Gabapentin (Neurontin): off label use for Anxiety and Insomnia
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- เผยแพร่เมื่อ 27 ธ.ค. 2022
- Dr. Pagnani of Rittenhouse Psychiatric Associates discusses Gabapentin (Neurontin) and its clinical utility for the off-label treatment of anxiety and insomnia. This medication has abuse potential (although, it is generally thought of as having less abuse potential than anxiolytics and sedatives like benzodiazepines (xanax, ativan, valium, klonopin) and other hypnotics (ambien & lunesta). Individuals should only take this medication under the direct supervision and direction of a medical professional.
Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.
Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.
These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.
Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.
This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.
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Thanks for the info Doctor.
I have started taking 400mg 30 minutes before bed combined with 500mg of the amino acid GABA and I sleep 9 hours soundly. Prior to this I was waking two to three times and having a hard time sleeping. This combo has worked wonders for me.
Honestly it's insane how much it helps my sleep , I'm on 900mg in the evening.
I'm glad to hear that this is working well for you.
Just woke up after 600 mg. Best sleep in years. I can’t imagine abusing it. Better than trazodone by a long shot. Certainly better than those ambien type drugs which, in my opinion, are dirty drugs.
How is it after 4 months? Thanks
No to teraz spróbujcie to odstawić. 😂 Zmienicie szybko zdanie o gabapentynie. 😢 To twardy narkotyk! Odstawienie gorsze od heroiny. 😱
Doesn't seem to work for everyone, but it's a miracle drug for my generalized anxiety and panic. I had anxiety my entire life and now I really don't. I still have stress but at a normal, manageable level. I've been taking 600-900 mg for 9 months with minimal side effect.
I don't know if it treats my insomnia directly since I also take trazodone, but helps my sleep in a few ways. Fewer unwanted thoughts at night. Less self-medicating with alcohol. No more nighttime itching, which used to keep me up for hours almost every night.
Can fit elaborate on the itching?
Pregablin and gabapentin are awesome!! They help a lot.
Dr, my brain generates random images non stop and flashback after short term usage of ssri , z drug, benzo pregabalin and propanol for work anxiety . Is it brain damage? Its been worsening for last 2 years
My experience with SSRIs was similar in that it got worse and worse over time.
I thought because of the pandemic and working alone I was becoming aggressively anti social but it just kept getting worse even when I was back working with other people.
Even seeing my friends felt like a strange exercise that I had to force on myself. My girlfriend and I would always fight about the dumbest stuff.
Once I stopped taking the Wellbutrin all the aggressive anti social thoughts faded away. I'm still left with the mental scars and I find myself getting angry at people very easily but it's nothing like before.
If a drug isn't working for you just tell your doctor and try something else. We don't really know how any of this shit works and if you research the different drugs you'll find personal reports of both miracles and horrors on the same dosages.
Thank you. Have you seen patients gain weight on this?
Dr. Pagnani, can 400mg Gabapentin be taken as needed for sleep? Currently I take it 3 time a week for sleep because I've read it may cause addition and or withdrawals. Thanks
Gabapentin can certainly be utilized to help with sleep (although I cannot speak to your specific circumstance, without an evaluation). It is important (as you mention) that individuals understand that it does have abuse potential (although likely a lot less than medications like ambien, lunesta and xanax). I recommend you speak directly with your provider about how often they recommend you take this medication for your specific difficulty. Thank you for watching and your question! - Dr. Pagnani
i could not sleep for more than 3h every night. i tried everything, nothing worked. Now i take 300mg 2h before i go to bed and another 300 mg and melatonin and ashwagandha right before i go to bed. Now i sleep 6 or 7h . I also give one 300mg at night to my dog
Thank you for sharing and I'm glad that you are sleeping well. Be sure to discuss your regimen with your health care provider (and vet)! Best, - Dr. Pagnani
My 19 year old daughter has just in the past year been diagnosed with brain tumor causing epilepsy. She’s on 2 anti seizure drugs but still has breakthrough seizures and is now dealing with pretty frequent panic attacks which feel just like her seizure aura. She takes klonopin when this happens and it works well but she’s needing to take it a couple times a week typically. We’d love to find something to help her anxiety/panic that she can take daily and is safe in epilepsy. This drug came to mind but am wondering if there’s a better option considering your mention of potential dependence.
