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Medical Forum / Diseases and Disorders / Epilepsy / September 2007Neurontin Gabapentin For Headaches
Anyone care to guess why this works .. ? Cephalalgia. 2007 Aug 10; [Epub ahead of print] Links Low-dose gabapentin in treatment of high-altitude headache. Jafarian S, Gorouhi F, Salimi S, Lotfi J. Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Headache is the most prevalent symptom of acute mountain sickness. We conducted a pilot clinical trial at an altitude of 3500 m to evaluate the efficacy of gabapentin in treatment of high-altitude headache (HAH). Twenty-four adult HAH patients (10 female, 14 male; age 18-50 years) were randomly assigned to receive either 300 mg of gabapentin capsule or identical placebo. After 1 h the presence of HAH and need to receive supplementary analgesic were assessed. The duration of the HAH-free phase after taking additional analgesic was also registered. Four patients in the gabapentin group asked for additional analgesics, whereas nine placebo recipients did not find primary medication satisfactory after the first hour of treatment (P = 0.04). The mean HAH-free period was 17.10 h in the gabapentin group, which was significantly higher than in the placebo group with a mean of 10.08 h (P = 0.02). This preliminary observation indicates that gabapentin is effective in treatment and alleviation of HAH. PMID: 17692105 [PubMed - as supplied by publisher] Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk Estrogen lowers red blood cell count .. high altitude headache is accompanied BY .. increased red blood cell count. Are hot flashes accompanied by .. headaches .. ? Gabapentin as effective as estrogen in treating hot flashes Jul 3, 2006, 22:51, Reviewed by: Dr. Priya Saxena "Gabapentin does appear to be as effective as estrogen, until now its efficacy relative to estrogen was unknown." By University of Rochester Medical Center, University of Rochester researchers, who have been investigating new therapies for hot flashes for several years, report in the July Obstetrics and Gynecology journal that the seizure drug gabapentin is as effective as estrogen, which used to be the gold standard treatment for menopause symptoms. Estrogen is no longer the preferred therapy because recent, large studies have shown that the hormone increases the risk of heart disease, stroke, breast cancer and Alzheimer's disease for some women. Given that news, millions of women have abandoned hormone replacement therapy (HRT) and are seeking other ways to ease symptoms. So-called natural remedies such as soy, herbal products or acupuncture have not proven safe or effective at this point. The latest Rochester study is the first to compare gabapentin and estrogen head-to-head against a placebo. Although it showed a substantial placebo effect similar to other menopause studies - women taking the sugar pill reported a 54-percent reduction in hot flashes - the women taking gabapentin and estrogen reported even better results, with a 71 percent to 72 percent decline in symptoms. "Gabapentin does appear to be as effective as estrogen," said lead author Sireesha Y. Reddy, M.D., assistant professor of Obstetrics and Gynecology at the University of Rochester Medical Center. "Until now its efficacy relative to estrogen was unknown." Approximately 75 percent of postmenopausal women between the ages of 35 and 60 experience hot flashes. Gabapentin (sold under the trade name Neurontin) was approved by the FDA in 1994 to treat epileptic seizures but has been used off-label for years to treat headaches, shingles pain and other ailments. Scientists hypothesize that gabapentin may reduce hot flashes by regulating the flow of calcium in and out of cells, which is one mechanism for controlling body temperature. An expert panel on menopause convened by the National Institutes of Health last year cautioned against the tendency to use treatments with scant safety data, and concluded that nothing to date was as effective as estrogen therapy although more research was needed. In the latest study, Reddy and colleagues enrolled 60 women in a randomized, double-blind, placebo-controlled trial for 12 weeks. Initially the researchers received more than 1,500 calls from women who wanted to participate, but after screening the callers to meet the study's protocol, the number was whittled to 60, with 53 women complying with every step. They were randomly divided into three groups: 20 women received gabapentin at 2,400 mg per day and a daily placebo or fake estrogen pill; 20 received estrogen in the form of Premarin at 0.625 mg per day and a fake gabapentin pill; 20 received sugar pills resembling gabapentin and estrogen. The women recorded the frequency and severity of their hot flashes in diaries. Results were tabulated using two statistical methods to compare the women's hot flash reports throughout the 12-week period with their baseline symptoms. Doctors did find that women who took gabapentin complained more often of headaches, dizziness or disorientation. Researchers believe that slowly ramping up the medication and taking it with meals can alleviate the side effects. - July Obstetrics and Gynecology journal www.urmc.rochester.edu Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > Anyone