Gabapentin: Wikis

  
  

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Gabapentin
Systematic (IUPAC) name
2-[1-(aminomethyl)cyclohexyl]acetic acid
Identifiers
CAS number 60142-96-3
ATC code N03AX12
PubChem 3446
DrugBank APRD00015
Chemical data
Formula C9H17NO2 
Mol. mass 171.237 g/mol
Pharmacokinetic data
Bioavailability Rapid, in part by saturable carrier-mediated L-amino acid transport system
60% for 0.9 g daily to 27% for 4.8 g daily dose
Food increases absorption by 14%
Protein binding Less than 3%
Metabolism Not appreciably metabolized
Half life 5 to 7 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat. .B1(AU) D(US) Benefit of treatment may outweigh risk to fetus.^ Use during pregnancy only if the potential benefit to the mother outweighs the potential risk to the fetus.
  • Gabapentin - Erewhon Natural Foods 16 January 2010 4:04 UTC www.erewhonmarket.com [Source type: Academic]

Risk of teratogenicity greater if more than one drug used[1]
Legal status POM (UK) Prescription only
Routes Oral
 Yes check.svgY(what is this?)  (verify)
.Gabapentin (brand name Neurontin) is a GABA analogue.^ Neurontin, which has the generic name of gabapentin .
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

^ Gabapentin does not bind to g-aminobutyric acid (GABA) receptors despite being a structural analogue of GABA [11] .
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

^ Chemistry, pharmacokinetics, and adverse effects Gabapentin, 1-(aminomethyl)cyclohexane acetic acid, is a structural analogue of the neurotransmitter -aminobutyric acid (GABA) (Fig.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

.It was originally developed for the treatment of epilepsy, and currently, gabapentin is widely used to relieve pain, especially neuropathic pain.^ Gabapentin is used as an anticonvulsant and to relieve chronic pain.
  • The Veterinary Use of Gabapentin (Neurontin) in Pets 16 January 2010 4:04 UTC www.peteducation.com [Source type: Academic]

^ [CrossRef] [Medline] Nicholson B. Gabapentin use in neuropathic pain syndromes.
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

^ The effect of gabapentin on neuropathic pain.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

[2]

Contents

Pharmacology

.Gabapentin was initially synthesized to mimic the chemical structure of the neurotransmitter gamma-aminobutyric acid (GABA), but is not believed to act on the same brain receptors.^ SatzingerG.Antiepileptics from gamma-aminobutyric acid.
  • Unbiased Membrane Permeability Parameters for Gabapentin Using Boundary Layer Approach 16 January 2010 4:04 UTC www.aapsj.org [Source type: Academic]

^ Gabapentin is an antiepileptic drug with a structure similar to -aminobutyric acid (GABA), which penetrates the blood-brain barrier.
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ Gabapentin does not bind to g-aminobutyric acid (GABA) receptors despite being a structural analogue of GABA [11] .
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

.Its exact mechanism of action is unknown, but its therapeutic action on neuropathic pain is thought to involve voltage-gated N-type calcium ion channels.^ Its precise mechanism of action is unknown.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]
  • Generic Gabapentin medication, side effects of gabapentin, Buy generic Gabapentin online from Drugstoreone, an online drugstore 16 January 2010 4:04 UTC www.drugstoreone.com [Source type: Reference]

^ AEDs with effects on voltage-gated sodium or calcium channels may be advantageous in neuropathic pain, e.g.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ AEDs with effects on voltage-gated sodium or calcium channels may be advantageous in treating neuropathic pain, e.g.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

.It is thought to bind to the α2δ subunit (1 and 2)[3] of the voltage-dependent calcium channel in the central nervous system.^ This site was later identified as the 2 subunit of voltage-dependent calcium channels ( 60 ).
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ A specific binding site (the 2 subunit of voltage-dependent calcium channels) has been described for gabapentin and pregabalin.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ It has been shown to bind to calcium channel subunits and to modulate high threshold calcium currents in brain neurons, implying that neuronal voltage-gated calcium channels are a possible target of gabapentin [24] .
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

[4]

Indications

.Due to the wide variety of conditions for which Gabapentin may be considered as a treatment, and the various claims and counterclaims surrounding it, this presentation of the indicated uses of Gabapentin has attempted to separate the FDA accepted uses, the putative uses, and the disputed uses of the drug.^ Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions.
  • BioMed Central | Full text | Gabapentin and postoperative pain; A qualitative and quantitative systematic review, with focus on procedure. 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ Injectable compositions comprising gabapentin may also be used as therapy to treat a disease or disorder responsive to gabapentin such as epilepsy, pain, tinnitus, drug addiction, bipolar disorder, osteoarthritis, migraine, and anxiety disorders including social phobia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

A capsule of gabapentin

Proven

.Gabapentin was originally approved in the U.S. by the Food and Drug Administration (FDA) in 1994 for use as an adjunctive medication to control partial seizures (effective when added to other antiseizure drugs).^ GABAPENTIN is used to control partial seizures in adults with epilepsy.
  • Drug Finder - Gabapentin 16 January 2010 4:04 UTC drugsaz.about.com [Source type: General]

