# Another silly Neurontin/gabapentin thread



## korey (Apr 25, 2006)

My psychiatrist gave me a list of medications on our last appointment that he wants me to research and consider. On the list is Lamictal, Trileptal, Depakote, and Neurontin. They're all anticonvulsants and/or mood stabilizers. I think the mood stabilizer property is what my psychiatrist is looking for. I've heard Lamictal is good at that, but it's a little pricey. The same goes for Trileptal. I've read that Depakote makes people nauseous and has some of the other unpleasant effects of the valproates, so I don't particularly want to delve into all that. 

So that leaves me with Neurontin. It is the only one available in generic form (which is a plus), but from some of the threads I've read here at SAS, it sucks and is worthless (though, a very few people seem to have had success with it). Who here is or has taken it? What were your experiences with it like? I've read that it is good for all sorts of things, from pain management to anxiety relief to mood stablization. Is that true? From what I've gathered, it's not actually metabolized by the body, so how does it have any effect whatsoever?

(Neurontin's younger brother, Lyrica, interests me, but it too is a bit pricey.)

Any information you can give about Neurontin will be appreciated. Thanks!


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## Thunder (Nov 5, 2003)

It helped me sleep a little when I first started it but thats all I can say because other than that I couldn't even tell I was taking it.


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## Caedmon (Dec 14, 2003)

Make pubmed your friend.


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## korey (Apr 25, 2006)

PubMed is nice and all, but I'd rather read personal accounts before I read case studies.

So with that said...Keep the replies coming, people!


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## SADLiath (Aug 5, 2005)

I've never taken it, but my dad used to.

He used to call it Neu-ROTTEN because all it did was eat money.


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## Pistachio (Aug 1, 2006)

The thing that gets me about this drug is that it is not metabolized. Drug goes in one end and comes out the other unmodified. So for those it does work on, how in the hell does it actually work? There are studies showing it's effectiveness as an anticonvulsant and analgesic, as well as it's well known sedative effects, but no one knows how it actually gets anywhere in the body.

Thankfully, it does help my insomnia and with my insurance coverage it's a minimal cost per month, but I sure would like to know what it actually does.


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## workman (Mar 5, 2004)

It looks like it is going to get approval for SA. It is in like phase III trials.


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## Caedmon (Dec 14, 2003)

Pistachio said:


> The thing that gets me about this drug is that it is not metabolized. Drug goes in one end and comes out the other unmodified. So for those it does work on, how in the hell does it actually work? There are studies showing it's effectiveness as an anticonvulsant and analgesic, as well as it's well known sedative effects, but no one knows how it actually gets anywhere in the body.
> 
> Thankfully, it does help my insomnia and with my insurance coverage it's a minimal cost per month, but I sure would like to know what it actually does.


It is a sort of amino acid. It is absorbed in the gut. It just isnt' filtered by the liver or kidneys... it either goes through the BBB or it gets peed out. I think. Does someone know more? (Please say yes.)


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## korey (Apr 25, 2006)

Maybe we should look into how Lyrica works in order to take a guess at how Neurontin works. I assume more is known about Lyrica and its method of action since it's a scheduled substance. I'm probably wrong, though.


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## Caedmon (Dec 14, 2003)

korey said:


> PubMed is nice and all, but I'd rather read personal accounts before I read case studies.


Your original question was in regards to efficacy. Efficacy is something that is established through empirical study, not anecdotes.


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## UltraShy (Nov 8, 2003)

Caedmon said:


> Efficacy is something that is established through empirical study, not anecdotes.


Paxil has empirical studies that the FDA found impressive enough to approve it for treatment of SA. Xanax lacks so much study and lacks FDA approval for SA. Which works better for most people?

Asking real people in the real world what works means a bit more to me than what some study done in fantasy land says.


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## Caedmon (Dec 14, 2003)

http://en.wikipedia.org/wiki/Anecdotal_evidence


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## korey (Apr 25, 2006)

Blah, I can make my own thread if I want  ::tries to dance but collapses from being sleepy::

From what I've gathered by reading posts on SAS along with some stuff on PubMed, Neurontin's effectiveness is mainly individual. For some, it helps with a whole list of things, but for others, it does absolutely nothing. There are probably more of the latter, though.

I guess I'll just have to try it out for myself. Hopefully my psychiatrist will be able to tell me how it works in greater detail.

Feel free to continue replying to my original post, though. I do like to read about others' experiences with medications, both anecdotally and empirically (but anecdotally is just easier. Those case studies can be hard to interpret sometimes :con)


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## korey (Apr 25, 2006)

Are there any other GABA analogs that have mood stabilization properties (hopefully some that actually get metabolized :b)?