care to guess why this works .. ? > [quoted text clipped - 30 lines] > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk In the cat .. seizures are caused by .. hyperviscosity .. and hyperviscosity accompanies .. erythrocytosis. Sooo .. does .. neurontin / gabapentin .. lower red blood cell count and / or hyperviscosity .. therefore .. chemical bloodletting .. ? http://tinyurl.com/2opp64 Causes of seizures In a study of cats with seizures, polycythemia was the only metabolic disease reported as a cause of seizures in this species but the cause of seizures in these cats was not the metabolic effect of the disease per se, but the vascular events that resulted from the hyperviscosity. http://my.epilepsy.com/?q=node/633223 Altitude induced seizuresI can't find the post someone asked about sz's and altitude, so I'm starting a new thread. Someone asked if being in or maybe it was moving to higher altitudes, or something about altitudes can cause seizures. The answer is now officially - YES. I've had epilepsy mildly all of my life. Then I went from 350 feet above sea level to over 5000 feet and started having seizures nearly immediately (2 days later). I maintained to my then "doctor" that I felt going up in altitude and coincidentally starting to sz was TOO coincidental. He insisted there was no literature to support that. Well guess what? Now there is. It's even been published. It's somewhere on the internet too but I haven't the time to dig into it now but I wanted this person to know it is there. My epileptologist and I both agree I have a low threshhold for seizing, I went up suddenly, in a day, in altitude and I started sz'ing. I have also gone way down in altitude however since I got epilepsy diagnosed and not stopped sz'ing. Darn't. But I wanted to share this information, inform there is a very good published article on increasing altitude in people with low sz thresholds can start sz's is somewhere on the internet. But I can't find the post where that person asked the question. So I started a new thread and hopefully that person asking the question will see this.Gretchen Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk >Anyone care to guess why this works .. ? > [quoted text clipped - 33 lines] >DEAD PEOPLE WALKING >http://tinyurl.com/zk9fk On another message we just discussed vasodilation and its role in causing some headaches including but not limited to Cluster types. In most cases gabapentin is not effective for Cluster Headache, but in most cases breathing pure oxygen is effective. High Altitude Headache (HAH) is also caused by vasodilation but there are differences in the two. In Cluster Headache vasodilation is severe, so much in fact that it is sometimes explained as *ballooning* of the vessel. In Cluster's it is this ballooning that causes the pain - the tremendous stretching of a blood vessel and the pressure it puts on surrounding structure. In addition, Cluster vasodialtion is typically confined to a single vessel or branch of vessels in a single and specific location. In HAH vasodilation is not as severe and is typically more widespread. The dilation causes increased cerebral blood flow and sensitization of vessel structure by inflammatory mediators. It is the sensitization of the vessel structures that causes pain. Evidently, Gabepentin works to block these mediators. In HAH hypoxia is the trigger and breathing pure oxygen can reverse the condition by reducing vasodilation. While Cluster headache is not caused by hypoxia, breathing pure oxygen will also reverse the vasodialtion. > >Anyone care to guess why this works .. ? > [quoted text clipped - 55 lines] > caused by hypoxia, breathing pure oxygen will also reverse the > vasodialtion. Strangely enough, i suffer from a wide array of seizures in additiond to my various back problems. Interestingly enough, My previous doctor tried Gabapentin/Neurontin on me, not for seizures, but for my back pain, didnt do spit to that, and caused personality changing depression within a week....may work for some or most, but me, no dice were allowed. I will have to look into the cluster headache angle, Ive always been told I had migraines due to light brightness and distortion, nausea and sensitivity to sound...all the classic migraine stuff, yet one of the things i know that helps is to go with steady, deep breathing and letting my jaw go slack. I noticed right away that if i hold my breath for a second, the whole time my breath is held there is no pain whatsoever, but as soon as i resume it then becomes a horrible, throbbing pain, 10 times worse than before, so oxygen plays a big role in the way my headaches work, but again Gabapentin didnt stop that either, so heck im likely screwed anyway. whatever, dave I tried gabapentin for neuropathic pain and it didn't work and gave me HORRIBLE side effects that I don't think I will ever fully recover from. I have really never been the same. Debs >>>Anyone care to guess why this works .. ? >> [quoted text clipped - 74 lines] > whatever, > dave > I tried gabapentin for neuropathic pain and it didn't work and gave me > HORRIBLE side effects that I don't think I will ever fully recover from. [quoted text clipped - 79 lines] > > whatever, > > dave