^ Gabapentin is an antiseizure (anticonvulsive) medicine that is approved by the U.S. Food and Drug Administration (FDA) for controlling epilepsy .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ What are Neurontin's FDA Approved Uses: Neurontin was approved in December 1993 a an adjunctive treatment (i.e.
  • Neurontin (gabapentin) - The Good, The Bad and The Funny. From People Who HaveTaken These Crazy Meds...and SCIENCE! 16 January 2010 4:04 UTC www.crazymeds.us [Source type: General]

.In 2002, an indication was added for treating postherpetic neuralgia (neuropathic pain following shingles), other painful neuropathies, and nerve related pain.^ What other treatment options to treat pain?
  • Boca Raton, FL Real Estate Agents, Homes for Sale in Boca Raton, FL, Deals & Incentives – Cash Back 16 January 2010 4:04 UTC www.eperks.com [Source type: General]

^ Treating HIV/AIDS-related Neuropathy.
  • Neurontin (gabapentin) - The Good, The Bad and The Funny. From People Who HaveTaken These Crazy Meds...and SCIENCE! 16 January 2010 4:04 UTC www.crazymeds.us [Source type: General]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

[5]
.Gabapentin (administered orally) is one of two medications (the other being flumazenil, which is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction.^ Gabapentin (administered orally) is one of two medications (the other being flumazenil, which is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

.Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days.^ Gabapentin dosage: 6400 MG (800 MG).
  • Gabapentin Side Effects: Report, View, Discuss and Compare Gabapentin side effects. FDA Gabapentin reports, Gabapentin on Twitter, Gabapentin posts, Gabapentin questions. Gabapentin safety polls, Gabapentin problems, Gabapentin symptoms, 1 16 January 2010 4:04 UTC www.patientsville.com [Source type: Academic]

^ Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing the withdrawal symptoms and almost eliminating cravings or desire to use methamphetamine.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

.Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol.^ Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Gabapentin (administered orally) is one of two medications (the other being flumazenil, which is administered intravenously) used in the expensive Prometa Treatment Protocol for methamphetamine, cocaine and alcohol addiction.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ There is only one prospective clinical study about gabapentin treatment in CPTP in the literature [14] .
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

.There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing the withdrawal symptoms and almost eliminating cravings or desire to use methamphetamine.^ There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing the withdrawal symptoms and almost eliminating cravings or desire to use methamphetamine.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ There is no way I am going to use it for 40 days!
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Gabapentin is administered at a dosage of 1200 mg taken at bedtime for 40–60 days.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

[6] .It also helps those addicted to prescribed pain medications, and reduces withdrawal symptoms.^ There have been reports by methamphetamine addicts that gabapentin alone in doses of 1200 mg at bedtime taken for 40–60 days has been effective in reducing the withdrawal symptoms and almost eliminating cravings or desire to use methamphetamine.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Nonetheless, this study suggests that gabapentin is likely to be helpful in reducing PHN pain symptoms.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ I guess it's not normally prescribed for withdrawals because it has not been approved for that but I would think most docs would prescribe it because it can be used for pain and is a non narcotic Drug abuse .
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

[7], [8]

Positive

.Gabapentin is frequently used to treat various types of Neuralgia.^ It addition to seizure control, gabapentin is also commonly used to treat chronic pain , migraine headache , panic disorder , and social phobia .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

^ Gabapentin medication is also used to help relieve certain types of nerve pain , and may be prescribed for other nervous system disorders .
  • Generic Gabapentin medication, side effects of gabapentin, Buy generic Gabapentin online from Drugstoreone, an online drugstore 16 January 2010 4:04 UTC www.drugstoreone.com [Source type: Reference]

.It has been found to be effective in prevention of frequent migraine headaches,[9] neuropathic pain[10] and nystagmus,[11] and is prescribed off-label (that is, without formal regulatory agreement) for these conditions.^ Levetiracetam may also be effective in the prevention of migraine and resistant headache.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ It addition to seizure control, gabapentin is also commonly used to treat chronic pain , migraine headache , panic disorder , and social phobia .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

.Gabapentin is widely believed to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly) and nerve pain associated with spinal cord injury.^ Prevention of chronic post-surgical pain .
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ I was having severe nerve pain with the withdrawal as well as back pain.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ A review of gabapentin and pregabalin in the treatment of post-operative pain.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

.It may be effective in reducing pain and spasticity in multiple sclerosis.^ Gabapentin is possibly more effective for one type of pain problem than for others, and these effects may have been washed out in the current sample.
  • Efficacy of gabapentin in treating chronic phantom limb and residual limb pain 16 January 2010 4:04 UTC www.rehab.research.va.gov [Source type: Academic]

^ In general, gabapentin treatment appears to be more effective in reducing paroxysmal pain with throbbing, pricking, and cramping quality than dull aching pain in MS patients.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ Free  Full Text] Houtchens MK, Richaert JR, Sami A, Rose JW. Open label gabapentin treatment for pain in multiple sclerosis.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

[12], and has also had success in treating certain instances of .Complex Regional Pain Syndrome.^ FULL TEXT Complex regional pain syndrome Harden Br J Anaesth 2001;87:99-106.
  • JAMA -- Abstract: Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: A Randomized Controlled Trial, December 2, 1998, Backonja et al. 280 (21): 1831 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]
  • JAMA -- Abstract: Gabapentin for the Treatment of Postherpetic Neuralgia: A Randomized Controlled Trial, December 2, 1998, Rowbotham et al. 280 (21): 1837 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