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## Caedmon (Dec 14, 2003)

Depakote & its cousins.


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## korey (Apr 25, 2006)

What about primidone, phenytoin, topiramate, etc? I've also read about baclofen, a GABA analog that is used as a muscle relaxant. I wonder if it has any mood stabilization effects...


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## Pistachio (Aug 1, 2006)

From : http://www.mcmanweb.com/article-236.htm


> Glutamate and GABA represent the yin-yang of the neurotransmitters, Darryle Schoepp PhD of Eli Lilly explained in a session at the 2003 American Psychiatric Association annual meeting, both present in nearly all synaptic function all over the brain, with the former acting in an excitatory capacity and the latter in an inhibitory role. The mood stabilizers are thought to act on one or the other or both.
> 
> There are two types of glutamate receptors, ionotropic (iGluR), including NMDA, kainate, and AMPA receptors; and metabotropic (mGluR), which mediate numerous chemical actions. When the NMDA receptor is working right, glutamate and glycine bind to the receptor, which opens up its corresponding ion channel and permits calcium entry into the neuron. This in turn promotes intracellular signaling essential to plasticity and survival.
> 
> ...


Even if it's processed in the gut, Gabapentine still has trouble crossing the blood brain barrier. As a matter of fact you might be better off working on increasing the levels of it's precursors rather than taking GABA straight.


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## Pistachio (Aug 1, 2006)

korey said:


> What about primidone, phenytoin, topiramate, etc? I've also read about baclofen, a GABA analog that is used as a muscle relaxant. I wonder if it has any mood stabilization effects...


Those are some serious drugs there. Lots of side effects and interactions. I'd definitely get a psychs opinion on them. All of them seem to interact badly with CNS depressants (including benzos).

From Drugs.com:
Primidoneis an anti-siezure medication and interacts with a host of other medication.

Phenytoin another anti-siezure medicine with muscle relaxant and nerve pain relief components. But it also puts you at high risk of gum disease strangely enough.

Topiramate Very Increased risk of kidney stones.

Baclofen Don't take with any AD. Serious sedation may occur.

None of them appear on the controlled substances list unless by some other name. I haven't seen anything that suggests they have mood stabilization properties other than the sedative/hypnotic effect. Sorry, no personal experience with them.


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## ohiomom (Oct 25, 2006)

*I don't like Neurontin*

I was just taken off Neurontin because of the side effects it was having on me....iching, fuzzy headed, feeling terrible and anxiety...


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## korey (Apr 25, 2006)

Well darnit :stu 

I guess I'll have to start considering the valproates again...


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## Caedmon (Dec 14, 2003)

Pistachio said:


> Even if it's processed in the gut, Gabapentine still has trouble crossing the blood brain barrier. As a matter of fact you might be better off working on increasing the levels of it's precursors rather than taking GABA straight.


:con I am very confused by this unreferenced statement. Your article said nothing about gabapentin. Also, gabapentin is not GABA. The _precursor _to GABA is glutamate - are you saying that we should increase glutamate levels?

Please read:
Gabapentin bioavailability: effect of dose and frequency of administration in adult patients with epilepsy.
The absorption of gabapentin following high dose escalation.
Mechanisms of the antinociceptive action of gabapentin.
for some nformation regarding mechanism of action and bioavailability in general. It is not at all comprehensive.


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## Pistachio (Aug 1, 2006)

I should preface by saying I'm no doc, I only play one on the internet, Caedmon. 

Thank you fo rthe links because I've been searching for how it works for a week now and all I keep coming across is stuff like what I referenced above.


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## korey (Apr 25, 2006)

http://en.wikipedia.org/wiki/GABA#Pharmacology

There's a nice and neat list of medications and/or classes of medications that I could consider. From them all, I would probably choose one of the ones not intended for mood stabilization :troll, but if forced to, I would probably go for either carbamazepine (Tegretol) or one of the valproates (probably valproic acid since it's inexpensive). Anyone have any experience with either of those two that they'd like to share? From what I've read, Tegretol is the parent drug of Trileptal, and since that medication is on the list my psychiatrist gave me, maybe it's a good possibility...


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## korey (Apr 25, 2006)

(I didn't want to make another thread about this, so I'll just bring this one back to life.)

