I started taking 1200mg Gabapentin for RLS and PLMA a few months ago. I take 600mg at 7pm and another 600mg at 9pm. It has been a life-saver, quite literally. Until now. After such a short time, it's no longer working. The symptoms started to come back about a week ago. So last night I took 1800mg (7, 9 and 11pm) and that had no effect either. I am at a loss as to my next move.
My understanding is that I can't take more than 600mg at once as the body cannot absorb it, which is why the doses are two hours apart. I could take more 600mg doses, but I'd have to start at 3 or 5pm, and by the time I get to bed, those earlier doses would be just about leaving my system.
Please can anyone advise.
With much gratitude.
Mark.
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magarlick
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It is normal to have to increase your dose in the first year but usually by only 100 to 200 mg so it is very strange that increasing it by 600 mg didn't work so I would look for some other cause for your increased symptoms. Have you changed anything at all from OTC supplements to medicines to food to lifestyle changes to timing of taking other medicines?
As to your other question, when you need more than 1800 mg you can switch directly to pregabalin by dividing the gabapentin dose by 6 so for 1800 mg that would be 300 mg. Pregabalin can be taken all at one time.
Thanks for your reply, Sue, as ever. No, no changes at all so I'm at a loss. I could give Pregabalin a go. What's the maximum dose? Are there any other meds, aside from the abandoned ones that cause augmentation?
Doesn't gabapentin usually take a couple of weeks to show its full effect? I know that this is usually said when you are starting it but perhaps it also applies to dose increases too. Maybe that's what's happening here and you just need to wait longer before the full effects kick in.
It could also be that you simply aren't absorbing it well beyond 600 mg. There's another drug called Gabapentin Enacarbil aka Horizant which afaik has improved absorbability. Maybe that could be worth a try?
I had to increase gaba until it was not viable to take the higher dose because of timings.
So I’ve switched to pregabalin. I find it so much better as I don’t take it until 10pm which means I can now function again in the evening unlike when starting the gaba at 6pm!
I’m at 450mg (10pm) now with a 30mg dihydrocodeine (10:20pm) and it seems to be working. It took a few weeks to kick in properly (no pun intended!) but the last several nights have definitely seemed better.
Gabapentin works by bocking the nerve signals but does nothing about what's responsible for causing the neurons (sensoly nerve cells) to send out those signals. The cause is often inflammation of the neurons caused by foods in the diet. You can google lists of 'foods that cause inflammation'. Some foods fight this inflammation to some extent but it's more effective not to cause it in the first pace, you can google 'foods that fight inflammation'. The inflammation could also be caused by fungal infections, mould or heavy metal poisoning but these causes are rare.
I would suggest taking 600 at five and 600 at seven and 600 at nine if you need it. The same thing happened to me but when I backed it up to 5 PM I was fine. I also don’t drink anymore no alcohol at all. If I have even one drink alcohol. The gabapentin doesn’t work at all. I also take iron every other day one tablet. I was taking a daily, but I have Dr. Winkleman as my doctor in Boston and he told me every day is too much and it actually backfires.. I also take a multivitamin for women every day. Avoid other meds there’s a whole list that can make the gabapentin not work, including Pepcid and other stomach pills. So I avoid Pepcid at all cost. I’m so sorry I feel for you. It’s awful. I never had to go to pregaba , but I did get a prescription because I was in the same boat, I changed the things I recommended and the gabapentin worked again. I’ve been good for 10 years on this regime. Of course I have breakthroughs where there’s sometimes several nights in a row and I can’t figure out what caused. And then I get into a hot bath. And that seems to work pretty quickly. Good luck take care and try to hang in there ! Also, Sue johnson is a saint. I’m so glad I found this support group because I was so depressed as well. And nobody really understands, friends family they don’t get it.
I have endured RLS for 50 years and only in the past 5 months have I been able to say it’s really improving . I have a strong genetic link to this disease. I now believe the root cause is not low iron but inflammation. I’ve been working with a Naturopathic Physician who ordered many blood tests which showed different sources of inflammation & toxicity. I’m now on multiple supplements as well as homeopathic remedies and have eliminated foods that I showed significant sensitivity to. Those foods really increased my inflammation. Wish I had known this info years ago. My ND is quite sure we can significantly reduce or eliminate my RLS.
I’m able to control symptoms with 600 mg Gabapentin, 2.5 mg Low Dose Naltrexone, and an occasional puff of cannabis flower.
I’m blood type O which for most of us means all dairy is very inflammatory. I also tested quite high to almonds and peanuts but that could be from consuming them both on a daily basis for years. I have leaky gut and digestive issues like SIBO ( sm intestinal bacterial overgrowth) so fo much better on low a low FODMAP diet. Sugar is very inflammatory to everyone so I avoid that. I think food sensitivity is quite individualized except for the classic offenders.
I had iron infusions and took iron supplements for years and never had any benefit. I’ve recently read several articles that also suggest that RLS is not a lack of ferritin in everyone but is clearly an inflammation issue.
Lab blood draws like C-reactive protein etc show inflammation but not the source of it. A functional medicine dr or Naturopath can order blood work that shows more detail concerning food sources as well as heavy metal and other sources of toxicity.
Just to update you all. Have been on 1800mg gabapentin now for two weeks and can confirm that the increased dose (up from 1200mg, which had previously been effective) has made no difference. For whatever reason, it's like I'm taking nothing at all.
It took two weeks to get a phone call with the GP (don't get me started) and he has suggested Pregabalin. I'll start on 150mg a day, which will probably not even touch me, then increase slowly.
Does anyone know if I have to split it into multiple doses because of poor absorption, as with gabapentin?
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