^ [Abstract/ Free  Full Text] Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ Subsequently, it was shown to be effective in treating a variety of chronic pain conditions, including post-herpetic neuralgia, diabetic neuropathy, complex regional pain syndrome, inflammatory pain, central pain, malignant pain, trigeminal neuralgia, HIV-related neuropathy, and headaches.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

[13][14]
It is not uncommon for the prescription of Gabapentin to occur in a mental health context. .It has been investigated as a mood-stabilizing treatment for bipolar disorder with the potential therapeutic advantage of having fewer side-effects than better established bipolar drugs such as lithium and valproic acid although numerous trials have shown that it is not effective.^ Emerging treatments for bipolar disorder: safety and adverse effect profiles.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

^ Lamotrigine and antiepileptic drugs as mood stabilizers in bipolar disorder.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ The same phenomenon is observed with mood stabilizers such as lithium, valproic acid and carbamazepine.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

.Gabapentin has limited usefulness in the treatment of anxiety disorders such as social anxiety disorder and obsessive-compulsive disorder, in treatment-resistant depression, and for insomnia.^ Injectable compositions comprising gabapentin may also be used as therapy to treat a disease or disorder responsive to gabapentin such as epilepsy, pain, tinnitus, drug addiction, bipolar disorder, osteoarthritis, migraine, and anxiety disorders including social phobia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

^ It addition to seizure control, gabapentin is also commonly used to treat chronic pain , migraine headache , panic disorder , and social phobia .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Of the newer AEDs studied in randomized, controlled trials for the treatment of anxiety disorders, gabapentin and pregabalin were effective in the treatment of social phobia; pregabalin was also effective in the treatment of generalized anxiety disorder.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

[15][16]
.Gabapentin has been used to treat some symptoms of opiate withdrawal,[17], and it has been tested for smoking cessation treatment with mixed results.^ I did some research on it and it is used for withdrawals.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ It addition to seizure control, gabapentin is also commonly used to treat chronic pain , migraine headache , panic disorder , and social phobia .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

[18][19]
.Additionally, Gabapentin has been prescribed to menopausal patients being treated with anti-androgenic compounds to reduce the incidence and intensity of the accompanying hot flashes[20].^ Gabapentin may lower the number of hot flashes each day and the intensity of hot flashes.
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Sometimes prescribed off-label to treat mild hot flashes.
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

^ Gabapentin for hot flashes .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

.It has occasionally been prescribed for treatment of idiopathic subjective tinnitus, although a double blind, randomized controlled trial has found this ineffective.^ Topiramate treatment in bulimia nervosa patients: a randomized, double-blind, placebo-controlled trial.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ Oral topiramate for treatment of alcohol dependence: a randomized controlled trial.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ A double blind randomized controlled trial.
  • Gabapentin for Neuropathic Cancer Pain: A Randomized Controlled Trial From the Gabapentin Cancer Pain Study Group -- Caraceni et al. 22 (14): 2909 -- Journal of Clinical Oncology 16 January 2010 4:04 UTC jco.ascopubs.org [Source type: Academic]

[21] .Gabapentin may help deepen sleep, positively affecting deep, slow wave sleep, and reducing arousals during the night [22].^ Nonetheless, this study suggests that gabapentin is likely to be helpful in reducing PHN pain symptoms.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ Gabapentin medication is also used to help relieve certain types of nerve pain , and may be prescribed for other nervous system disorders .
  • Generic Gabapentin medication, side effects of gabapentin, Buy generic Gabapentin online from Drugstoreone, an online drugstore 16 January 2010 4:04 UTC www.drugstoreone.com [Source type: Reference]

^ They really helped at night with getting to sleep.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

[citation needed] It could potentially be helpful for both sleep onset and sleep maintenance..July 2009" style="white-space:nowrap;">[citation needed] Gabapentin is sometimes prescribed for RLS (Restless Legs Syndrome).^ Neurontin (gabapentin) for Pain : It is prescribed to my father-in-law because he lost his legs in a fire.
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

^ Neurontin (gabapentin) for Restless Legs Syndrome : Neurontin has really helped my Restless leg syndrome.
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

^ Neurontin (gabapentin) for Restless Legs Syndrome : Nothing seemed to work for my restless legs until I tried Neurontin.
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

.Finally, it may be effective in treating akathisia - a side effect of antipsychotics that causes severe agitation and anxiety.^ It doesn't cause any side effects for me..
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Gabapentin may cause other side effects.
  • Gabapentin | LIVESTRONG.COM 16 January 2010 4:04 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ The drugs have a toxic effect on cells and may cause damage to the ovaries, resulting in early menopause for many women.
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

[citation needed]

