GutturonasalParaphrase: Gabapentin taper

[GutturonasalParaphrase]

I started taking gabapentin about six years ago when a colleague of mine gave me a bottle of it. My emotions and energy did a 180 degree turn on the first dose. I think I fall into the small percentage of people who have an almost psychedelic GABA-induced reaction from gabapentin, with heightened body sensations, brightened color perception, superior cognitive abilities, and surges of creativity.

 

I finally obtained a prescription and stayed on 900 mg per day for about three years, and then 1500 mg per day for about three more.

During that time, I got addicted to Adderall for about six months after I decided to return to school. I underwent a short period of psychosis as I raised the dose and became sleep deprived/malnourished. This was about two or three years ago.

 

My most recent addiction has been with phenibut, an OTC anxiolytic, that brings with it a "pseudo benzo" withdrawal upon discontinuation. This was about one year ago.

 

I am now using rhodiola rosea, which is very helpful all-around. I was also born with hypothyroidism and take Synthroid and Cytomel.

 

I have tapered down to 900 mg of gabapentin: I maintained a 1200 mg dose for a bout six months and have been on 900 for about two months. I want to stop it because it is now only a shadow of what it was in the beginning. It still sometimes offers relief from anxiety and depression, but now almost seems to be inducing both.

 

Each time I have lowered the dose I have felt some anxiety for about a month. I am also having some nerve pain in my extremities, needles and electrical shocks.

 

The most bothersome symptom is a rigidity and stiffness in my limbs, along with a lack of coordination. I notice it mostly at my job when standing and pivoting. I almost feel frozen as if my nerve communication is short-circuiting. Does this sound familiar to anyone as being related to the withdrawal? It seemed like it occurred before I began the taper, and that the other drugs I have taken (and since ceased) aggravated it. I am noticing it more profoundly now, and I noticed when I quit phenibut and when I was taking Vyvanse for one month.

 

My taper plan is going to be decrease by one 300 mg capsule every four to six months: 900, 600, 300, 0. Is this doable? What can I expect in terms of withdrawal.

 

I am using magnesium citrate and an epsom salt rinse, and it is helping significantly, especially with morning anxiety. Is there anything else I can do?

 

I am glad to have found this forum. Any assistance is much appreciated.

Edited March 8, 2014 by tezza
Added member name to title

[Rhiannon]

We don't really have a large body of anecdotal experience with tapering gabapentin here, although I've done it myself. I would advise following the same 10% tapering method that we advise with all psych meds.  In particular that cut from 600 to 300 and from 300 to zero, I would expect those to be pretty harsh. 

 

From my experience and the people I've met online who have tapered gabapentin, it seems that withdrawal reactions can range from fairly mild to as bad as anything a person could experience withdrawing from benzos and ADs. For me, the symptoms were similar to benzo tapering, but they tended to fade consistently over time and not do as much of the up and down roller coaster thing as some other withdrawals do. But we're all quite different and your own experience with your own body is the best information you can have.

 

In the "tapering" section of the forum, under the threads pinned to the top, is tons of good information on tapering.

 

I found it very easy to make a liquid solution of gabapentin in water for tapering. That way you can go down in as small of increments as you want, even a milligram at a time.

[tezza]

Hi and welcome! I agree with Rhi and I've come off gabapentin, as well. I did have a fairly easy time but many others have extreme difficulty. Given the dose and length of time on, I'd say you definitely need to go slowly. Try to prevent WDs from getting worse since you felt the large drops from the first cuts.

 

Rhi is very knowledgeable and I've learned much from her about tapering. Reading her posts about how she's made liquid suspensions was a big help to me and gave me confidence to do it myself. It's really very simple and, for me, much more preferable and accurate than trying to weigh.

 

Thank you for joining us!

[GutturonasalParaphrase]

Thank you for the responses.

 

The cluster of symptoms that I'm having are really bothersome.  It is essentially a difficulty moving, rigidity, and overshooting with quick movements (sometimes dropping things, knocking things).  I also have a slight tremor, but I have had what my pediatrician once called a "benign tremor" for most of my life.  Are any of these symptoms part of gabapentin withdrawal or benzo withdrawal?  I have done internet research and have found little.

 

I know that gabapentin is used to treat peripheral neuropathy.  Is it possible that its withdrawal could manifest as neuropathy?  I'm terrified to say that this almost feels Parkinsonian.  I am 31 years old, and it would be very rare for PD to occur at my age (to my knowledge).

 

I am also very interested in the magnesium remedy, and I believe in it because it has worked.  What is the best supplement to use?  Magnesium citrate has helped, but it causes a laxative effect sometimes.  I have used magnesium taurate as well.  Do any of the topical magnesium treatments work?

 

Thanks again and any feedback at all would be wonderful.  

[Altostrata]

Welcome, GP.

 

See our topic on tapering gabapentin here http://survivingantidepressants.org/index.php?/topic/2309-tips-on-tapering-neurontin-gabapentin/

 

Many people do well with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

Magnesium is not a remedy. It can lessen some symptoms. It does not reduce the need for proper tapering.

[GutturonasalParaphrase]

I just wanted to add to my thread that I have found an herbal supplement that treats gabapentin withdrawal quite profoundly.  Gotu kola is known in benzo-withdrawing circles as being an effective symptom evacuator.  It is a GABA agonist of some sort, but does not have an associated withdrawal syndrome.  It seems to "replace" the drug somewhat and lifts the anxiety and brain fog. 

