Neurontin is the trade name for the generic drug gabapentin. It is useful as an anti-epileptic drug and as an analgesic, particularly for pain of the neuropathic or neurogenic type. (pain from irritation or inflammation of nerves). When used for controlling epilepsy, it is usually used in conjunction with another anti-epileptic drug.
It is used much more extensively in the medical field to treat pain than it is to treat epilepsy.
How Gabapentin Works
Gabapentin is believed to work by altering the release of glutamate and other neurotransmitters in your brain.1 Neurotransmitters send messages from one brain cell to another. Glutamate is really helpful for certain things, like learning new information. That’s because it gets your brain cells stirred up and active.
Kind of like a toddler with chocolate, though, if you have too much glutamate running around, your brain cells can become overstimulated. That can make all kinds of things go wrong.
Glutamate has more than one job, though. It also helps transmit pain signals in your brain and nerves. Too much glutamate may play a role in hyperalgesia, which essentially turns up the volume of pain.
To counter the effects of glutamate, you have another neurotransmitter called gamma-aminobutyric acid (GABA).2 It calms your cells and quiets your brain. When GABA and glutamate exist in balance with each other, things go well. (It’s likely out of balance in fibromyalgia, though.)
Some diseases and conditions—including fibromyalgia—may interrupt this balance and let glutamate run amok. Gabapentin is believed to reduce your brain’s release of glutamate so the cells can calm down and your brain can function better.
Gabapentin belongs to a class of drugs known as anticonvulsants, used to help control seizures in the treatment of epilepsy. Neurontin will only be able to control seizures for as long as you take it. It can’t cure epilepsy. Gabapentin capsules, tablets, and oral solution are used to help control certain types of seizures in people who have epilepsy.
Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).
Gabapentin is in a class of medications called anticonvulsants. It has also been reported to be helpful in controlling the pain of fibromyalgia.
Gabapentin for Fibromyalgia
Research suggests that people with fibromyalgia have too much glutamate in certain parts of their brain, so gabapentin has long been prescribed for it. But is it effective? Research is mixed.
Two reviews of the evidence disagree. One released in 2016 found that gabapentin is an effective fibromyalgia treatment,3 while another, published in 2017,4 reported only low-quality evidence.
A 2014 review of gabapentin for fibromyalgia and neuropathy found that about 35 percent of study participants saw their pain drop by at least 50 percent while on the drug.5 It’s important to note, though, that 21 percent saw similar drops when taking a placebo.
In studies comparing gabapentin with pregabalin (Lyrica), including one published in The Journal of the American Medical Association, pregabalin appeared to perform better.
An extended-release form of gabapentin showed promise in one small trial published in Pain Practice.3 Researchers say it improved pain, sleep, and quality of life. This was a preliminary trial, though, so more work needs to be done before we’ll know for sure whether it’s safe and effective long term.
Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
Gabapentin Off Label Usages
Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (”change of life”, the end of monthly menstrual periods). Talk to your doctor about the risks of using this medication for your condition.
Pregabalin (Lyrica), a drug similar to gabapentin, was the first medication approved by the Food and Drug Administration (FDA) to treat fibromyalgia. While gabapentin hasn’t been approved by the FDA for the treatment of fibromyalgia, some doctors may prescribe it off-label for such use.
Gabapentin and pregabalin were originally approved to treat certain types of epilepsy and nerve pain. Both drugs work by limiting the release of pain-communicating chemicals by nerve cells in the brain and spinal cord. The most common side effects of both drugs are dizziness and drowsiness.
It is also used to control pain associated with shingles and has been evaluated for pain conditions, including migraine, as its pain-modulating properties may regulate the perception of pain.
Anticonvulsant drugs, such as gabapentin, are becoming increasingly popular for migraine prevention.
Efficacy of gabapentin in migraine prophylaxis research on a history of migraine episodes for a mean of about 21 years shows that Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness.
Gabapentin is generally well tolerated. The main side effects are dizziness and drowsiness. Occasionally there maybe some fluid retention, unsteadiness or G.I upset, mainly diarrhea.
The effective dose of gabapentin varies greatly. Some persons need only 200-300 mg a day whereas others may need 3000 mg or more a day. It may take several weeks to become effective, so it is important to stay on it for an adequate length of time.
Gabapentin has a lot of off-label usage. It is widely used nerve related diseases. Most of them are reviewed by patients and reviewed high.
General speaking, Gabapentin can be off label used to treat Cough, Hot Flashes, Occipital Neuralgia, Trigeminal Neuralgia, Transverse Myelitis,
Alcohol Withdrawal, Pruritus, Bipolar Disorder, Migraine, Anxiety, Postherpetic Neuralgia, Insomnia, Restless Legs Syndrome, Vulvodynia, Benign Essential Tremor, Peripheral Neuropathy, Fibromyalgia, Diabetic Peripheral Neuropathy, Pain, Neuropathic Pain, Reflex Sympathetic Dystrophy Syndrome, Epilepsy, Hiccups, Syringomyelia, Periodic Limb Movement Disorder, Spondylolisthesis, Burning Mouth Syndrome, Pudendal Neuralgia, Small Fiber Neuropathy, Nausea/Vomiting, Chemotherapy Induced.