Negative

.There has been a growing controversy regarding the psychiatric off-label use of Gabapentin.^ Use of gabapentin for hot flashes is an off-label use .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Although gabapentin appears to have diverse therapeutic utility in the treatment of pain disorders [ 1 ], psychiatric illnesses [ 2 ] and epilepsy [ 3 ], there is controversy regarding its molecular mechanisms of action.
  • BioMed Central | Full text | A study comparing the actions of gabapentin and pregabalin on the electrophysiological properties of cultured DRG neurones from neonatal rats 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ Anxiety : Although this medicine is not approved and is used off label for anxiety it has helped me a lot.
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

[12] .Although some small, non-controlled studies in the 1990s — mostly sponsored by gabapentin's manufacturer — suggested that gabapentin treatment for bipolar disorder may be promising,[12] other more recent and better controlled studies have found it to be no more effective (and in one study, slightly less effective) than placebo.^ Preliminary evidence suggests that gabapentin may be effective in the treatment of this disorder.
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ Double-blind placebo-controlled study of gabapentin in essential tremor.
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ Will it be more or even less effective in some applications?
  • Neurontin (gabapentin) - The Good, The Bad and The Funny. From People Who HaveTaken These Crazy Meds...and SCIENCE! 16 January 2010 4:04 UTC www.crazymeds.us [Source type: General]

[23] .Subsequent to the corporate acquisition of the original patent holder, the pharmaceutical company Pfizer admitted that there had been violations of FDA guidelines regarding the promotion of unproven off-label uses for Gabapentin in the Franklin v.^ Use of gabapentin for hot flashes is an off-label use .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ Both gabapentin and its only FDA-approved use are now off-patent.
  • WARNER-LAMBERT COMPANY v. APOTEX 16 January 2010 4:04 UTC www.ll.georgetown.edu [Source type: Reference]

^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

Pfizer case. .Concerns about the distorting effects of Pfizer's research practices upon the represented efficacy of Gabapentin have been summarized for the Prescription Access Litigation project in an August 10, 2008 article written by Kay Dickersin, M.D, Ph.D, a scholar of publication bias at Brown University.^ Accepted for publication August 10, 1998.
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ Efficacy and tolerability of gabapentin in clinical practice.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

^ August 18, 2008 10:50 AM .
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

[24].
.Despite this controversy, many psychiatrists continue to prescribe it for a variety of off-label purposes.^ [CrossRef] [Web of Science] [Medline] 87 Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ Will Lyrica (pregablin) be used for as many off-label applications?
  • Neurontin (gabapentin) - The Good, The Bad and The Funny. From People Who HaveTaken These Crazy Meds...and SCIENCE! 16 January 2010 4:04 UTC www.crazymeds.us [Source type: General]

.It is often tried as an alternative treatment, when patients are unable to tolerate the side effect of more proven mood stabilizers such as lithium; as or more frequently, it is prescribed on a speculative basis as an auxiliary treatment, when single-drug therapy has consistently failed to yield sufficiently positive results.^ Disclaimer: The content of this database of side effects (adverse drug reactions) is intended for educational and scientific research purposes only.
  • Side effect information for Gabapentin 16 January 2010 4:04 UTC sideeffects.embl.de [Source type: Academic]

^ Following a 1-week washout period, patients were crossed over to the alternative drug therapy.
  • Arch Intern Med -- Randomized Double-blind Study Comparing the Efficacy of Gabapentin With Amitriptyline on Diabetic Peripheral Neuropathy Pain, September 13, 1999, Morello et al. 159 (16): 1931 16 January 2010 4:04 UTC archinte.ama-assn.org [Source type: Academic]

^ We compared GP with NS, a NSAID, which is used frequently as a conventional agent in the treatment of CPTP. NS decreased VAS scores below 5 only in 15% of the patients, but GP decreased VAS scores below 5 in 85% of the patients.
  • Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain -- Solak et al. 32 (1): 9 -- European Journal of Cardio-Thoracic Surgery 16 January 2010 4:04 UTC ejcts.ctsnetjournals.org [Source type: Academic]

[25]

Precautions

.Gabapentin should not be discontinued abruptly after long term use.^ Long-term gabapentin causes weight gain in epileptic patients.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

^ Kang M-G, Felix R, Campbell KP: Long-term regulation of voltage-gated Ca 2+ channels by gabapentin.
  • BioMed Central | Full text | A study comparing the actions of gabapentin and pregabalin on the electrophysiological properties of cultured DRG neurones from neonatal rats 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ However, several clinical issues of gabapentin should be addressed to introduce a rational use of this drug in pain management.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

.Abrupt or over rapid withdrawal may provoke a withdrawal syndrome similar to alcohol or benzodiazepine withdrawal.^ Gabapentin withdrawal syndrome Abrupt discontinuation of high-dose gabapentin may cause withdrawal symptoms.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ Clinically, it resembles alcohol or benzodiazepine withdrawal, perhaps due to a similar mechanism of action.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ [Abstract/ Free Full Text] Bonnet U, Banger M, Leweke FM, Maschke M, Kowalski T, Gastpar M (1999) Treatment of alcohol withdrawal syndrome with gabapentin.
  • Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence -- Roberto et al. 28 (22): 5762 -- Journal of Neuroscience 16 January 2010 4:04 UTC www.jneurosci.org [Source type: Academic]

