Gabapentin

[Cinders]

My MWO friends,

I am taking Antabuse and THRILLED with how well "it" is working for me. As I told my hubby, even if it was just a placebo, it would be working. Having the fall back to "if I take one drink I will become sick as a dog" has been an extraordinary boost in this fight.

However, anxiety is one of the reasons I have self-medicated for many years, I believe. Not depression, not bipolar, pure anxiety.

My doctor also prescribed Gabapentin for that since I was adamant that I not be given any SSRI's. (I have had and heard so many bad things about them that I was unwilling to try any of them.) So he put me on Gabapentin. I started at 100 mg 3xday, titrated to 200 mg 3xday and now am at 300 mm 3xday.

I am finding that my anxiety levels are less, I am not having the allergic reaction I did to topamax, and I am not a zombie. My GP was completely surprised the Gabapentin did not turn me into a zombie. She said I should feel like the walking dead with that dose so early in the titration process.

Does anyone else take or have you ever taken Gabapentin? What were your reactions to it?

I am asking because I am curious if it is also a piece of this puzzle that is helping me feel so good about being sober and allowing me to make better decisions about staying sober. i.e. I know the NIAAA is doing studies with Gabapentin and alcoholism and wondering if there truly is a good effect for those of us trying to get off AL?

TIA!

Love,
Cindi

[Noelle]

Gabapentin

The only thing I know about Gabapentin is what you've told me. But I've written it down and when I see my psychiatrist again the second week of May I'm going to tell her about it. Maybe then I could stop taking my Cymbalta. So thanks for letting me know about this drug.

I love how you write in roman numerals for your days! XVIII is so good!!! I'm so proud of you!!

[trixietrack]

Gabapentin

I was reading a little bit about gabapentin the other day. I think you are on to something cindi.

people who drink heavily are trying to up their GABA. alcohol does the job, but then it fails after a while.

anxiety is a side effect or low GABA.

keep us posted.

[Ripple]

Gabapentin

300 mgs. 4 x's day. STOPPED.

i had those orange thingies...i stopped them..made me so tired. i ate a lot of them though in the start of sobriety. as a substitute for non-addictive meds. uses are for anxiety, seizures, pain...etc.

now that i am at 176 days...i only take one topa 25mgs. and thats about it! kudzu...and Sleep Supplements...:yes:

[Laurav]

Gabapentin

Interesting post.
I was put on Lamictal four weeks ago to combat my anxiety disorder. This med is also an anti-seizure medication (same type as Topa and Gabapentin). It could be a coincidence but I swear that when I quit drinking 2 weeks ago that I had very few to no physical cravings – most of it was trigger driven and even then they were few and far between.
BTW…I have had no side effects from the med other than in the third week I was tired during the day. Now that I am into the 4th week that has gone away.

[spiritwolf333]

Gabapentin

Pass it on.

[Otter]

Gabapentin

Oh lordy, lordy! Where do I start with this one.

Cinders was one of the first to start using baclofen when no one else did.

Reviving this thread as if to give gabapentin some sort of kick start is doomed as those of us who have been here this long know.

What happeded with Cinders and gabapentin?

Here it is:

11-07-2013, 09:55 PM
Replies: 7
Gabapentin, your thoughts?
Views: 278
Posted By Cinders
I have taken Gabapentin up to 2400 mgs/day for...

I have taken Gabapentin up to 2400 mgs/day for years.

It did nothing to help me with my drinking.

I has done an amazing job of keeping my cluster headaches at bay.

Sorry. I wish it was a..."

It may have helped someone but it is important here not to mislead people who are looking for answers to a serious health problem by making them think that it is more effective than it really is.

[Randall]

Gabapentin

I've heard a lot of conflicting reports online about Gabapentin and the build up of tolerance. This is where I think problems might arise. I know Pregabalin can be a nightmare when it comes to building tolerance. I've heard of people losing thew effects of it after a week or two.

[spiritwolf333]

Gabapentin

Randall;n2382187 wrote: I've heard a lot of conflicting reports online about Gabapentin and the build up of tolerance. This is where I think problems might arise. I know Pregabalin can be a nightmare when it comes to building tolerance. I've heard of people losing thew effects of it after a week or two.

