Gabapentin not working

[Elsie77]

I’ve just increased Gabapentin to 900 mg at 800 mg I was still waking up at 2.00am with agitated legs but 1 or 2 paracetamol would settle them after about 30 minutes. I took 300 mg at 7.30 pm and 600mg at 9,30pm I woke up at 3.30 am legs were worse than night before, paracetamol did nothing. Ended up exercising , shaking them etc for over an hour, then distraction before getting back to sleep about 5.00am ish. Is it normal to get worse on a higher dose? Should I just keep taking 900 mg?

[SueJohnson]

900 mg is still a fairly low dose. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." I take 1500 mg. Add 100 mg every couple of days until you find the dose that works for you. Don't jump by 300 mg as you may then take more than you need. If 300 mg capsules are all you have, then yes you can increase by 300 mg until you get a prescription for 100 mg and then you can decrease by 100 mg every few days.

[Joolsg]

I agree with Sue. Also try changing timing of doses so you take last dose half an hour before bed & first dose 2 hours before that.

[Bananie123]

Hi Elsie,Yes, you're absolutely fine taking 900mg of gabapentin a day. I've been taking that amount for 9 years, but just recently have been adding another 300mg tablet - and that's still OK.

I suffer 24 hrs RLS so wake up with it. I take one tab on waking, one at 5pm and one at bedtime - but recently have had to take an extra one mid evening.

I also have Tramadol tabs and find taking one at bedtime, along with the gabapentin, gives a good night's sleep.

All the best x

[marigold60]

I take less gabapentin than you but I find what works best for me if I wake in the night twitchy, is to take an extra one or two, 100mg gabapentin pill. I find it stops the sensation and helps me sleep.

[SueJohnson in reply to marigold60]

How much gabapentin do you take before you go to bed?

[marigold60 in reply to SueJohnson]

I take 400mg at around 6pm, sometimes this is enough, other times I wake up in the night twitchy. If I do I'll take 100 mg tablet, this relaxes me and I can usually drop off. Occasionally I'll wake a bit later twitchy again so I'll take another and am able to sleep the rest of the night. Originally I was on pramipexole, I then augmented and had a horrible time getting off it. I started taking gabapentin in a higher dose but I was able to reduce it after a while. I stopped at 400mg but I still get breakthrough symptoms. I found the best way of dealing with it is to take extra meds in the night

[whitney2044]

Hello, I'm interested in your experience, for the last six weeks I've been struggling with my daily dose of 700mg Gabapentin I've put it down to other medications like Amolodipine as it's top for causing muscle cramps and boy did I find out, I've changed to Felodipine and at least the cramps have stopped, but I'm still waiting up anytime soon after 1am, I looked at my other medications and Pravastatin also reacts badly so I've stopped them, but I'm still struggling, so now I'm looking at my Ramipril 10mg that's also an antagonist, A couple of nights ago I decided to up my last dose of Gabapentin from 300mg to 500mg and it worked a treat for the first night and one night only, last night I went to bed around 23:30 hrs and have been awake since 1am, my legs are crawling I've tried my usual, exercise, cold rub, shower, not one has worked,.I'm hoping to discuss with a doctor but appointments are week's away, I feel for you, like me there is no cure or proper treatment

[SueJohnson in reply to whitney2044]

You are or were taking drugs that were all bad for RLS except Ramipril which is OK. There is no cure but there is treatment. 700 mg of gabapentin is a low dose so it is no wonder it is not working. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." Ask your doctor for 100 mg capsules and increase it by 100 mg every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime. Since you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. If you take magnesium, take it at least 3 hours before gabapentin as it interferes with the absorption.of gabapentin. Have you had your ferritin tested? If so what was it? Increasing it to 100 or more reduces symptoms in 60% of people.

[Elsie77]

I had the same experience one night the Gabapentin worked the next night was awful, last night at 900mg worked I slept through till 6.00am. I’ve tried getting an appointment to discuss this all but no chance of one in the foreseeable future. It’s email consultations or nothing. Having said that he has been clueless from the day I asked for help following augmentation on Pramipexole. I have had much more help and support on here, thanks everyone.

[Woody4]

I took 300 mg around 7 then 600 mg 2 hour’s before bedtime. That lasted. 3-4 months. Started waking up after a couple hours sleep and having to take another 300 mg. So went to 600 mg around 7 and another 600mg before bedtime. Good for another 3-4 months. Now starting the same routine, sleep a couple hours and wake up, take another pill. Trying to get prescribed horizant to see if it is any better. Good Luck to,you