.Gradual reduction over a period of weeks or months helps minimize or prevents the withdrawal syndrome.^ Neurontin (gabapentin) for Pain : I have tried this drug 2 separate times in a 6 month period and it did not help.
  • gabapentin systemic User Reviews at Drugs.com 16 January 2010 4:04 UTC www.drugs.com [Source type: General]

^ During this 14 week period, we tested rats twice per week at 6 h withdrawal for operant ethanol responding.
  • Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence -- Roberto et al. 28 (22): 5762 -- Journal of Neuroscience 16 January 2010 4:04 UTC www.jneurosci.org [Source type: Academic]

[26]

Withdrawal

.Although the potential for serious withdrawal symptoms are very limited as described in official literature, there is increasing awareness among users about existence and sheer frequency of potentially serious withdrawal symptoms even after long tapering.^ Withdrawal symptoms are well described on the discontinuation of antidepressants.
  • Phase III Trial of Gabapentin Alone or in Conjunction With an Antidepressant in the Management of Hot Flashes in Women Who Have Inadequate Control With an Antidepressant Alone: NCCTG N03C5 -- Loprinzi et al. 25 (3): 308 -- Journal of Clinical Oncology 16 January 2010 4:04 UTC jco.ascopubs.org [Source type: Academic]

^ The symptoms can sometimes be described as tingling or even painful.
  • Brachioradial Pruritis, Scratching Makes the Itching Worse | The Dermatology Blog 16 January 2010 4:04 UTC thedermblog.com [Source type: Original source]

^ However, withdrawal syndrome can still rarely occur even in the presence of dose tapering.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

Adverse effects

.Gabapentin's most common side effects in adult patients include dizziness, drowsiness, and peripheral edema (swelling of extremities);[27] these mainly occur at higher doses, in the elderly.^ Side effects of Tigabine include dizziness and somnolence.
  • Generic Gabapentin medication, side effects of gabapentin, Buy generic Gabapentin online from Drugstoreone, an online drugstore 16 January 2010 4:04 UTC www.drugstoreone.com [Source type: Reference]

^ Side effects associated with Gabapentin include: .
  • Generic Gabapentin medication, side effects of gabapentin, Buy generic Gabapentin online from Drugstoreone, an online drugstore 16 January 2010 4:04 UTC www.drugstoreone.com [Source type: Reference]

^ I am on Lyrica which has the same side effects as Gabapentin .
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

.Also, children 3–12 years of age were observed to be susceptible to mild-to-moderate mood swings, hostility, concentration problems, and hyperactivity.^ It is reported as adjunctive therapy in the treatment of partial seizures with and without secondary generalization in patients over 12 years of age with epilepsy and in the treatment of partial seizures in pediatric patients age 3-12 years.
  • COMPOUNDS AND METHODS FOR USE IN DETECTING GABAPENTIN - Patent application 16 January 2010 4:04 UTC www.faqs.org [Source type: Reference]

.Although rare, there are several cases of hepatotoxicity reported in the literature.^ There are sporadic case reports of gabapentin-induced polyneuropathy ( 65 ) and psychomotor agitation ( 66 ).
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ In the literature there are a number of reports of PKA altering neuronal excitability and modulating K + conductances.
  • BioMed Central | Full text | A study comparing the actions of gabapentin and pregabalin on the electrophysiological properties of cultured DRG neurones from neonatal rats 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ Multiple Sclerosis (MS) Several case reports have shown a reduction of pain associated with MS ( 17 – 20 ).
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

[28] .Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity.^ FULL TEXT The use of gabapentin for post-operative and post-traumatic pain in thoracic surgery patients.
  • JAMA -- Abstract: Gabapentin for the Treatment of Postherpetic Neuralgia: A Randomized Controlled Trial, December 2, 1998, Rowbotham et al. 280 (21): 1837 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

^ One patient reported transient paresthesias in the arms while taking gabapentin; 3 patients reported instability with propranolol use (this was disabling in 1 patient, although he decided to continue the study).
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ In addition, EMG recordings might be of some use in identifying patients who would or would not respond to gabapentin or propranolol.
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

[29][30]
.An increase in formation of adenocarcinomas was observed in rats during preclinical trials, however the clinical significance of these results remains undetermined.^ These questions will be addressed by relating mechanisms of action to clinical efficacy, as demonstrated in preclinical and clinical studies.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ In summary, a significant opioid-sparing effect was observed in almost all studies reporting of cumulative opioid consumption, which, however, was of varying magnitude.
  • BioMed Central | Full text | Gabapentin and postoperative pain; A qualitative and quantitative systematic review, with focus on procedure. 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ In particular, both clinical and preclinical trials have clearly shown an antiallodynic effect of gabapentin and a lack of effect on nociceptive thresholds.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

.Gabapentin is also known to induce pancreatic acinar cell carcinomas in rats through an unknown mechanism, perhaps by stimulation of DNA synthesis; these tumors did not affect the lifespan of the rats and did not metastasize.^ A ), nor did any dose of gabapentin alter water responding by any group of rats ( Fig.
  • Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence -- Roberto et al. 28 (22): 5762 -- Journal of Neuroscience 16 January 2010 4:04 UTC www.jneurosci.org [Source type: Academic]

^ In addition, these two trials did not assess the effects of gabapentin on various indices of mental and physical functions.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

