Neurontin

[Guest guest]

Okay gang, tell me what you have experienced with this drug.

Thanks, Savannah

[Editor's Note:

Savannah: The drug, gabapentin (Neurontin), has been around for a few decades.

It has been used in epilepsy and partial siezures (it's an anticonvusant),

particularly adjunctively in the latter when older medications do not achieve

desired results. It has been put forward as useful in the treatment of

neuropathic pain, as in diabetic peripheral neuropathy. It is not related to the

opiates or synthetic opioids. It has been reported in various publications as

having been " used with great success in the treatment of neuropathic pain of all

origins. " It has a better side effect profile than valproate and Carbamazapine,

according to the same sources. (Source: " Update on the Management of Pain "

July/August 2002 in the California Journal of Health-System Pharmacy, by

Lowe, Pharm.D., Associate Director of Pharmacy, Arrowhead Regional Medical

Center, Colton, CA. According to Dr. Lowe, there are no drug interactions with

gabapentin, which cannot be said for the other 2 anticonvulsants noted; side

effects include somnolence and ataxia. The average effective dose, says Dr.

Lowe, is at least 1800 mg. of gabapentin. (As you know, everyone's different, so

you needn't, a priori, assume the doc has it wrong when establishing a lower

titrated maintenance dose for a patient.

HOWEVER: Please also see " The Illegal Corporate Creation of a Blockbuster Drug, "

at www.citizen.org/ELETTER/ARTICLES/neurontin.htm . This was published by the

Ralph Nader-related Public Citizen network (the medical arm of which is, or at

least was,headed by Sidney Wolfe, M.D., who's always impressed me with his

integrity and concern for public health), and therefore, to my mind, a highly

creditable source (make your own evaluation, of course; and please let me note I

have no affiliation with, nor membership in, Public Citizen or its various

advocacy affiliates). The article reports the (drug's) maker as having engaged

in deceptive and illegal practices in seeking to promote " off-label " uses of the

drug, including use in the treatment of neuropathic pain.

In reading Dr. Lowe's journal article, I found that--to my mind--his highly

positive evaluation for Neurontin was congruent with the (suspect) information

the drug's maker promulgated.

Neurontin undoubtedly has been a efficacious and relatively safe drug for use in

some patients, with regard to its " on- " label uses. As to 'off- " label uses such

as neuropathic pain relief, if it were me, I'd question my doc(s) and

pharmacist(s)until I was completely satisfied the risk/benefit/side effect

picture was in my favor. If this drug is for you, we can look forward to your

commentary.

Good fortune to you!

D.