Hi Randall -Thanks for this post. So far, I have not been able to find any scientific or medical evidence that suggests Gabapentin 'builds up tolerance'. I am surprised to hear that a drug used to help control seizures (convulsions) in the treatment of epilepsy would lose its ability to work without higher doses (in a week or two). Just curios about the dosage levels these people were at? I would really like to know more about your findings if you have the time to reply. Thanks

[Rand all]

Gabapentin

...

[Rand all]

Gabapentin

...

[terryk]

Gabapentin

Randall;n2382187 wrote: I've heard a lot of conflicting reports online about Gabapentin and the build up of tolerance. This is where I think problems might arise. I know Pregabalin can be a nightmare when it comes to building tolerance. I've heard of people losing thew effects of it after a week or two.

Gabapentin and pregabalin: abuse and addiction. [Prescrire Int. 2012] - PubMed - NCBI

Gabapentin and pregabalin: abuse and addiction.
[No authors listed]
Abstract

In Europe, in mid-2011, about 30 cases of dependence, abuse or withdrawal symptoms attributed to pregabalin had been reported to Swedish and French pharmacovigilance centres and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). About 20 cases of gabapentin addiction were published in detail. The most frequently reported disorders were withdrawal symptoms. More than half of the patients were hospitalised for withdrawal. Cases of excessive increases in the doses of gabapentin or pregabalin, unauthorised routes of administration, and combination with other substances were also reported. Some patients had no known history of substance abuse. In practice, it is better to avoid exposing patients to these risks when the expected benefits are not properly documented. Healthcare professionals should take care to prevent and detect addiction to pregabalin or gabapentin. When necessary, assistance with tapering off the medication should be offered.

Misuse and abuse of pregabalin and gabapentin: cause for concern?

Misuse and abuse of pregabalin and gabapentin: cause for concern?
Schifano F.
Author information

Abstract

Gabapentinoids (e.g. pregabalin and gabapentin) are widely used in neurology, psychiatry and primary healthcare but are increasingly being reported as possessing a potential for misuse. In fact, increasing levels of both prescriptions and related fatalities, together with an anecdotally growing black market, have been reported from a range of countries. This article reviews the current evidence base of this potential, in an attempt to answer the question of whether there is cause for concern about these drugs. Potent binding of pregabalin/gabapentin at the calcium channel results in a reduction in the release of excitatory molecules. Furthermore, gabapentinoids are thought to possess GABA-mimetic properties whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system. Overall, pregabalin is characterized by higher potency, quicker absorption rates and greater bioavailability levels than gabapentin. Although at therapeutic dosages gabapentinoids may present with low addictive liability levels, misusers' perceptions for these molecules to constitute a valid substitute for most common illicit drugs may be a reason of concern. Gabapentinoid experimenters are profiled here as individuals with a history of recreational polydrug misuse, who self-administer with dosages clearly in excess (e.g. up to 3-20 times) of those that are clinically advisable. Physicians considering prescribing gabapentinoids for neurological/psychiatric disorders should carefully evaluate a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication.

Gabapentin-induced delirium and dependence

Gabapentin-induced delirium and dependence.
Kruszewski SP1, Paczynski RP, Kahn DA.
Author information
Abstract

Gabapentin (Neurontin) is approved by the US Food and Drug Administration for treatment of epilepsy and post-herpetic neuralgia. Despite lack of strong evidence, gabapentin is also often prescribed off-label for psychiatric conditions. The case described here involved a 38-year-old male physician with substance intoxication delirium and psychoactive substance dependence due to high self-administered doses of gabapentin, which had been prescribed at lower doses in combination with buspirone and bupropion for depression and anxiety. This unusual case of gabapentin dependence and abuse involved toxic delirium, intense cravings, and a prolonged post-withdrawal confusional state reminiscent of benzodiazepine withdrawal. Gabapentin is a central nervous system inhibitory agent with likely gamma-aminobutyric acid (GABA)-ergic and non-GABAergic mechanisms of action. The similarity between benzodiazepine withdrawal and what this patient experienced with gabapentin suggests a common role for GABA-related effects. The case reported here suggests the need for heightened concern regarding the off-label prescription of this drug to vulnerable individuals with psychiatric conditions.