^ At 20 mg/kg, gabapentin did not significantly affect TLESRs in dogs.
  • The Anticonvulsant Gabapentin (Neurontin) Does Not Act through γ-Aminobutyric Acid-B Receptors — Molecular Pharmacology 16 January 2010 4:04 UTC molpharm.aspetjournals.org [Source type: Academic]

[31]

Overdosage

Persons who accidentally or intentionally ingested overdoses have manifested drowsiness, blurred vision, slurred speech and somnolence or coma. .Serum gabapentin concentrations may be measured to confirm diagnosis.^ The 50 µ M concentration of gabapentin produced a maximal increase in the mean amplitude of evoked GABA-IPSCs (by 40%) measured over all stimulus strengths ( Fig.
  • Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence -- Roberto et al. 28 (22): 5762 -- Journal of Neuroscience 16 January 2010 4:04 UTC www.jneurosci.org [Source type: Academic]

^ Another factor that may influence the wide range of gabapentin effects in different brain regions in slice preparations may be the wide range of gabapentin concentrations used between studies.
  • Cellular and Behavioral Interactions of Gabapentin with Alcohol Dependence -- Roberto et al. 28 (22): 5762 -- Journal of Neuroscience 16 January 2010 4:04 UTC www.jneurosci.org [Source type: Academic]

^ The quantitative relationship between polarization and concentration of the unlabeled gabapentin in the sample can be established by measuring the polarization values of calibrations with known concentrations of gabapentin.
  • COMPOUNDS AND METHODS FOR USE IN DETECTING GABAPENTIN - Patent application 16 January 2010 4:04 UTC www.faqs.org [Source type: Reference]

[32]

Recreational use

.Although gabapentin is not a controlled substance, it does produce psychoactive effects that could lead to recreational use of the drug.^ It addition to seizure control, gabapentin is also commonly used to treat chronic pain , migraine headache , panic disorder , and social phobia .
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ The 479 neurodegenerative method patent does not claim a method of using gabapentin and its derivatives for partial seizure.
  • WARNER-LAMBERT COMPANY v. APOTEX 16 January 2010 4:04 UTC www.ll.georgetown.edu [Source type: Reference]

^ The antihyperalgesic effect of gabapentin is likely to be mediated at a central site, because intrathecal gabapentin injection produced an effect similar to that of systemic gabapentin administration ( 8 , 35 ).
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

.May 2009" style="white-space:nowrap;">[citation needed] However, it is widely regarded as having little or no potential for misuse.^ This may indicate that PKA has little or no basal or tonic activity on K + currents in DRG neurones in culture.
  • BioMed Central | Full text | A study comparing the actions of gabapentin and pregabalin on the electrophysiological properties of cultured DRG neurones from neonatal rats 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

.Pregabalin, a gabapentinoid with higher potency marketed for neuropathic pain, is a controlled substance, under Schedule V of the United States' Controlled Substances Act.^ ABSTRACT Pregabalin relieves symptoms of painful diabetic neuropathy: A randomized controlled trial Lesser et al.
  • JAMA -- Abstract: Gabapentin for the Treatment of Postherpetic Neuralgia: A Randomized Controlled Trial, December 2, 1998, Rowbotham et al. 280 (21): 1837 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

^ Pregabalin is used to relieve neuropathic pain (pain from damaged nerves) that can occur in your arms, hands, finger...
  • Gabapentin | LIVESTRONG.COM 16 January 2010 4:04 UTC www.livestrong.com [Source type: FILTERED WITH BAYES]

^ Because pregabalin is a Schedule V controlled substance, its utility is not compromised by substantial limitation of access or the need for extra steps in prescribing.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

Risk of Suicide

.The FDA has issued a warning of an increased risk of suicidal thoughts and behaviors in patients taking gabapentin.^ The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts.
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ One patient reported transient paresthesias in the arms while taking gabapentin; 3 patients reported instability with propranolol use (this was disabling in 1 patient, although he decided to continue the study).
  • Arch Neurol -- A Randomized Placebo-Controlled Comparative Trial of Gabapentin and Propranolol in Essential Tremor, April 1999, Gironell et al. 56 (4): 475 16 January 2010 4:04 UTC archneur.ama-assn.org [Source type: Academic]

^ Body weight gain occurred in patients taking gabapentin with other drugs but also in those taking gabapentin alone.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

.An independent analysis by the FDA showed that anticonvulsant drugs, including gabapentin, can increase suicidal thoughts in patients.^ Thus, data from 23 trials including a total of 1529 patients, of which 810 received gabapentin were included.
  • BioMed Central | Full text | Gabapentin and postoperative pain; A qualitative and quantitative systematic review, with focus on procedure. 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

^ The majority of patients had analgesic drug regimens including nonsteroidal anti-inflammatories and steroids.
  • Gabapentin for Neuropathic Cancer Pain: A Randomized Controlled Trial From the Gabapentin Cancer Pain Study Group -- Caraceni et al. 22 (14): 2909 -- Journal of Clinical Oncology 16 January 2010 4:04 UTC jco.ascopubs.org [Source type: Academic]

^ The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts.
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