First, I'm very sorry to hear about your daughter's difficulties. I will keep both your daughter and your family in my thoughts. Her specific condition is very complicated. Discussing options including continuing with her current regimen, gabapentin, and even SSRI's/SNRI's with her current provider may be helpful. Of note, although gabapentin can have abuse potential, it has been my experience that this is only in a small percentage of patients. While anti-depressants like SSRI's/SNRI's can lower the seizure threshold, it is not uncommon for neurologists to find it reasonable to utilize these medications (particularly if seizures are controlled with other medications). Again, I apologize for not being able to offer more direct advice, but do believe it's very important for you to continue to discuss options with your daughter and her providers. Sincerely, - Dr. Pagnani
@@RittenhousePsych thank you so much for the kind response. We are discussing pros and cons with her drs. Appreciate your feedback and the channel!
I know this is going to sound weird but explore the use of the keto diet. Many professional articles on this
@@betterd9160 doesn’t sound weird at all. She tried but felt it led to an eating disorder and she got very weak. Thank you!
@@katebruno9255 Kate I hope the best for her. You’re a good mom, I can tell.
I was thinking 175mg of Zoloft and 300mg pill of gabapentin a day and made my depression worse I felt so confused and crazy
If taken 3 times a day, How long does this medication take to work for anxiety?
Gabapentin tends to work more quickly than SSRIs or SNRIs for anxiety (possibly in 15 - 30 minutes or so, as opposed to 4-8 weeks of building up in one's system). It is sometimes used "as needed" for this reason. I could never know if a medication would be safe for someone without an evaluation, but this could be something to discuss directly with your provider. Best, - Dr. Pagnani
Excercise
Does this help depersonalisation disorder?
Gabapentin and buspirone has been helpful for my depersonalization. The gaba kicks in pretty quick and buspar is nice and grounding for my psyche
I wake up 2-3 every night nothing works
I'm sorry to hear that you're continuing to have difficulty with sleep. It sounds like you have had several trials of medications, but I hope that you are able to work with your provider on finding a regimen that does work. Of note, CBT-I (CBT for insomnia) may be a type of therapy that is worth looking into. Sometimes non-pharmacological treatments work just as well (or better) for conditions like insomnia, especially for long-term. Best, - Dr. Pagnani
Have you tried plain old Benadryl? I have allergies and I took a 25mg pill and I fell into a deep sleep...I don't know if people take it for long term use.
@@joeyconvery2055 long term use is linked to dementia
I was put on Gabapentin for nerve pain and it caused insomnia and panic attacks. After being off it for a few weeks, these problems still linger. Horrible stuff. I wish I had never tried it.
I'm sorry to hear that you had this experience, and hope that you either no longer need a medication, or have found a strategy that is helpful for your insomnia and panic. Best, - Dr. Pagnani
How long were you taking it to begin with? Did you taper off or just stop the drug suddenly?
@@Milburt I tapered off it by decreasing the number from 3-2-1 and then opened the single capsule and emptied half out for the final few days. It took me longer to taper it than the time I was on the full dosage.
@@Em-vj8sm Hopefully those symptoms will clear up soon if they already haven’t. Panic attacks and insomnia are horrible.
@@Milburt I have ended up needing to take duloxetine for the panic attacks and melatonin helps the insomnia slightly. Really hope it doesn't last. Thankfully the duloxetine seemed to work wonders. After about 3.5 weeks I didn't feel randomly panicky anymore.
You seem like a good doctor. Few and far between. Biggest drug pushers around.
Thank you for your comment, and I very much appreciate that. I agree, that there are many physicians (in particular in mental health) who overly diagnose and overly prescribe. Thanks again, - Dr. Pagnani