Adverse drug reactions to gabapentin and pregabalin: a review of the French pharmacovigilance database.[Drug Saf. 2013] - PubMed - NCBI

Adverse drug reactions to gabapentin and pregabalin: a review of the French pharmacovigilance database.
Fuzier R1, Serres I, Guitton E, Lapeyre-Mestre M, Montastruc JL; French Network of Pharmacovigilance Centres.
Author information
Abstract

BACKGROUND:

Gabapentin and pregabalin are widely used as antineuropathic pain drugs. Their use is also associated with the development of adverse drug reactions (ADRs), mainly neuropsychiatric.

OBJECTIVE:

The aim of this work was to study 'serious' and/or 'unexpected' adverse reactions associated with pregabalin and gabapentin.

STUDY DESIGN:

We studied ADRs reported to the French Pharmacovigilance System occurring between 1995 and 2009.
MAIN OUTCOME MEASURE:

For each ADR associated with gabapentin or pregabalin, we noted year, patient age and sex, type of adverse reaction, as well as the imputability score. Reporting rate of serious ADRs for gabapentin and pregabalin was estimated with regard to data of use (obtained from the French National Health Insurance Fund) using the defined daily dose. A global and descriptive analysis of the adverse reactions for each drug is presented. Secondly, details of deaths and ADRs with an imputability score of at least 'probable' or 'likely' were presented.

RESULTS:

Overall, 1333 cases were recorded (725 related to gabapentin, 608 related to pregabalin), mainly neuropsychiatric ADRs. Among the 22 deaths recorded, 8 were related to gabapentin in obstetrical situations. Other less well-documented ADRs were identified, such as hepatitis associated with gabapentin and haematological ADRs associated with pregabalin.

CONCLUSION:

This study confirmed the prevalence of neuropsychiatric ADRs associated with gabapentin or pregabalin. A high rate of death occurred with gabapentin in an obstetrical context. New adverse reactions have been noted, such as haematological or hepatic adverse reactions associated with pregabalin and gabapentin, respectively.


Prevalence of gabapentin in impaired driving cases in Washington State in 2003-2007[J Anal Toxicol. 2009] - PubMed - NCBI

Prevalence of gabapentin in impaired driving cases in Washington State in 2003-2007.
Peterson BL.
Author information
Abstract

Gabapentin (Neurontin) is an antiepileptic drug commonly prescribed for pain treatment. In the past 15 years, indications for gabapentin have been increasing even though the complete mechanism of action is unknown. Side effects include somnolence, dizziness, ataxia, nystagmus, and fatigue. This study reviewed all cases positive for gabapentin submitted to the Washington State Toxicology Laboratory between January 2003 and December 2007. The concentrations of gabapentin in blood from impaired driving cases (n = 137) ranged from < 2.0 to 24.7 mg/L with a mean of 8.4 +/- 5.4 mg/L and a median of 7.0 mg/L. The driving population was 50% male with a mean age of 43.0 +/- 10.9 years (range 23-73). Of the cases studied, only 7% were positive for gabapentin alone with the remaining 93% indicative of polydrug use. Drug Recognition Expert reports from four cases in which the only drug detected likely to be causing impairment was gabapentin were examined. These reports demonstrated that subjects may exhibit psychophysical indicators of a central nervous system depressant (e.g., horizontal gaze nystagmus, poor performance on standardized field sobriety tests) with clinical indicators (e.g., dilated pupils, low body temperature, and elevated pulse and blood pressure) that are not consistent with a depressant.

Profiles of pregabalin and gabapentin abuse by postmortem toxicology. [Forensic Sci Int. 2014] - PubMed - NCBI

Profiles of pregabalin and gabapentin abuse by postmortem toxicology.
H?kkinen M1, Vuori E2, Kalso E3, Gergov M2, Ojanper? I2.
Author information
Abstract

