BlueComet: Gabapentin withdrawal never ends. Should I reinstate?

[BlueComet]

I was on valium and ambien for four years, from 2010-2014. The last year of being on them was a tough time because of tolerance withdrawal. Everything became really bad and, after unsuccessfully tapering, I detoxed off the medicine in August 2014.

 

I had the usual withdrawal; extreme fatigue, major cog fog, severe insomnia, major anxiety, hair loss, etc. After about two months I began feeling better and by month 4 I was doing pretty well. I went back to work, drove, and socialized and went to family events.

 

When I returned to work, I had a difficult time because of my severe insomnia. My doctor gave me gabapentin after a lengthy discussion about possible temporary medicines. I went on this medicine for insomnia and some residual anxiety. I originally took 1200mg per day in divided doses.

 

Shortly after I started it, I began to have some nasty psychological symptoms. Major depression, uncontrollable anger. I remember I ate by myself on my birthday because I did not want to see family or friends. My doctor responded by upping my gabapentin to 2100mg per day. This led to things getting a lot worse so he upped it to 3000mg. I would never take 3000mg; usually 1500-2400mg per day.

 

I then developed a tolerance withdrawal and had HORRIBLE physical symptoms if I took a lower dose or missed a dose. Shakes, nerve pain, rapid heartbeat, pins and needles. I also was gaining a lot of weight. All of this happened within a one month period. It took another 3 weeks and five ER visits, including one 5 day inpatient stay, to get me off this stuff in basically a cold turkey.

 

It has been a horrible four months. Things have improved but there are so many things that haven't really made any progress. I have so much anxiety that I can't drive or speak to people at work. I shake all the time and have a rapid heart rate. Any thing I do, like smoke weed or drink beer, intensifies these withdrawal symptoms.

 

This isn't getting any better. This has been four months of suffering for 7 weeks of use of this medicine.

 

Has anyone dealt with a similar situation? What should I do?

[Altostrata]

Welcome, BlueComet.

 

I'm sorry to hear you're suffering the aftereffects of gabapentin.

 

There's a small chance that reinstatement of a very small dose, perhaps 10mg, could help. You would taper off this later. See

 

What is withdrawal syndrome?
 
The Windows and Waves Pattern of Stabilization

About reinstating and stabilizing to reduce withdrawal symptoms

 

about titrating gabapentin Tips for tapering off Neurontin (gabapentin)

 

Also see our Symptoms and Self-Care forum for suggestions about how to deal with symptoms.

 

What symptoms have improved? How is your sleep now?

[BlueComet]

For the most part, sleep has improved. Still have some periods where I go a few days or a week with horrible insomnia.

 

My irrational fears have largely disappeared. For the first month off of it I used to not be able to even ride in a car because it was so stressful and overwhelming for me. I would lay in bed freaking out that I was going to get maimed or killed.

 

I had very strong derealization that has begun to go away.

 

My physical symptoms are rapid heart rate, nerve pain, and shakes. The nerve pain is seldom now (maybe every two weeks) but the rapid heart rate and shakes are pretty common.

 

Now for what is still here...

 

Anxiety is OUT OF CONTROL. I can't drive a car or handle speaking to my boss. Lots of stress and anxiety.

 

The physical symptoms are brutal. Shakes, heart beat, nerve pain are the worst thing ever.

 

I still have a bit of derealization and irrational fears, especially when I go out with friends. It's almost just a fear of "what if I get derealization" and fears of "what if someone tries to rob me" or another hypothetical stressful situation.

 

Cog fog is still pretty bad.

 

My CNS is totally screwed up. Last night I was partying and drank a lot of beer and smoked some weed. It exascerbated my symptoms, especially the one where the right side of my body tingles/feels different than the left side. I also had a horrible hangover today. I can't even drink one beer without it giving me horrible symptoms and keeping me awake all night.

 

I just wanna go back to normal; be able to drive, handle going out, not have anxiety, and be able to drink a beer without it giving me horrible symptoms. I could literally do all of these things before I started gabapentin and was five months off benzos.

[oskcajga]

For the most part, sleep has improved. Still have some periods where I go a few days or a week with horrible insomnia.

 

My irrational fears have largely disappeared. For the first month off of it I used to not be able to even ride in a car because it was so stressful and overwhelming for me. I would lay in bed freaking out that I was going to get maimed or killed.

 

I had very strong derealization that has begun to go away.

 

My physical symptoms are rapid heart rate, nerve pain, and shakes. The nerve pain is seldom now (maybe every two weeks) but the rapid heart rate and shakes are pretty common.