.The approved label for Neurontin now includes a warning about an increased risk of suicidal thoughts or actions and a guide to help patients understand this risk[33].^ A nonhormonal prescription drug (marketed as Neurontin) government approved for the treatment of seizures from epilepsy, sometimes prescribed off-label for treating hot flashes.
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

^ The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts.
  • Health Information 16 January 2010 4:04 UTC www.mmc.org [Source type: Academic]

^ I have been taking Neurontin ( Gabapentin ) now for about a month.
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

In July 2009, the first case against Pfizer, the maker of Neurontin, went to trial, and there are an estimated 1200 pending cases regarding the safety of Neurontin. .Although a Pfizer spokesperson noted that "the reliable scientific evidence does not demonstrate a causal association between Neurontin treatment and suicidal behavior," the FDA analysis found an 80 percent rise in suicidal thoughts and behavior in data from 199 studies of gabapentin and other anticonvulsants[34].^ Oral gabapentin has been primarily used to treat epilepsy although it has been used off-label to treat neuropathic pain and has recently received an FDA-approval for the treatment of one type of neuropathic pain, post-herpetic neuralgia.
  • Process for producing injectable gabapentin compositions - Patent 7169812 16 January 2010 4:04 UTC www.freepatentsonline.com [Source type: Reference]

^ Although gabapentin has anti-hyperalgesic effects, 21 62 there is no scientific evidence to support its use for the prevention of CPSP. The effects of gabapentin on attenuating haemodynamic response to tracheal intubation, preventing PONV, and reducing postoperative delirium are promising but, as yet, inconclusive and more studies are expected in the near future.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ Jan 06, 2008 09:02PM To: wait2long Catalogue of side effects for the anticonvulsant Neurontin - generic Gabapentin - which is sometimes prescribed as a mood stabilizer in the treatment of bipolar disorder.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

Sales

.Gabapentin is best known under the brand name Neurontin manufactured by Pfizer subsidiary Parke-Davis.^ Neurontin, which has the generic name of gabapentin .
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

^ Though Parke-Davis maintains Gabapentin is not a drug of abuse, I must disagree; I think it ...
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

^ The authors thank Pfizer both in the USA and UK (formerly Parke-Davis) for support and Ms Jennifer Spratt for constructive comments on the manuscript.
  • BioMed Central | Full text | A study comparing the actions of gabapentin and pregabalin on the electrophysiological properties of cultured DRG neurones from neonatal rats 16 January 2010 4:04 UTC www.biomedcentral.com [Source type: Academic]

A Pfizer subsidiary named Greenstone markets generic gabapentin.
In December 2004, the FDA granted final approval to a generic equivalent to Neurontin made by the Israeli firm Teva.
.Neurontin is one of Pfizer’s best-selling drugs, and was one of the 50 most-prescribed drugs in the United States in 2003. However, in recent years, Pfizer has come under heavy criticism for its marketing of Neurontin, facing allegations that, behind the scenes, Parke-Davis marketed the drug for at least a dozen supposed uses for which the drug had not been FDA approved.^ In 1993, Warner-Lambert obtained approval of a New Drug Application (NDA) from the United States Food and Drug Administration (FDA) to market gabapentin for use in adjunctive therapy in the treatment of partial seizures with and without secondary generalization in adults with epilepsy, one of the several indications claimed in the now-expired epilepsy method patent.
  • WARNER-LAMBERT COMPANY v. APOTEX 16 January 2010 4:04 UTC www.ll.georgetown.edu [Source type: Reference]

^ A nonhormonal prescription drug (marketed as Neurontin) government approved for the treatment of seizures from epilepsy, sometimes prescribed off-label for treating hot flashes.
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

^ If FDA approval is given, the product may then be offered on the US market for the approved health indication(s).
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

Franklin v. Pfizer case

.By some estimates, so-called off-label prescriptions account for roughly 90% of Neurontin sales.^ Neurontin for off-label prescriptions account for these.
  • Malaysia's Premier F1 Online - 2005 DTM Driver - gabapentin - Brand and Generic. 16 January 2010 4:04 UTC www.pitstop.com.my [Source type: Academic]
  • Malaysia's Premier F1 Online - 2005 DTM Driver - gabapentin - Brand and Generic. 16 January 2010 4:04 UTC www.pitstop.com.my [Source type: Academic]

^ By some estimates, so-called off-label prescriptions account for roughly 90% of Neurontin sales.
  • Gabapentin: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 16 January 2010 4:04 UTC www.chemie.de [Source type: Academic]

^ Gabapentin has not been approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia, although some doctors may prescribe it off-label for such use.
  • Fibromyalgia treatment: Does Neurontin relieve symptoms? - MayoClinic.com 16 January 2010 4:04 UTC www.mayoclinic.com [Source type: FILTERED WITH BAYES]

[35] .While off-label prescriptions are common for a number of drugs and are perfectly legal (if not always appropriate), marketing of off-label uses of a drug is strictly illegal.^ FULL TEXT The use of "off-label" drugs.
  • JAMA -- Abstract: Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: A Randomized Controlled Trial, December 2, 1998, Backonja et al. 280 (21): 1831 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

^ Off-label drug use raises safety concerns .
  • Neurontin, Gabapentin News - Topix 16 January 2010 4:04 UTC www.topix.com [Source type: General]

^ The off-label use.

