would say of course, talk with doctors and do your own research, but this is what I have come up with --

I have not found an exact response to "what is the effect of neurontin on inflammed arteries"

Found this, which may be helpful on a site, by Gaye and Andrew Sandler. It seems Gaye uses neurontin and has been asked by Pfizer to do some further research on it. She gives information, no pressuring to use it. Her information seems helpful. and again, a doctor, or practioners are the best. I bring this kind of information to my doctors and usually we come up with a "plan".

Here, she is saying that it stops the production of a substance that causes inflammation and this, I believe, is the end result we are working towards. So, my perception, is that it may help.

" . . . Neurontin helps to stabilize misfiring nerves by slowing down neurological impulses traveling from the spinal cord out to the peripheral tissues. There is the probability that Neurontin decreases Substance P activity. Substance P is a neurotransmitter chemical in the pain system that carries pain messages through the nerves and stimulates inflammation. Elevated levels of substance P have been found in IC and FMS patients.

It is believed that Neurontin reduces the over-stimulation of nerve endings in IC patients. According to Dr. Seastrunk, a psychiatrist in Texas, "Neurontin also appears to minimize a focal brain injury in Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FMS) patients."

Presumably, part of the brain's limbic system, the hippocampus may be damaged by stress chemicals (such as adrenaline and cortisol) in CFS and FMS patients. The hippocampus is responsible for controlling the stress response network. It also handles pain signals, routing them from the spinal cord to the brain. The nervous system in CFS and FMS patients is thought to be in a state of hyper-stress. Exposure to stress chemicals may cause the development of chronic pain, as well as, memory and learning problems in these patients. The actions of Neurontin seem to minimize the sympathetic pain. ..."

Another valid site:

In response to "What does neurontin actually do?" , from Doctor Ronald Krauser

"Blocks glutamate

The exact mechanism is not fully understood. Neurontin may work by binding to certain sites on nerve cells in order to block the release of glutamate. Glutamate in turn causes nerve cells to be abnormally excited and therefore accentuate pain. "

site: healthtap.com/#topics/is-ne...

From Doctor Norman J. Marcus

"There are many reasons for hand pain. If there is suspected nerve problems causing the pain, Neurontin may help. Swelling will not be helped and Neurontin can actually cause swelling in the hands, legs and feet in some people."

Same site.

From Doctor Bennett Machianac

"Neurontin: drowsiness, dizziness, weight gain, ankle/foot edema. Elavil: visual blurring, mouth dryness, difficulty starting urination, drowsiness, dizziness, weight gain, lethargy, paradoxical anxiety, and maybe forgetfulness."

From Doctor Brian Le

"Neurontin is not an anti-inflammatory medication. It is anti-seizure medication. it is effective for nerve pain, like sciatica."

Neurontin is working well for me with neuropathy and migraines.

Believe the question is -- what effect does it have on the arteries. Can it cause or increase swelling?

If anyone has information or experience, would you share ? Thanks. best, Whittlesey

[polkadotcom]

I've been on Gabapentin (Neurontin) for almost two years to help with nerve pain but it has never occurred to me that it may be helpful for inflammation - it doesn't seem to work like that for me, but it definitely helps with the nerve pain (peripheral neuropathy).

I have found I need to be careful with it. If not taken with enough food it does cause me dizziness and a lightheaded feeling (quite nice, really!) I am on a very slowly increasing dose, currently taking 300mg (1 capsule) 3 times daily. However, I've been getting episodes of severe nausea and I am beginning to think it is the Gaba causing it.

I see my Rheumy again next month and this is top of the list for discussion.

[Whittlesey in reply to polkadotcom]

Agreed. I get that effect, too. Have ginger tea, which helps and something light. I know of others who are having the gaba increased. My understanding is that it can go to 2300 mgs safely. I was encouraged to take a high dosage on some days of major pain, but I've never gone over 500 mgs. I know they say it is safe, but with the prednisone -- I don't know. and 500 mgs clearly got to the pain.

Agreed on discussing with rheumatologist, will do that also. best, Whittlesey

[Whittlesey]

Hello, I wanted to post the link about neurontin and what it does in the body:

ic-network.com/iclifestyles...

text:

". . . Neurontin helps to stabilize misfiring nerves by slowing down neurological impulses traveling from the spinal cord out to the peripheral tissues. There is the probability that Neurontin decreases Substance P activity. Substance P is a neurotransmitter chemical in the pain system that carries pain messages through the nerves and stimulates inflammation. Elevated levels of substance P have been found in IC and FMS patients.

It is believed that Neurontin reduces the over-stimulation of nerve endings in IC patients. According to Dr. Seastrunk, a psychiatrist in Texas, "Neurontin also appears to minimize a focal brain injury in Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FMS) patients."

Presumably, part of the brain's limbic system, the hippocampus may be damaged by stress chemicals (such as adrenaline and cortisol) in CFS and FMS patients. The hippocampus is responsible for controlling the stress response network. It also handles pain signals, routing them from the spinal cord to the brain. The nervous system in CFS and FMS patients is thought to be in a state of hyper-stress. Exposure to stress chemicals may cause the development of chronic pain, as well as, memory and learning problems in these patients. The actions of Neurontin seem to minimize the sympathetic pain.