 

Now for what is still here...

 

Anxiety is OUT OF CONTROL. I can't drive a car or handle speaking to my boss. Lots of stress and anxiety.

 

The physical symptoms are brutal. Shakes, heart beat, nerve pain are the worst thing ever.

 

I still have a bit of derealization and irrational fears, especially when I go out with friends. It's almost just a fear of "what if I get derealization" and fears of "what if someone tries to rob me" or another hypothetical stressful situation.

 

Cog fog is still pretty bad.

 

My CNS is totally screwed up. Last night I was partying and drank a lot of beer and smoked some weed. It exascerbated my symptoms, especially the one where the right side of my body tingles/feels different than the left side. I also had a horrible hangover today. I can't even drink one beer without it giving me horrible symptoms and keeping me awake all night.

 

I just wanna go back to normal; be able to drive, handle going out, not have anxiety, and be able to drink a beer without it giving me horrible symptoms. I could literally do all of these things before I started gabapentin and was five months off benzos.

 

Sounds like your recreational drug using days are over, my friend.

[Altostrata]

That is probably true, BlueComet. Once you stress your nervous system with prescription drug withdrawal (or any kind of withdrawal), it's likely you won't be able to challenge it again with chemical adventures -- it will be too sensitive.

[BlueComet]

What should I do about these horrible withdrawals and their complete disruption on my life?

[Altostrata]

You need to help your nervous system to heal. Please read the links I gave you above.

[BlueComet]

So based upon those, I shouldn't reinstate the gabapentin for a tapering purpose?

 

Do all these drugs have reinstatement risks? I thought it was just benzos.

[oskcajga]

So based upon those, I shouldn't reinstate the gabapentin for a tapering purpose?

 

Do all these drugs have reinstatement risks? I thought it was just benzos.

 

I think Alto recommended a small reinstatement of 10mg. 

[BlueComet]

You're right, he did. Please forgive me; my cognitive and reading skills aren't as sharp as they used to be.

 

I took 100mg of gabapentin about two hours ago. I had some leftover. So far it hasn't done anything, or if it has it isn't noticable.

 

I was on a real high dose of it so I think if I did reinstate it would have to be a higher dose. The gabapentin caused problems right away, such as with major depression and anger. I'm sort of in a lose-lose situation with these options.

[jammin83]

It could easily take a couple days of taking it get relief. It takes a while to kick in and has absorption issues on top of that. With what you are dealing with, it's not really that similar to benzo withdrawals and at this point it's not just withdrawal but your CNS being scrambled which is another issue on top of the withdrawal, so you have a lot going on. Give it a little while longer. With your negative reaction your best bet is to keep your dosage as low as possible.  

[oskcajga]

You're right, he did. Please forgive me; my cognitive and reading skills aren't as sharp as they used to be.

 

I took 100mg of gabapentin about two hours ago. I had some leftover. So far it hasn't done anything, or if it has it isn't noticable.

 

I was on a real high dose of it so I think if I did reinstate it would have to be a higher dose. The gabapentin caused problems right away, such as with major depression and anger. I'm sort of in a lose-lose situation with these options.

 

Well you decided to do 100mg, so I guess you're going to have to just keep taking it every day for a while and see how it goes.  the key is to keep it stable, so if you take 100mg today, keep doing it for a few weeks until your central nervous system stabilizes.

[BlueComet]

All I had was 100mg capsules and no means to make cuts to the pill. I was also somewhat desperate for some relief.

 

I reacted to the dose poorly. I am very depressed and having dark thoughts. It also isn't providing any real relief to my symptoms, which the exception of a minor reduction in the rapid heart beat.

 

Based on this, I'm not sure reinstatement would even work

[oskcajga]

All I had was 100mg capsules and no means to make cuts to the pill. I was also somewhat desperate for some relief.

 

I reacted to the dose poorly. I am very depressed and having dark thoughts. It also isn't providing any real relief to my symptoms, which the exception of a minor reduction in the rapid heart beat.

 

Based on this, I'm not sure reinstatement would even work

 

You could cut the capsule in 1/4 peices and take one of those tomorrow.  You can go buy a pill cutter from CVS or something for like $2.  I'd recommend a little bit (25mg if it's easy).

 

If that doesn't work you can just not take anything - but I'd recommend trying the lower dose first before totally giving up.

[BlueComet]

Okay so after I took the gabapentin, the only type of relief I got was a reduction in my rapid heart rate. All other physical symptoms remained unchanged.

 

However, two things did get worse. My depression became very bad and my vision problem became worse. I also had a little derealization.