Pregabalin (PRG) and gabapentin (GBP) are used in the treatment of neuropathic pain and epilepsy, and PRG also in generalized anxiety disorder. There is increasing evidence that PRG possesses considerable abuse potential. PRG may have a higher addiction potential than GBP due to its rapid absorption and faster onset of action. Our objective is to estimate the proportion of all PRG- and GBP-related fatalities attributable to PRG and GBP abuse. We investigated all medico-legal death cases in Finland in which PRG or GBP was found in postmortem toxicology during 2010-2011. PRG was found in 316 cases and GBP in 43 cases. Drug abuse was associated with 48.1% of the PRG and 18.6% of the GBP findings. PRG poisoning accounted for 10.1% of all PRG cases and GBP poisoning for 4.7% of all GBP cases. In the drug abuser cases, PRG poisoning represented 19.1%, and GBP poisoning 12.5%. The median blood concentration of PRG was 15 mg/L in the abuser group and 5.8 mg/L in the other cases. For GBP, these concentrations were 12 mg/L and 8.3mg/L, respectively. In the PRG abuser group, 91.4% of cases showed concomitant opioid use, while in the rest of these cases neither alcohol nor opioids were detected, but other central nervous system acting drugs were found in each abuser case. In the GBP abuser group, 87.5% of cases showed concomitant opioid use. PRG abuse with high doses is increasingly common and can be fatal when combined with opioids.

Copyright ? 2014 Elsevier Ireland Ltd. All rights reserved.



Substance misuse of gabapentin
Br J Gen Pract. Aug 2012; 62(601): 406–407.
doi: 10.3399/bjgp12X653516
PMCID: PMC3404313
Substance misuse of gabapentin

Neuropathic pain affects up to 8% of the population,1 causing significant distress and morbidity. Good evidence-based treatment is available,2 so early diagnosis is important. Recent publicity and guidelines, and increasing prevalences of age-related causes of neuropathic pain (including postherpetic neuralgia and diabetic neuropathy), have led to increasing rates of diagnosis and treatment in primary care. Gabapentin is one of the recommended mainstays of evidence-based treatment.3

Unfortunately, our clinical experience suggests that gabapentin is now prevalent as a drug of abuse. The drug’s effects vary with the user, dosage, past experience, psychiatric history, and expectations. Individuals describe varying experiences with gabapentin abuse, including: euphoria, improved sociability, a marijuana-like ‘high’, relaxation, and sense of calm, although not all reports are positive (for example, ‘zombie-like’ effects). In primary care, an increasing number and urgency of prescription requests cannot necessarily be explained by the increased number of cases of neuropathic pain. In the substance misuse service, the numbers admitting to using gabapentin (local street name: ‘gabbies’, approx ?1 per 300 mg) are also growing.
figure bjgp62-406S1

Prescribing data from the Tayside region of Scotland show a rise in the number of patients receiving gabapentin, and an exponential rise in the total number of prescriptions issued, particularly since it was licenced for postherpetic neuralgia in 2002 (Figure). In the substance misuse services in Tayside in 2009, we found that of those who had been attending for at least 4 years (n = 251), 5.2% were currently receiving gabapentin on prescription, with a mean dose of 1343 mg, and were >3 times more likely to admit to non-medical use of analgesics (P = 0.006). Meanwhile, of 1400 postmortem examinations in Central, Tayside, and Fife regions of Scotland in 2011, 48 included gabapentin in their toxicology report, with 36 also including morphine and/or methadone, indicating recent possible opioid dependence. Gabapentin is easily prescribed without restriction, and escalating doses are recommended.3,4 It is therefore easy to facilitate any misuse and addiction potential, and to stock the black market. A recent police report indicates the increasing tendency to use gabapentin as a ‘cutting agent’ in street heroin (and to recover gabapentin on the street and in prisons), further adding to the abuse and danger potential.5 Like opiates, gabapentin is fatal in overdose; unlike opiates, there is no antidote and the long half-life instils the need for prolonged, intensive management of overdose.

The epidemiology of gabapentin misuse needs further detailed and urgent assessment, including cross-linking data from Police, NHS, and other sources. We should consider introducing routine gabapentin testing in urine drug screens. This will inform clinical and political approaches to this possible new and dangerous type of substance misuse, as well as safe management of the distress caused by neuropathic pain.

Potential misuse of pregabalin and gabapentin
BMJ. 2014 Feb 5;348:g1290. doi: 10.1136/bmj.g1290.
Potential misuse of pregabalin and gabapentin.
Loftus H1, Wright A.