My psych prescribed me Neurontin yesterday. 300mg 4x day. I took 300mg of it twice last night, and I was out like a light. My psychiatrist thinks it will complement the Valium I take. I'll try to update this thread as often as I can about my adventures with Neurontin


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## Caedmon (Dec 14, 2003)

We were trying it for sleep, initially. Or anyway that was one thing we hoped it would help. I'm tolerant to sedative effects from it now though.


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## korey (Apr 25, 2006)

The sleep it put me in last night was similar to the sleep I was put under when I had my wisdom teeth removed. I was wide awake and watching TV around 7PM or so, and the next thing I knew, it was 10PM or later. I didn't bother to do anything other than take my pajama shorts and socks off, then I went back to sleepytime land. 

So far today, I've been calmer than usual. My mind seems "centered", if that makes any sense. It probably has to do with both the Neurontin and the doubling of my Wellbutrin SR dosage.


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## Caedmon (Dec 14, 2003)

korey said:


> The sleep it put me in last night was similar to the sleep I was put under when I had my wisdom teeth removed. I was wide awake and watching TV around 7PM or so, and the next thing I knew, it was 10PM or later. I didn't bother to do anything other than take my pajama shorts and socks off, then I went back to sleepytime land.
> 
> So far today, I've been calmer than usual. My mind seems "centered", if that makes any sense. It probably has to do with both the Neurontin and the doubling of my Wellbutrin SR dosage.


How are you dosing it? 300mg x2 and then 600 at night?


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## korey (Apr 25, 2006)

I'm supposed to take it 4 times per day without any particular scheduling. Last night, I took 300mg before dinner and then 300mg near bedtime. Today, I took 300mg this morning and 300mg after school. I'll probably take two 300mg capsules in a little while when I decide to go to bed. So yes, your dosing schedule is accurate for the time being.


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## korey (Apr 25, 2006)

Update:

The effects I noticed before seem to have subsided, and the Neurontin doesn't appear to have any effects at all anymore. I'll continue taking it until my next psych appointment, but I doubt it will do anything for me.


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## firedancer (Nov 14, 2003)

i've been on all of those you mentioned. currently i'm on lamictal (the best med that i've ever been on) but it is very pricey, luckily my insurance is great and i don't pay that much for it. my neuro and pdoc both gave me tons of samples when i was going through not having insurance until my cobra kicked in.

gabapentin did nothing. 

lyrica helped tremendously with anxiety but i was taking it for migraines and for that it did nothing. 

trileptal worked well for anxiety also and stomped my mania. 

depakote - can't really say that i saw a difference. i did have some stomach issues but compared to what i have read about others experience, i think i had it good.


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## korey (Apr 25, 2006)

I want to amend my last update. One thing I have just begun to notice is that I've been more loosely talkative since I started Neurontin. I also talk to myself aloud often now, too. I've also gotten to the point where I take only 5mg to 10mg of Valium per day rather than the 15mg per day I'm prescribed. I don't know if that's because of the Neurontin decreasing my need for it, or if it's Neurontin's effects on memory and coodination. Oh yes, I have been clumsy flumsy since I started Neurontin. Usually a while after I take it, I'll walk somewhat like a drunk . I will still probably ask for an increase in Valium on my next appointment because I have a feeling that my taking less Valium lately is only a passing effect on my memory because of Neurontin (obviously, I have no proof of this. It's just my feeling. Plus, Valium costs a lot less than Neurontin.)

I might go back to that list of alternatives I discussed with my pschiatrist on my last appointment (the one that contained tegretol and valproic acid). I'll have to look into them again because my memory is a little fuzzy lately (probably due to Neurontin).

This is unrelated, but I've noticed that Valium's anxiolytic effects are only reached at high doses for me. So far, the dosage rank with Valium has been:

5mg - no noticeable effects on SA, some slight muscle relaxation, and noticeable sedation

10mg - some effects on SA but not as potent as 1mg of Xanax; more muscle relaxation, and more noticeable sedation

15mg and up - it follows the same trend of slightly increasing anxiolytic effects trailing far behind the sedation and muscle relaxant effects

Hopefully, I'll be able to get my psych to up my Valium to 30mg/day as I had layed out on my last appointment. The only reason he didn't up it then was because he thought that the Neurontin would increase the Valium's effectiveness, which it has to an extent, but not the anxiolytic effects I'm looking for.


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## korey (Apr 25, 2006)

firedancer said:


> i've been on all of those you mentioned. currently i'm on lamictal (the best med that i've ever been on) but it is very pricey, luckily my insurance is great and i don't pay that much for it. my neuro and pdoc both gave me tons of samples when i was going through not having insurance until my cobra kicked in.
> 
> gabapentin did nothing.
> 
> ...


