Below you will find a summary about a medication used very often in the medical field to treat a variety of pain conditions- gabapentin, but with information specific to treating neuropathic pain in diabetes.

Please be aware that the article below is limited for informational purposes only. You should not consider it to be comprehensive or medical advice, since only a medical provider can assess your individual situation and safety of treatments in your individual case. Medicine is a constantly changing field, and you should consult your medical provider before applying any information below to your treatment. You may use the information below to learn more about the treatment, and as a basis to ask questions to your medical provider.

Introduction

Gabapentin was first introduced as a drug to control seizures in patients with epilepsy, and was often better known by the brand name NEURONTIN. It is now also available in the generic form which is usually inexpensive. It is officially approved by the Food and Drug Administration (FDA) to treat nerve pain from shingles (post-herpetic neuralgia), but over the years has become recognized and well accepted in the medical field as a medication to treat a variety of pain conditions including ‘nerve pain’ disorder like diabetic nerve pain (neuropathy), sciatica (radiculopathy), and even fibromyalgia.

How It Works

Although there has been extensive research on gabapentin, and it has been used as a medication for many years, the medical field does not know exactly how gabapentin works. The thought is that gabapentin relieves pain by altering the way the brain senses pain. In any case, many studies and a great deal of research has been done showing that gabapentin is effective in controlling pain, and reasonable safe for most people to use.

Possible Benefits

You may have heard that acetaminophen can cause permanent liver damage at higher doses. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, etc have been shown to  cause damage to the stomach lining, affect the heart causing increased chance of heart attacks, and increase the chance of strokes. One of the main benefits of gabapentin is that it is unlikely to cause any serious injury to any organs in the body, at least as long one does not exceed the maximum recommended dose.

Gabapentin is not intended to be used as an ‘as needed’ pain medication. It is recommended to be taken on a daily basis, for maximum effect. This way, it keep the pain under steady level of control.

How It Is Used

Typically, gabapentin is most effective when taken three times daily, but often doctors and patients will adjust the medication based on each person’s individual condition and preferences, to either twice daily or sometimes even just once daily. Gabapentin is usually started at a dose of either 100mg or 300mg pills, and slowly increased over a period of days or weeks, to the intended dose.

It is important to know that usually you will NOT start noticing reduction in pain right away after starting gabapentin. It usually takes days or weeks for gabapentin to have its beneficial effect and for you to start noticing improvement in your pain. So it is best to stick with the medication and not discontinue it without checking with your medical provider if you have side-effects.

Possible Side-effects, Risks, Precautions

That brings us to a discussion about the possible side-effects of gabapentin. As mentioned above, gabapentin is a safe medication in that it rarely has any organ-damaging side-effects like acetaminophen or NSAIDs. But like all medications, there are some side-effects that can be bothersome enough that some people are forced to discontinue gabapentin. Keep in mind that not everyone experiences side-effects, and you may not experience any problem at all. However, it is important to be aware of the possible side-effects. Some of the common initial side-effects are  drowsiness and tiredness. This may be just temporary when starting gabapentin, and often goes away within a few days of being on gabapentin, but can occur every time an increase is made in the dose of gabapentin. Dizziness is another possible side-effect but again, does not affect everyone, only some people. You and your medical provider should monitor for any serious negative change in your mood, especially if you have have a mood disorder like Bipolar disorder. Gabapentin does cause weight gain in some people. There is also the possibility of some swelling of the feet, lower legs, or hands. If you are unsteady or your feet, then please be extra cautious as gabapentin can worsen unsteadiness. Be aware that if you are on other medications that can cause drowsiness or dizziness or consume alcohol, then adding gabapentin could possibly make you feel more drowsy or dizzy. If you notice drowsiness or dizziness, please do not drive. People with kidney disease need a lower dose of gabapentin, and will have special dose instructions from their medical provider.

For a complete list of all possible side-effects, please click on the link below under ‘Additional Resources’, and consult your medical provider.

Conclusion

Gabapentin has undergone extensive research and has been used for many years to treat people for a variety of pain disorders including diabetic nerve pain (neuropathy) and other nerve pain disorders like shingles pain (post-herpetic neuralgia), and fibromyalgia. It is generally a safe medication that is tolerated well by many people. But like most medications, there is the potential for side-effects. Some side-effects are tolerable, and the benefits outweigh the risks. But for some people, the side-effects are bothersome enough or serious enough to warrant discontinuing the medication. If gabapentin has not been offered to you for your pain, then this would be a good starting point for a discussion about gabapentin with your medical provider.

Additional Resources

For a detailed description description of gabapentin for patients, you may visit this resource from the U.S. National Library of Medicine by copying and pasting this link in your web browser: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000940/

(Neurontin, Tylenol are Trade/Brand names copyrighted by the pharmaceutical companies that manufacture these medications)