[36] .In 2004, Warner-Lambert agreed to plead guilty and pay $430 million in fines to settle civil and criminal charges regarding the illegal marketing of Neurontin for off-label purposes, and further legal action is pending.^ Warner-Lambert to pay $430 million to resolve criminal & civil health care liability relating to off-label promotion.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ [CrossRef] [Web of Science] [Medline] 54 Larkin M. Warner-Lambert found guilty of promoting Neurotin off label.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ Gabapentin drew substantial media attention, because its manufacturer was investigated and convicted for inappropriate marketing of off-label uses of the drug 54 and for inappropriate promotion of unapproved uses for gabapentin.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

.The courts of New York State, for example, have refused to certify a class of injured parties who took Neurontin for off-label use, finding that they had failed to state that they had any injury.^ A nonhormonal prescription drug (marketed as Neurontin) government approved for the treatment of seizures from epilepsy, sometimes prescribed off-label for treating hot flashes.
  • Menopause, Perimenopause - Glossary 16 January 2010 4:04 UTC www.menopause.org [Source type: Academic]

^ FULL TEXT The use of "off-label" drugs.
  • JAMA -- Abstract: Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: A Randomized Controlled Trial, December 2, 1998, Backonja et al. 280 (21): 1831 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

^ Outcome Reporting in Industry-Sponsored Trials of Gabapentin for Off-Label Use Vedula et al.
  • JAMA -- Abstract: Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: A Randomized Controlled Trial, December 2, 1998, Backonja et al. 280 (21): 1831 16 January 2010 4:04 UTC jama.ama-assn.org [Source type: Academic]

[37]
.The University of California, San Francisco (UCSF) has archived[38] and studied[39] the documents made public by this case, which opens a unique window into the illegal promotion and marketing of pharmaceuticals.^ The tsA cells were a generous gift from Dr. Penelope S.V. Jones (University of California, San Diego, CA).
  • The Anticonvulsant Gabapentin (Neurontin) Does Not Act through γ-Aminobutyric Acid-B Receptors — Molecular Pharmacology 16 January 2010 4:04 UTC molpharm.aspetjournals.org [Source type: Academic]

.However, Pfizer maintains that the illegal activity originated in 1996, well before it acquired Parke-Davis (through its acquisition of Warner-Lambert) in 2000. Several lawsuits are underway after people who had been prescribed gabapentin for off-label treatment of bipolar disorder later attempted or committed suicide.^ Open-label adjunctive topiramate in the treatment of unstable bipolar disorder.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

^ Though the combination of flumazenil infusions and gabapentin tablets is a licensed treatment, there is no prohibition against a physician prescribing gabapentin outside the Prometa protocol.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

^ Jan 06, 2008 09:02PM To: wait2long Catalogue of side effects for the anticonvulsant Neurontin - generic Gabapentin - which is sometimes prescribed as a mood stabilizer in the treatment of bipolar disorder.
  • Gabapentin Neurontin - Addiction: Substance Abuse - MedHelp 16 January 2010 4:04 UTC www.medhelp.org [Source type: General]

Related drugs

.Parke-Davis developed a drug called pregabalin to be a successor of gabapentin,[2] which was brought to market by Pfizer as Lyrica after they acquired Warner-Lambert.^ Though Parke-Davis maintains Gabapentin is not a drug of abuse, I must disagree; I think it ...
  • Gabapentin discussions (experiences, side effects, dosages, etc...) 16 January 2010 4:04 UTC www.drugtalk.com [Source type: General]

^ Pregabalin is a recently licensed and marketed antiepileptic drug for use as adjunctive treatment of partial epilepsy.
  • Neurontin & weight gain - CareCure Forums 16 January 2010 4:04 UTC sci.rutgers.edu [Source type: Academic]

^ Drugs with this potential include tiagabine, vigabatrin, valproate, gabapentin, pregabalin and topiramate.
  • Antiepileptic Drugs in Non-Epilepsy Disorders: Relations bet... : CNS Drugs 16 January 2010 4:04 UTC adisonline.com [Source type: Academic]

.Pregabalin is related in structure to gabapentin and is approved for treatment of epilepsy, neuropathic pain associated with diabetes, fibromyalgia, post-herpetic neuralgia, and generalized anxiety disorder.^ Gabapentin is indicated for the management of post-herpetic neuralgia in adults.
  • COMPOUNDS AND METHODS FOR USE IN DETECTING GABAPENTIN - Patent application 16 January 2010 4:04 UTC www.faqs.org [Source type: Reference]

^ In 2002, gabapentin was approved by the US Food and Drug Administration for the treatment of post-herpetic neuralgia.
  • Gabapentin: a multimodal perioperative drug? -- Kong and Irwin 99 (6): 775 -- British Journal of Anaesthesia 16 January 2010 4:04 UTC bja.oxfordjournals.org [Source type: Academic]

^ The effect of gabapentin on neuropathic pain.
  • Gabapentin in Pain Management -- Mao and Chen 91 (3): 680 -- Anesthesia & Analgesia 16 January 2010 4:04 UTC www.anesthesia-analgesia.org [Source type: Academic]

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External links


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