I wish those effective ones you mentioned (Lamictal and Trilepta) were available in generic. I've read great things about all of them. Stupid money-based economy :cry


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## Caedmon (Dec 14, 2003)

I'm trying Lamictal, again. Just got back from the shrink, with a new starter pack. This time i am _totally committed_ to getting up to the 150-200 mark at least.

Gabapentin def. made me feel - well, sort of drunk. The clumsiness (walking into things) and stupidity wore off, although if I increase the dose I get those effects again. Which, you know, has pros and cons to it I guess. :lol

Actually I feel pretty stupid a lot of the time these days... but I don't think that it's the gabapentin!


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## korey (Apr 25, 2006)

Good luck with the Lamictal, Caedmon!

Update:

I'm starting to think that the Neurontin is having _slight_ painkilling effects on me. It might just be amplifying the muscle relaxant properties of the Valium, though. Either way, it's a plus.


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## korey (Apr 25, 2006)

Update:

I can't really tell if the Neurontin is doing anything for me anymore. I sleep better and I talk more now, but that could easily be attributed to the Valium. I think I'm gonna switch to Tegretol on my next appointment. This Neurontin stuff isn't really doing much.


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## Broshious (Dec 23, 2006)

Neurontin helped me quite a bit with anxiety actually. I was taking 1200mg twice a day. It was a different sort of help then I'd had before though(took Clonazepam for awhile). I would feel that a situation should make me anxious still, but the anxiety just wasn't there. Was kinda neat, not to mention the fact that they can get you high as ****.


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## Caedmon (Dec 14, 2003)

*Re: re: Another silly Neurontin/gabapentin thread*



Broshious said:


> Neurontin helped me quite a bit with anxiety actually. I was taking 1200mg twice a day. It was a different sort of help then I'd had before though(took Clonazepam for awhile). I would feel that a situation should make me anxious still, but the anxiety just wasn't there. Was kinda neat, not to mention the fact that they can get you high as @#%$.


Neurontin has been good for my anxiety. 300mg prn for situations made me feel drunk and aggressive. There seems to be a GABAergic and dopaminergic component to it, at least for me it def. feels that way. It wasn't nearly as lovely-feeling as high-dose Parnate (which feels _just! damn! good!_) but yeah I would say there is something to what you're saying about Neurontin.

I'm in the process of trading in Neurontin for Lamictal, and hopefully it'll work out.


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## korey (Apr 25, 2006)

Ack! Necromancy! :b

Apparently lithium can cause higher blood serum levels of Neurontin because I recently began treatment with lithium (after I quit the Neurontin), but I had some Neurontin left and I wanted to get to sleep relatively quickly one night, so I took 1200mg at once and I slept for over 13 hours straight :fall I've taken that amount of Neurontin before the lithium, and it wouldn't do much for me, but with the lithium, it definitely had a more noticeable effect.

Eh well. I'm sticking with the lithium. It has some sedative/anxiolytic properties (for me, at least) on top of the other therapeutic effects I'm taking it for.

If the Neurontin works for you, keep at it! :yes


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## paranoia (Mar 5, 2004)

If you stop lithium I would say trying depakote next....seems to be helping me alittle. I was told I am more focused, less shaky(didn't really notice it, until I was told) I wasn't prescibed depakote for anxiety so :banana first med that gave me a positive effect instead of negative side effects!


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## Caedmon (Dec 14, 2003)

*Re: re: Another silly Neurontin/gabapentin thread*



paranoia said:


> If you stop lithium I would say trying depakote next....seems to be helping me alittle. I was told I am more focused, less shaky(didn't really notice it, until I was told) I wasn't prescibed depakote for anxiety so :banana first med that gave me a positive effect instead of negative side effects!


Depakote can be very good for anxiety. You're not the only person to report this. I think there is also an open-label study showing that it helps SA, although there is much more evidence of it helping mania/hypomania, and often depressions (uni-, bi-, or multi-polar), psychosis, and/or other anxiety symptoms. (Oh and I guess it helps seizures and headaches, lol.)


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## korey (Apr 25, 2006)

NECROMANCY once again :b

Since I stopped taking Remeron not too long ago due to weight issues, my sleeping problems have returned with a vengeance. I did not get to sleep this morning until past 4AM, and then I had to wake up at 6AM to get ready for class. So, I'm running on a couple hours of sleep right now (thanks to Adderall).