 

I am using the Source Naturals brand, and I take about four capsules per day.  (I tried a higher dose once and got some slightly "trippy" side effects, and not in a good way.) It's fairly cheap, and along with a good magnesium supplement, my symptoms are now down to a very manageable level.    

[Rhiannon]

Just FYI, gabapentin actually doesn't work on/with GABA, in spite of its misleading name. If the gotu kola is helping, that's not why.

 

As usual (for other folks reading this) I'd recommend caution with any herbal supplements. They can be quite powerful and often what helps one person makes another person sick. So be cautious and do your own due diligence, regardless of someone else's results. Even fish oil, which helps almost everyone, is too stimulating for some people.

 

But as for you, GP, glad to hear you're feeling well! Yay! 

[Altostrata]

GP, please start a topic on gotu kola in the Symptoms and Self-care forum, others may want to discuss it.

 

How is your taper going?

[GutturonasalParaphrase]

Gabapentin does not interact with GABA system directly, but its mechanism indirectly results in an increase in GABA biosynthesis.

 

http://www.ncbi.nlm.nih.gov/pubmed/9686247

 

"In vitro, gabapentin modulates the action of the GABA synthetic enzyme, glutamic acid decarboxylase (GAD) and the glutamate synthesizing enzyme, branched-chain amino acid transaminase. Results with human and rat brain NMR spectroscopy indicate that gabapentin increases GABA synthesis. Gabapentin increases non-synaptic GABA responses from neuronal tissues in vitro."

 

In the scientific community, it is most accepted that gabapentin blocks voltage-dependent calcium channels.  But evidently, its acute effects are not a result of this, and their cause is actually unclear.

 

Anecdotally,  its effects on users, including myself, resemble those of other drugs that have been scientifically perceived to directly modulate GABA.  These include phenibut, baclofen, GHB, benzodiazapines, kava, valerian, etc.  All of these have an effect profile that significantly overlaps with that of gabapentin.  In my experience, phenibut, a GABA-b agonist, has an almost identical "feel."  Outside of any scientifically sound explanations, this alone is enough to convince me of GABA activity.  Gabapentin circumvents withdrawal symptoms of alcohol, benzos, and phenibut.  And vice versa.

 

I recommend mild herbal supplements for withdrawal like kava or valerian, but stronger prescription medications present the risk of a new dependency and possibly a worse obstacle.

[GutturonasalParaphrase]

I just added a signature and want to note that it is a very basic and over arching representation of what I have used in the past years, mainly in that it only includes doctor-ordered medications and not the self-medicating uppers and downers I have used "off-label" (amphetamine analogs and benzodiazepines).

 

I have now ceased usage of everything and am in the process of a long (6 month) taper with gabapentin.

 

My question today revolves around my experience with desipramine, and the two seperate times I was prescribed it.  

 

The first time:  the doctor prescribed 10mg pills and allowed me to increase the dose until it worked.  It seemed that about 100mg per day completely relieved my depression and anxiety (and worked immediately).  At the time, I decided to stop the desipramine because it was interfering with the Adderall.  (I was in the position to continue either one independently, and chose the latter.)

 

The second time:  years later, I tried the desipramine again at 25mg per day.  This time I was immediately inflicted by explosive anger and irritability and discontinued it after approximately a week.  

 

I am currently dealing with a typical PAWS from the stimulant and benzodiazepine analogs that I abused off-and-on for about one year.

 

I have never tried an SSRI, had mild success with bupropion, and, as stated above, very mixed results with desipramine.

 

Could the wide variety of effects produced by the tricyclic AD be purely the result of the dosage difference?  Is this normal for this class of drugs?  It was not in any way an additive effect with the higher dosage, but a completely different spectrum of effects.  

[scallywag]

My best guess is that the difference in the two experiences comes from what happened in the years between. You took other medications in the interim; those medications would have had effects on your CNS (central nervous system). So although you are the same person, your CNS wasn't in exactly the same state each time.

[GutturonasalParaphrase]

Thank you, scalllywag.  This is most certainly the other possibility besides strictly the difference in the doses.

[Vickki1000]

On 4/7/2014 at 0:21 PM, Rhiannon said:

Just FYI, gabapentin actually doesn't work on/with GABA, in spite of its misleading name. If the gotu kola is helping, that's not why.

 

As usual (for other folks reading this) I'd recommend caution with any herbal supplements. They can be quite powerful and often what helps one person makes another person sick. So be cautious and do your own due diligence, regardless of someone else's results. Even fish oil, which helps almost everyone, is too stimulating for some people.

 

But as for you, GP, glad to hear you're feeling well! Yay! 

 

[Vickki1000]

Greetings, Gabapentin is confusing when it come to GABA. Gabapentin does not attach to GABAa like a Benzodiazepine. It does however uptick GABA as a "whole" through a back door. The calicum channel on voltage-gated calcium (Ca2+) will uptick GABA by a possible 55% depending on a persons overall health and other medications they take. So, some people have the same issues that are common with Benzodiazepines. 

[Altostrata]

Thanks for that clarification, Vickki. Please start an Introductions topic for yourself, we'd like to get to know you.

[Altostrata]

GutturonasalParaphrase, how are you doing?