Gabapentin restart?

[wantokporo]

I may have asked this at some time, but ...

has anyone gone off gabapentin (or pregabalin or horizont) because it wasn't effective anymore, waited a while and gone back on it with success?

[grassgree]

Yes. I was taking 600 mg of gabapentin for 18 months or so, when it stopped working. The doc didn't want to go higher, so I tapered off and quit. I had withdrawal symptoms for about four months. I should also note that the doc had also advised me to take magnesium glycinate at bedtime, and I know now that magnesium interferes with the absorption of gabapentin. Anyway, after a year of no drugs I restarted gabapentin with a different doc and no magnesium, and it worked. Is that because of the drug holiday or because I stopped taking magnesium at the same time? I don't know. Now, 18 months later, I notice signs of tolerance again.

I know that some will advise me to increase the dose, but gabapentin withdrawal is not fun. Not as bad as withdrawal from a dopamine agonist, but, for me it was a difficult time with no sleep. I don't want to keep taking more. I'm not sure if this is useful information for you. Everybody is different.

[PoorRichard in reply to grassgree]

I wonder about drug tolerance, too, since I recently had to increase my dose. While still on a very low dose (150mg), the increase concerns me. I guess I'll find out... (fyi - I use liquid gabapentin which allows me to titrate up in small increments. )

[grassgree in reply to PoorRichard]

Yeah. Everybody has to balance the pros and cons. Not sleeping is very unhealthy too, with lots of risk. My new doc (recommended by the RLS Foundation) set 900 mg as a maximum. So far, none of the docs I've seen are willing to go up to 1,800 as suggested by Mayo.

[SueJohnson in reply to PoorRichard]

150 mg is below the normal starting dose of 300 mg of gabapentin. You don't need to worry about tolerance since normal effective dose is 1200 to 1800 mg. And if you are worried about coming off it, see my reply to grassgree.

[PoorRichard in reply to SueJohnson]

We are all different. My sleep doctor started me at 100mg 2 years ago. It was sufficient until recently. I am very sensitive to drugs.

[SueJohnson in reply to grassgree]

If you decide to come off the gabapentin you need to do so very slowly to avoid withdrawal effects. Reduce by 100 - 200 mg every 2 weeks. If you do so you will have no withdrawal effects. And if you start having any, just reduce by a smaller amount or wait longer. If need be you even get an inexpensive jewelry scale that measures down to .01 gram from Amazon ($11 in the US) and open up the capsules and measure it. Then reduce by a smaller amount every 2 weeks.

[SueJohnson in reply to grassgree]

How much are you taking?

[grassgree in reply to SueJohnson]

I'm only taking 400 mg now. If I ever stop again, I'll definitely keep your advise in mind. I am small and the typical dosages tend to be too much for me.

[grassgree in reply to SueJohnson]

I should add that 100 mg worked for me for several weeks, and I spent months easing my way up to 400 mg. 100 mg wouldn't do much of anything for most people.

[wantokporo]

Thanks, Sue.

[wantokporo]

Zero. I did not decrease as slowly as you describe, more like 100mg every five days. I'm in my 6th day at zero and last night was a bit better. If it gets worse again, I'll open the capsules and take a few more weeks. I was taking 500mg but it was not a therapeutic amount, and I was taking other meds and couldn't come off of it until recently.