The reason I'm bringing this thread back to life is because my psychiatrist told me to call him if my sleeping problems return, so I plan on calling him tomorrow to see about getting on Neurontin again exclusively for sleep. I have read some old posts (though, newer than this thread :b) of some people on here who have found Neurontin to help them sleep. Would it make a good sleep aid, do you think? I know it helped me sleep when I took it as a mood stabilizer, but I don't know if it will retain its sedative effects since I was taking it once before. I would only take it as needed, which would hopefully preserve its sedative properties. As far as dosing is concerned, I would probably take 600mg or 800mg at once near bedtime when necessary. Does anyone have anything to contribute about this possibility? As far as sleep aids go, Neurontin probably has the lowest side effect profile (probably because it's not even metabolized) of any non-controlled sleep aid I can think of.


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## Noca (Jun 24, 2005)

try elavil, its helping me sleep


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## korey (Apr 25, 2006)

Noca said:


> try elavil, its helping me sleep


I considered the tricyclics (mainly doxepin), but I don't want the weight gain or anticholinergic effects. Neurontin is practically side-effect free.


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## Fragmntedsilence (Jul 4, 2007)

I've said this before, but I've been on 1800 mg of Neurontin for 5 years now, and it's been really helpful in reducing my anxiety and letting me sleep.


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## Fragmntedsilence (Jul 4, 2007)

I am concerned about possible withdrawal effects of going off of Neurontin. I've noticed that on the few times I forgot to take my meds at night, I can't sleep at all and my anxiety comes back with a vengence. Does anyone know if Neurontin is addictive?


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## korey (Apr 25, 2006)

According to the DEA, Neurontin is not addictive at all. It's younger, stronger brother, Lyrica, is a controlled substance, though. Whenever I was on Neurontin back around December and then decided that it wasn't much of a mood stabilizer, my psychiatrist told me to make sure to taper down the dose over a few days because Neurontin technically is an anticonvulsant (and stopping those cold-turkey can be dangerous, though I seriously doubt it for Neurontin in particular).

I wonder if anyone's tried Gabatril for their anxiety problems? It is another GABA analog like Neurontin, and the website describes it as a "GABA reuptake inhibitor"...which I assume means that it's a SRI but for GABA, not serotonin. That could hold some very nice possibilities for some anxiety sufferers, I would think... Too paying for it at the pharmacy would probably induce a panic attack. The cost is disgustingly high.


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## Fragmntedsilence (Jul 4, 2007)

My psychiatrist had me try Gabatril a few years ago for a week or so, but I hated it and switched back to Neurontin.


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## Broshious (Dec 23, 2006)

Fragmntedsilence said:


> I am concerned about possible withdrawal effects of going off of Neurontin. I've noticed that on the few times I forgot to take my meds at night, I can't sleep at all and my anxiety comes back with a vengence. Does anyone know if Neurontin is addictive?


I was prescribed 2400mg/d of Neurontin for around 4 months. I quit cold turkey without any problems.


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## korey (Apr 25, 2006)

SHABAM! Necromancy yet again :b

Earlier today, my psychiatrist and I added 900mg/night of Neurontin to a lower dose of lithium... And thus begins my journey of _mood stabilizer combination therapy_! Yay! :boogie :fall

When I took my dose (900mg) of it around 8PM yesterday evening - along with 450mg of lithium (really low, I know) - I was out like a light. Reading some of my posts earlier in this thread, it seems that I'm experiencing the same Neurontin knock-out that I did last year. It was the same thing - I was lying in bed watching "Law and Order: SVU" (great show, BTW), and the next thing I knew, my alarm clock said that it was almost 2AM and my TV was turned off. Things were a little topsy turvy upon waking up. (When I reached to turn on the lamp on my nightstand, it took more than one attempt :um) I'm still under the pleasantly sedated effects of that dose of Neurontin, but I'm lucid enough to type (I think :b). I woke up extremely thirsty, so I guzzled three or so bottles of water and then I brewed and drank a large glass of Sleepytime tea (with honey and orange to taste...yum).

I suppose I'll try to keep this thread updated with my Neurontin-Lithium combination experiences. Has anyone else been on this particular combination? If so, what were your results/reactions?

Well, I must return to the land of blankets, sheets, and pillows now. Oh, what a glorious land, indeed. :yes :eyes

:sas


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## Knomebe (Feb 26, 2008)

Tried Neurontin then Lyrica. Neurontin you can tell when it's waring off. And even when it's working it's O.K. at best. Lyrica a hair better. Anxiety is still a problem and going to try lexapro next.

Take care


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