Debs, what sort of side effects did you have?...if you're willing to discuss....mine were like seeing the edge of hell. If you dont want to talk publicly about it you can email me if you like, or just leave it alone altogether....anythings col. -dave > > I tried gabapentin for neuropathic pain and it didn't work and gave me > > HORRIBLE side effects that I don't think I will ever fully recover from. [quoted text clipped - 86 lines] > > -dave Dave, I'm not Debs, but until she answers, I can tell you what happened to me. I started to feel relaxed-but not in a good way, kind of out-of- control. When I tried talking, to my complete surprise, only garbled gibberish came out. No one could understand me. I finally went to s;eep, and after a day and a half (mind you, I had only taken one 300mg tablet. I didn't try it again, until another doctor, years later, gave me samples for 100mg. capsules. I tried one-it just made me feel kind of dopey, so I didn't try it again. I'm kind of glad that I didn't now-since I didn't have any lasting effects. I have a feeling that I would have, if I had even attempted it. Oh, yes-the first time, it was given to me for headaches. Since I never took enough for it to build up in my system, I never found out if it would work. And really don't care. -Legend Sure I can talk about it. I could barely talk because I stuttered so badly. I was emotionally labile. I couldn't think straight which was a huge problem at work. I made very many very stupid mistakes. I had trouble peeing when my bladder was full. I know there are more but I can't recall them all right now. Feel free to email me if you want to talk more. Just take out your foot! :-) Debs >>I tried gabapentin for neuropathic pain and it didn't work and gave me >>HORRIBLE side effects that I don't think I will ever fully recover from. [quoted text clipped - 86 lines] > > -dave I forgot to add that my dose had been titrated up to 5600 or 5800 mg/day!!!!! Debs > Sure I can talk about it. I could barely talk because I stuttered so > badly. I was emotionally labile. I couldn't think straight which was a [quoted text clipped - 96 lines] >> >> -dave > I forgot to add that my dose had been titrated up to 5600 or 5800 > mg/day!!!!! [quoted text clipped - 100 lines] > > >> -dave WOW, thats quite a high doseage. I dont remember what my starting doseage was, but in the week i tried it for pain it brought on extreme melancholy....to the level of crying at sappy lovesong compilation album commercials....I was depressed but this was something far beyond that. I couldnt talk with anyone in my family without worrying one of them would die that day....it was an incredible change in personality for me....zoloft on the other hand made me into a monster for the 4 days i took it...and im glad that is passed. I still shake my head at all the furor over opiods and their dangers when they pass out brain altering pills like chicklets.. Legend...what you describe is very similar to a type of absence seizure I have. Ive talked about it before, and my kids find it very entertaining. I start speaking directly from my subconscious mind, as if I am speaking out of a dream, the weirdest part to me is that I am totally aware its going on, and I am unable to stop it. I will shake my head to try and come out of it, and it goes away when it chooses to....who would think living the dream would be so weird and spooky? Im glad I can no longer drive. Imagine me at some public place like a store, and starting to talk like that...i would be in a mental ward in a snap. For both of you and anyone, Im always interested in how these meds affect us. Ive had some very frightening things happen, and though Ive either taken myself off them, or told the dr and they took me off them, Ive never felt like an MD took it very seriously. Debs, what parts have stayed with you? all of them? if so I would pursue it relentlessly...sometimes I wonder if a lot of my mental problems, and even more, my seizures have been caused by one of the meds that have been tried along the way. Maybe we should start a new thread about the bizarre, unexpected results and side effects of some of these meds that seem to be the in vogue standard these days. Thank you both for your candor, if there is anything else i can answer for any of you, please ask.... Deus Vobiscum, -dave The parts that remain are: when I get nervous or very exhausted I stutter a little. My memory is really really bad. Really really bad.This is an amazing problem at work. Those are the two things that I know are from the gabapentin. Did I mention the Lyrica? Before my stim my pain Dr wanted me to try Lyrica. I told him it would really mess me up. He insisted. It's a lot cheaper to take a med than have a stim implanted. So I acquiesced (sp). After 3 pills I couldn't talk. BADLY! STUTTERVILLE!!! I went right up to their office and spoke so all my Drs and nurses there could hear me. Just so there wasn't any question of embellishment or exaggeration. Unfortunately forcing me to try the damn Lyrica put off my surgery date for six weeks! That really pissed me off. Oh well... Feel better Dave!! Debs >>I forgot to add that my dose had been titrated up to 5600 or 5800 >>mg/day!!!!! [quoted text clipped - 141 lines] > Deus Vobiscum, > -dave  Signatureremove YOURFOOT before responding On Aug 30, 5:42 am, Deb Schuback <YOURFOOTschub...