 

I don't think it's feasible for me to reinstate this. I don't know how big of a dose id have to go to, nor how bad the depression and vision issue would get if I went back on.

[Altostrata]

100mg gabapentin is clearly too high for you. Adverse effects are dosage-related, which is why we suggest trying a very low dose, such as 10mg -- to avoid an adverse reaction.

 

Tips for tapering off Neurontin (gabapentin) contains suggestions for titrating gabapentin.

 

The idea is you'd take perhaps 10mg regularly for a while, then taper off. This is explained here About reinstating and stabilizing to reduce withdrawal symptoms Please read the links we give you.

[BlueComet]

I have read all the links that you posted.

 

The reinstatement section states that you should start with a reinstatement of a small fraction. Going based upon the low end of my final dose range (1500-2400mg), taking 100mg would equal 6% of the final dose. If I were to take 10mg, it would equal 0.6%. How could such a small fraction do anything noticable, or positive to my body? I received minimal benefit from the 100mg (the reduced heart beat was nice, though) and received some nasty sides. I had depression for about 24 hours after taking that dose.

 

Also, I had took the 100mg before I had any pill cutter. I don't believe that I can cut this small capsule to anything smaller than 25mg.

 

Additionally, the reinstatement section states that it is not recommended to reinstate due to a low probability of it working. It seems to inply that it may disrupt healing as well.

[oskcajga]

I have read all the links that you posted.

 

The reinstatement section states that you should start with a reinstatement of a small fraction. Going based upon the low end of my final dose range (1500-2400mg), taking 100mg would equal 6% of the final dose. If I were to take 10mg, it would equal 0.6%. How could such a small fraction do anything noticable, or positive to my body? I received minimal benefit from the 100mg (the reduced heart beat was nice, though) and received some nasty sides. I had depression for about 24 hours after taking that dose.

 

Also, I had took the 100mg before I had any pill cutter. I don't believe that I can cut this small capsule to anything smaller than 25mg.

 

Additionally, the reinstatement section states that it is not recommended to reinstate due to a low probability of it working. It seems to inply that it may disrupt healing as well.

 

2400mg is a whooping dose of gabpentin.  Have you considered filing a complaint against your doctor in the state medical board?

[Altostrata]

BlueComet, your mistaken reading of About reinstating and stabilizing to reduce withdrawal symptoms   aside, empirically you've found 100mg gabapentin to be too much for you.

 

And, as About reinstating and stabilizing to reduce withdrawal symptoms  states clearly, a very low dose may reduce withdrawal symptoms while not triggering adverse effects or a reaction from a sensitized nervous system. However, while many people on this site have benefited from reinstatement of a tiny dose, it is not guaranteed to work.

 

You went off a high dose of gabapentin cold turkey. You're here asking what to do about withdrawal symptoms.

 

If you don't care to try a 10mg reinstatement of gabapentin, that's your choice. Otherwise, see our Symptoms and Self-care forum for suggestions about how to cope with symptoms.

[BlueComet]

I have filed complaints with his supervisor, the center he works for, and the health care system he works for. The center he works for didn't do anything. His supervisor (who doesn't work at the center) had me meet with another doctor and did an "investigation" and "determined that gabapentin couldn't have caused my problems." The health care system quality control center had me speak to a medical director who said it was "possible" that gabapentin could cause this but "it should resolve shortly."

 

I have nothing but pure hatred for this doctor and all the people I've dealt with in regards. As you see in my first post, he negligently kept raising my dose. Also, I went on this medication because he told me that this medicine would "absolutely not" require a taper. If he had even told me that it was possible that it MIGHT require a taper, I would've never touched this stuff.

 

My symptoms caused me to go to the ER seven times, go inpatient for five days, and go see a neurologist, cardiologist, internist, endocrinologist, and others. All tell me they have no idea what is wrong with me. When I was inpatient I was crying from pain from withdrawals and nobody cared nor took my complaints seriously since CT scans and blood work didn't show anything wrong with me.

 

I have filed a complaint with the Montana Department of Public Health's Quality Assurance Division but never really followed through with it due to being sidetracked with other life obligations.

[oskcajga]

I have filed complaints with his supervisor, the center he works for, and the health care system he works for. The center he works for didn't do anything. His supervisor (who doesn't work at the center) had me meet with another doctor and did an "investigation" and "determined that gabapentin couldn't have caused my problems." The health care system quality control center had me speak to a medical director who said it was "possible" that gabapentin could cause this but "it should resolve shortly."