Kalso and colleagues summarise drugs used to manage neuropathic pain.1 However, they should have mentioned the potential misuse of pregabalin and gabapentin, which Spence highlighted last year.2 Reports of gabapentin and pregabalin being used alongside opiates to potentiate opiate effects are increasing.3 4 The drugs can also be used alone in higher than recommended doses to produce sedative and psychedelic effects.5 6 The consequences of overdose can be severe and unpredictable. Seizures are a recognised presenting feature in emergency departments and can require admission to intensive care.7 The half life of 5-7 hours necessitates prolonged monitoring of patients. A recent study suggested that patients at high risk of addiction were prescribed higher than the recommended dose of pregabalin.8

Although when used correctly gabapentinoids can provide great relief for patients with neuropathic pain, the potential for misuse should be considered before they are prescribed. Quantities supplied should be limited because of the possibility of misuse.
Notes

Cite this as: BMJ 2014;348:g1290

Bad medicine: gabapentin and pregabalin
BMJ. 2013 Nov 8;347:f6747. doi: 10.1136/bmj.f6747.
Bad medicine: gabapentin and pregabalin.
Spence D.

People have died from the drugs I have prescribed. I rationalised that these drugs were prescribed in good faith, in line with guidelines, and deaths were the result of misuse. But this offers no comfort to my sense of guilt. Prescription drug misuse is a problem, especially psychoactive drugs such as opioids and benzodiazepine. And there is an iatrogenic epidemic of harm in the US with nearly 15 000 deaths annually from prescribed painkillers. This is the tiny tip of an abuse iceberg, with an estimated 12 million Americans misusing these drugs recreationally.1 We have a social and professional responsibility to be cautious in how we prescribe psychoactive drugs. Increasingly, I confront drug seeking behaviours for different drugs—gabapentin and pregabalin. Could it be that these seemingly harmless epilepsy drugs are being misused?⇑

Gabapentin and pregabalin are in fact also licensed for neuropathic pain, and pregabalin for general anxiety disorder. These are common and chronic conditions, together affecting 20% to 40% of the population.2 3 Their prescribing is anointed by Cochrane reviews4 5 and a NICE guideline6: gold plated evidence of benefit. Gabapentin and pregabalin are being prescribed freely and rapid dose up titration is recommended. Pregabalin prescribing has increased by 350% in just five years, to 2.7 million scripts. Likewise gabapentin prescribing has increased 150% in five years, with 3.5 million scripts.7 This stellar prescribing growth seems set to continue. And this is big business too, with combined sales worth ?200m (€240m; $322m) a year.7 But a word of caution: pain and anxiety symptoms are subjective, with wide variation in reported prevalence.2 The longest neuropathic pain study lasted a mere 13 weeks,6 and highly psychoactive drugs are difficult to compare with placebo.

And there is increasing published evidence of concern about the abuse of pregabalin and gabapentin,8 9 10 and these drugs are now commonly being detected in toxicology in autopsies after drug overdoses.11 So what is the motivation to misuse these drugs? Users describe the effects as the “ideal psychotropic drug,” “great euphoria,” “disassociation,” and “opiate buzz,” and are achieving these effects by taking large quantities as a single dose.10 Accordingly there is a growing black market, and these drugs are being bought through online pharmacies. The US recognises the problems associated with pregabalin, which has now become a scheduled drug under the Controlled Substance Act.12 Is the UK ignoring the misuse of pregabalin and gabapentin? Should we re-examine the so called evidence for gabapentin and pregabalin and consider alternatives?13 14 For the risk from iatrogenic harm is bad medicine indeed. Time to tackle the rise and rise of gabapentin and pregabalin prescribing?
Notes

Cite this as: BMJ 2013;347:f6747



Re: Bad medicine: gabapentin and pregabalin
BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f6747 (Published 08 November 2013) Cite this as: BMJ 2013;347:f6747

Concern about the 350% increase in use of pregabalin in England in the five years to 2012 is rightly expressed by Des Spence.(1) Scotland, where Dr Spence practices, has also seen huge increases in its prescription. The table attached illustrates a similar, but more up-to-date period for Scotland and NHS Highland. It contains data for both pregabalin and gabapentin. Pregabalin was a particular concern for us in NHS Highland, where we were seeing great increases in prescribing of pregabalin for neuropathic pain and, to a lesser extent, generalised anxiety disorder. We were concerned about the appropriateness of prescribing and the very significant resultant cost pressure. We were also becoming aware of anecdotal reports that pregabalin was becoming a drug of misuse.