Neurontin as an Alternative to Opiates

Many doctors are relieved to have another option to treat pain besides opiates. There are several reasons for this. For one thing, opiates are the least effective pain drug for treating neuropathic pain. Another problem is that opiates, such as morphine and Oxy-Contin, need to individualized, because patients have different responses to different opiates...."

So they are speaking of "P" which I believe the paper on GCA and PMR speaks of. I can't find that post. But will find it and compare.

Would be good if neurontin helped with inflammation, but I am not sure, will compare both links. Many of us use neurontin for pain, along with pred for GCA/PMR.

This link seems to be educational, these people Gaye and Andrew Sandler, seem to be running an "Assisted Living" facility, which is less intensive than a nursing home, regulated, etc. They both have some kind of medical certification. They seem to be researching IC, which Gaye apparently has. They are involved in treating, daily, it would seem and doesn't seem like they are trying to sell anything. I have worked in nursing home reform, here in the U.S. and I know that neurontin is often prescribed for many people, esp. for those suffering from MS. So they may be trying to get a sense of "what is it" and is it "ok" long term. They seemed to have turned up some information, which may be helpful.

Two new sites "came up" when I reaccessed this. Will look at them also.

best, Whittlesey

[PMRpro Ambassador]

You have to separate the "needs/causes" - it isn't just "inflammation" that drugs work on, it is dependent to a great extent on what is causing that inflammation.

Gabapentin works on nerve pain and that is the main reason for it being used in many apparently inflammatory illnesses: some of them cause damage to the nerves, probably by poor blood supply leading to damaged cells. Where that is the cause of the neuropathy pain, gabapentin may help. However, gabapentin has been implicated in actually CAUSING a vasculitis.

In GCA there is some recent evidence that it is neutrophils (a white blood cell) that are involved in the inflammation. PMR is closely related so it could also be the case there although it hasn't yet been looked at. It is thought that one of the mechanisms of pred is to prevent neutrophils attaching to the blood vessel walls - and that could, theoretically at least, account for the way pred works in GCA and some PMR - you have to remember that PMR is a label for the SYMPTOMS, it is not the disease but here we are talking about pred-responsive PMR, not other forms of the syndrome due to other underlying causes.

Gaba probably works in the brain by altering our PERCEPTION of pain. Pfizer themselves say the mechanism of action isn't known. But it doesn't appear to have a mechanism of action that would work on the blood vessels.

[Whittlesey]

Understood. Thanks. This is the information I am looking for.

Have read about GCA and the neutrophils. If neurontin doesn't have a mechanism of action to work on the arteries -- can it harm them ? I guess possibly -- "yes" -- or we aren't sure.

Neurontin works tremendously for meralgia paresthetica, for me. When I first took neurontin, I found I could walk almost regularly and it was great. But when the neurontin wears off, back to the constricting situation, pain, spasm and difficulty walking.

Due to all that has occurred, I am now taking neurontin for migraine headaches. Prior to GCA diagnosis, after a year I had reactions to topamax (which was very good, for a year and then side effects occurred and I had to change from topomax) and heart reactions to the tryptophans -- these are currently the major migraine relievers. Can't use them. I am seeing a migraine specialist and she said due to the prednisone, methatextrate and heart medicines, at this time, the only thing I can really take is neurontin to relieve the inflammation of migraines..

Thanks for this information PMRPro. I don't think doctors are taking this into account -- potential effects of neurontin. In my research I also found that neurontin may cause certain vasculitis s. I am trying to stay away from that especially in the large vessels. My GCA has gone somewhat systemic.

So now what ? Ibupropren or one of the stronger migraine medicines. ?

Believe this is important. And yes, agreed gabapentin probably can have good "brain" effects.

And yes, I have nerve damage in my left arm (I am left handed) hand to above the elbow. I notice it quite a bit, but I don't think it is otherwise noticeable. But it is new and can cause problems. Gabapentin helps this.

But now with the vasculitis potential -- am really hesitant about continuing to use it. I was using another antispasmodic --can't remember the name and then they changed it. Will look into it, possibly change back and keep searching for a migraine remedy. I use topical remedies for migraines now, too -- hot cloths with ginger and pieces of aloe vera (from the sleeve) on my forehead, both sides, dark room, etc. These are not bad. Was using neurontin with them and they were effective. Time being will just the topicals and ibupropren.

Went to see friends today, in the county of Queens, did a lot of walking (a Jamaican beef patty, possibly with salt) and now don't feel good. May have a migraine and GCA headache. am using the topicals and ibupropren.

Thanks PMRPro, believe this is important information. Thanks for the explanation, I understand your points.

[1Roadrunner]

I ruptured a disc in June of this year and have been taking Gabapentin since that time (4 months). It just dawned on me to check for swelling as a possible side effect of this drug, and I found this site with all your posts.

In the past I've had some arthritis developing in my hands but nothing too terrible; however, since taking the Gabapentin my hands have begun swelling, the joints are continuously having spells of inflammation and I have extremely painful trigger finger in six fingers. I had blood drawn today to check for RA and to check inflammation levels. I can barely use my hands.

At one point I tried cutting back on my pain pills and increasing the Gabapentin, for fear of becoming addicted to the pain pull before my disc is repaired. I gained 6 pounds in two days so I went back to taking the med as prescribed.

I am hopeful stopping the Gabapent I n will return my hands to normal and will be talking with my doctor and researching other meds that could help with nerve pain on my own