 

I have nothing but pure hatred for this doctor and all the people I've dealt with in regards. As you see in my first post, he negligently kept raising my dose. Also, I went on this medication because he told me that this medicine would "absolutely not" require a taper. If he had even told me that it was possible that it MIGHT require a taper, I would've never touched this stuff.

 

My symptoms caused me to go to the ER seven times, go inpatient for five days, and go see a neurologist, cardiologist, internist, endocrinologist, and others. All tell me they have no idea what is wrong with me. When I was inpatient I was crying from pain from withdrawals and nobody cared nor took my complaints seriously since CT scans and blood work didn't show anything wrong with me.

 

I have filed a complaint with the Montana Department of Public Health's Quality Assurance Division but never really followed through with it due to being sidetracked with other life obligations.

 

Perhaps you could contact some law firms in the area and see if they would be willing to take your case.  I'd recommend following through with the complaint to the state medical board.  It might not do anything - but at least you'll have done it

 

I'm sorry to hear that your doctor was a bad person - many of us are in this situation because our doctors were either bad people, or just horrendously negligent or ignorant.  I think they're all guilty - they should know better having 8+ years of science education.

[BlueComet]

I have done that as well. Spoke to two, both of which chose not to take the case because I don't have any medical tests confirming that there is anything wrong with me and that it would be a tough case to win.

[Pugknows]

Hi Blue,

 

Welcome to the forum. I am sorry you are suffering like this. You are not alone. You have a CT gabapentin buddy, MEEEEE.

 

I am coming up on 10 months of CT discontinuation withdrawal of gabapentin. I suffer every day from insomnia, 3am wakeup calls complete with cortisol surges and heart palps, severe anxiety, intrusive thoughts and head whooshing tinnitus. The akathisia I had was horrifying, but it has subsided. I do not get windows.

 

Gabapentin is pure evil. I had to CT because I was suffering from tolerance for a year with extreme nausea, severe brain fog and over the top anxiety.

 

If you can, get the 25mg liquid to reinstate and taper, or follow the instructions on how to make your own solution and ask Rhiannon to help you. She's a mod who successfully tapered off the cr*p.

 

Alto is telling you that the 100mg pill you took to reinstate is too high for your sensitive nerves, which is why you're reacting poorly. Although there are no guarantees reinstatement will work, her suggestion was that you try 10mg, not 100mg.

 

I did not reinstate. I am white knuckling it all the way. I don't recommend the route I took because you may get relief from reinstating a small amount and tapering. I get no relief.

 

PM me if you want to chat. I'll hold your hand, reassure you that this is temporary and support you any way I can. You are gonna be okay. I promise. I'm seeing improvements. Small ones. This is a long a** road.

 

Love and hugs, Pug

[BlueComet]

Okay so Sunday evening I took 100mg gabapentin in an attempt to try to reduce some withdrawal I have. It didn't do a whole lot. It made me depressed but it also slowed my very fast heart rate down a little bit.

 

Fast forward 48 hours later to last night. I began having some bad de realization. Eventually fought through it and went to bed. Today I woke up with derealization BAD. I couldn't go to work, couldn't handle a walk outside, couldn't speak to my roommate, couldn't speak on the phone. I'm in my room laying in bed not doing anything but relaxing and trying to ignore this.

 

This sort of follows a pattern of gabapentin rebounded side effects that I have had with painkillers. Back in June I was prescribed Tylenol with codeine and then Percocet to deal with the horrible nerve pain I've been having. It would do the trick but two days later I'd get some gabapentin rebound withdrawal symptoms, mainly a very rapid heart beat, severe anxiety, inability to drive, etc.

 

Is it possible that these pills are just too much for my CNS to handle and end up sending me into bizarre withdrawals a few days after the last use?

[Altostrata]

Is it possible 100mg is too much and 10mg might be worth a try?

[Pugknows]

Hi BC,

 

It breaks my heart to see you suffer like this.

 

The only way I got rid of the gabapentin side effects was to stop taking it.

 

Months 1-3: Three months of acute WD and the nausea, dizziness, brain fog and back pain went away.

 

Still had akathisia, anxiety, 3am cortisol surges, head whooshing in sync with my heartbeat, intermittent heart palps, insomnia and high anxiety.

 

Months 4-7: All the same symptoms I was left with from acute WD, just worse and more powerful. Got relief every evening around 5-6pm.

 

Months 8-9: All the same symptoms, but reduced in severity and duration. Akathisia stopped (thank you Lord!) Same relief from symptoms came around 6-7 pm each evening, sometimes even earlier.