@helix.mgh.harvard.edu> wrote: > The parts that remain are: when I get nervous or very exhausted I > stutter a little. My memory is really really bad. Really really bad.This [quoted text clipped - 162 lines] > > - Show quoted text - Aloha Everyone! Dave? I agree with you on starting a thread or, if possible, PINNING a thread at the very beginning of all the posts about this very subject. For YEARS I've wondered if ANY of my memory and/or mental health problems are or can be traced back to a certain medication or combination of. Ever since I started seeing my shrink about my depression back in 2000 or 2001 when he started me on Celexa as an anti-d (or even back when I was still with the doc that withheld the fact that depression was a PART of living with CP and put me on PROZAC! Just a side note about Prozac: If anyone ever wanted to turn me into a pure, unadulterated, 100% Paranoid Schizophrenic that is living in a constant PANIC ATTACK who completely believes that he is going to DIE at any moment...Just feed me 20 or mor MG'S of Prozac. I took only 20mgs a DAY for only THREE days and felt (HONESTLY! No kidding at all!) like I was ever so slowly turning into a dying alien! Of course when I finally came to that conclusion I immediately STOPPED taking it. JEEZ! After TWO days I was feeling VERY strange and couldn't even verbally describe the feeling...I'd NEVER had a feeling anywhere like that, and you are reading a post from a person, who, 35 years or so ago had taken EVERY recreational drug available at least ONCE (but NEVER, EVER used needles. That's my one and just about ONLY golden rule. Its a good one too, don't you think? Or ... don't you?) I feel I never fully regained having my senses completely knocked out of me like THAT. I cannot put my finger on it exactly, however... I'd also like to know just ONE other thing...OH! Before I mention that, I wanted to mention THIS: Up until about a month ago when I read the 40th Anniversary edition of Rolling Stone (yes, it's been THAT long!) and an interview with (Sir) Paul McCartney about some of the shenanigans that he and John Lennon (MY favorite Beatle) pulled when they made the now infamously Classic, but changed Rock-n-Roll forever, Sgt. Peppers Lonely Hearts Club Band record...I'd thought that it was Paul that hadn't ever taken LSD because he somehow concluded that once you take LSD, you never see the world like you did before taking it. Apparently, it was GEORGE that believed that. ANYWAY, I thought THAT was something related to what we are trying to discuss here. Interesting, NO? YES! Anywho, back to my 'other' question. I remember telling my boss at the time that somehow and in someway, after I had had my FIRST surgery in a string of FOUR (which was my parathyroid removal, not by spine) and once I was recouped and back at work for a few weeks that I felt that I had changed in some way or had never completely "come back" from the anesthesia from that first surgery! My boss(es) at the time were this married couple and it was the woman I was talking to because she was talking about one of her gazillion surgeries that she had. She was NOT a very stable person mentally and actually had to be forcibly institutionalized a few years earlier. She also was on so many medications she wondered about this very topic! Again, in my usual fashion I veered left when I should have veered right! Sorry. My question is this: Does anyone else here feel like ever since they had their FIRST surgery (as an adult) that when you were all healed and back at work, there seemed to be something "different" or out of place or whatever you want to call it...just not completely NORMAL or like it seemed like it was before?? OK, I know some of you are thinking, "Boy! This guy's really "over the edge. No wonder he got his SSDI approved so fast!" LOLOL! BWAHAHAHA! Well, all I can say to that is ("blow me") NO...just kidding! NO, REALLY! I've felt like that and then as the years have gone by and with all the meds I've tried that didn't work out for one reason or another, then the ones that did...after over TEN years now, I find that I've enabled the medical profession to make a substantial amount of $$$ off of me by getting me to take AT LEAST a DOZED different meds for various reasons in the course of a MONTHS time! Some I take several times a day, some I take twice a month! The FACT remains that I take what I feel is too many but if you asked me which one to give up...I couldn't. They ALL serve some sort of REAL purpose for taking them. So I'm stuck. So MY answer to this nagging question is (obviously) YES! There is something out of all the meds I take that affects "this or that" in me. One may be memory, another may be appetite, another may be libido and quality of erection, another is wakefulness and I could go through and "tag" a good or bad side effect to each one...almost. Lasst thing. Anyone know HOW we can "PIN" a thread so it stays at the beginning of the posts? Good idea y'all! I'm for this all the way even if we CAN'T get it PINNED. I am curious (yellow). (Heh-heh) Aloha Just For Now, Hawaiian Wayne
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