 

Insomnia came on strong. Now couldn't GET to sleep and still got cortisol surging, but at 4am instead of 3am.

 

Months 10- Who the hell knows?

 

BC, this is just my journey to bear, not necessarily yours. You may be fine tomorrow. I have learned in my case, time is the only healer (and God, of course!)

 

Love, Pug

[BlueComet]

Is it possible 100mg is too much and 10mg might be worth a try?

It is possible. A few things have me reluctant..

 

1) the 100mg dose provided minimum relief and caused depressive side effects that negated that relief. I don't think 10mg would provide any type of relief that would be noticeable

 

2) I seem to react horribly to these drugs a few days after a dose. I imagine being on 10mg on a daily basis would just postpone an inevitable

 

I don't know what's happened to my body, all I know is I doubt I'll ever be able to take a pill anytime soon, especially one that alters brain receptors.

 

I'm hoping I didn't screw myself with the 100mg pill and these nasty rebound symptoms go away in a few days

[Altostrata]

I've explained why 10mg might be better than 100mg.

 

If you don't want to try it, that's your choice. There is no other alternative but to support your nervous system while it recovers. See our Symptoms and Self-care forum for suggestions about how to cope with symptoms http://tinyurl.com/3hq949z

 

Also read What is withdrawal syndrome?
 
The Windows and Waves Pattern of Stabilization

[Pugknows]

BC,

 

Please give what Alto said a shot. Don't suffer like I have, if you can go slower and live, rather than grab the railing to survive.

 

Love Pug.

[BlueComet]

Thank you alto, and thanks for sharing your experience and offering your support Pug

 

I have to do a little more reading before I decide on trying the 10mg again. I'll admit I'm nervous about it

[Pugknows]

I know. 10mg won't do much, but maybe just enough. I'm here for you. Pug

[BlueComet]

That 100mg dose really set me back. Today I had HORRIBLE chest pains, major cog fog, OCD, shakiness/jitteriness, and I've been hearing "beeping" noises.

 

Did I shoot myself in the foot trying the 100mg? Or was this just a shock that should go away in a few days or week?

[Altostrata]

Forget about the 100mg. It's the cold turkey that's the problem.

[oskcajga]

That 100mg dose really set me back. Today I had HORRIBLE chest pains, major cog fog, OCD, shakiness/jitteriness, and I've been hearing "beeping" noises.

 

Did I shoot myself in the foot trying the 100mg? Or was this just a shock that should go away in a few days or week?

 

 

 

So based upon those, I shouldn't reinstate the gabapentin for a tapering purpose?

 

Do all these drugs have reinstatement risks? I thought it was just benzos.

 

I think Alto recommended a small reinstatement of 10mg. 

 

 

At first Alto recommended a small dose, but you took 100mg (see the quotations above this text).  Perhaps in the future you'll heed the advice on here.  I doubt you "shot yourself in the foot" - but it may have caused some exacerbation of the cold-turkey effects. 

 

A small 5-10mg dose, as suggested, might help.

[jammin83]

He took the 100 mg before the advice was given. I really don't see how giving him an attitude is helping anything. He is struggling just like the rest of us. Maybe we should show compassion instead of scolding him because of some perceived disobedience. Reinstating seems counter-intuitive to everybody, it's a tough decision and we should try and give blue the support he needs so he can get through this. We all make mistakes along the way in withdrawal and many people learn through trial and error. Somebody in the midst of withdrawal doesn't exactly have all of their faculties running at full speed. 

 

Hang in there blue. I do think you should try the 10 mg and see how it goes before giving up. Hang in there man, we will get through this but we have to be smart and utilize the experience of the people that have been through it before. 

[oskcajga]

He took the 100 mg before the advice was given. I really don't see how giving him an attitude is helping anything. He is struggling just like the rest of us. Maybe we should show compassion instead of scolding him because of some perceived disobedience. Reinstating seems counter-intuitive to everybody, it's a tough decision and we should try and give blue the support he needs so he can get through this. We all make mistakes along the way in withdrawal and many people learn through trial and error. Somebody in the midst of withdrawal doesn't exactly have all of their faculties running at full speed. 

 

Hang in there blue. I do think you should try the 10 mg and see how it goes before giving up. Hang in there man, we will get through this but we have to be smart and utilize the experience of the people that have been through it before. 

 

you're 100% correct.  I completely apologize for being a bit of a jerk above.  I get frustrated because I just want to see people get better :/  Please forgive me for having a bit of an attitude and misinterpreting the situation.

 

Love and hugs,

Osk