In May 2009, the Scottish Medicines Consortium (SMC) finally accepted pregabalin for restricted use within NHS Scotland for the treatment of peripheral neuropathic pain in adults. The SMC drew attention to the methodological limitations of studies and their small numbers of patients. (2) It was added to the Highland Formulary for this indication shortly afterwards, although its use was restricted to specialist initiation. The following year, NHS Highland’s prescribing advisers disputed the NICE guidance on the pharmacological treatment of neuropathic pain in adults in non-specialist settings, which had recommended offering oral amitriptyline or pregabalin as first-line treatment (except for people with painful diabetic neuropathy). (3) The prominence given to pregabalin was felt to be surprising and contrary to the evidence base and cost considerations. NICE Clinical Guidelines do not have legal or statutory authority in Scotland, so its guidance on this matter could be considered as interesting but foreign.

We credit ourselves in Highland as having exercised some control over the increase in use of pregabalin: it's use continues to rise but its prescription is now less in Highland than in Scotland generally. It remains a cause of great concern to us. The use and misuse potential of pregabalin and gabapentin have been discussed with all practices across NHS Highland over the past two years. Their use as analgesics is discussed in NHS Scotland's National Therapeutic Indicators for 2013-14.(4)

Most recently, NHS Highland publicised concerns about the abuse potential of pregabalin and gabapentin that have been growing locally over the past two to three years, where the local drug-related deaths group had noted that 20% of drug related deaths had involved pregabalin or gabapentin, with one death caused directly by illicit intravenous use of gabapentin.(5) Pregabalin and gabapentin also featured in a list detailing the reported street value of prescribed medicines in the Highlands.(6) It is interesting to note that, in the highly critical and free-market world of drug misuse, they were reported to have the same monetary value, which casts doubt on perceived therapeutic advantages of pregabalin over gabapentin based on pharmacokinetics.

These last two are by the same author:

Gabapentin: can it be misused? I

Gabapentin: can it be misused?
Howland RH.
Abstract

Gabapentin, a gamma-aminobutyric acid analog drug, appears to be safe and efficacious for the treatment of alcohol dependence. Gabapentin is not a controlled drug, but there are anecdotal reports of its misuse and abuse as well as reports of withdrawal symptoms associated with abrupt discontinuation. The risk of gabapentin misuse is inconsistent, the magnitude of the risk is small, and the risk is not comparable to the much higher risks associated with alcohol use; benzodiazepine, opioid, and stimulant drug use; or illicit drug use. Reports of gabapentin misuse are not unique to this drug, as misuse of prescription medications not typically considered "drugs of abuse" can also occur.

Gabapentin for Substance Use Disorders: Is it Safe and Appropriate?

Gabapentin for Substance Use Disorders: Is it Safe and Appropriate?
Howland RH.
Abstract

Gabapentin is effective for the treatment of alcohol dependence and can be used for treating anxiety, insomnia, headaches, and/or pain in patients who have comorbid substance use disorders (SUDs) or who are at high risk of substance abuse. Deaths from unintentional drug overdoses are increasing, are the leading cause of injury death in the United States, and are mostly attributable to prescription drugs, in particular opioid agents. Compared to other psychotropic drugs, gabapentin is not especially harmful or lethal. Gabapentin misuse is possible, similar to other medications not typically considered drugs of abuse, but it should be considered safe and appropriate for use in patients with all types of SUDs, including patients who take opioid drugs. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Copyright 2013, SLACK Incorporated.



-tk

[Rand all]

Gabapentin

...

[spiritwolf333]

Gabapentin

Hi TK and Rand -Great information and I thank you both -I am sure others appreciate your efforts and appreciate your work as well.

From what I have just now read, it sounds as if there might exist the potential for abuse with Gabapentin. The abuse potential appears to be very minimal -but, nevertheless, someone who decides to take 7 to 20 times the recommended dosage will run into big problems.

Rand -there certainly is lot of information to research regarding Gabapentin. In what I was able to read, I still never saw anything that said that Gabapentin was addictive -at least from a tolerance standpoint. I certainly have read where there is real problem with sudden withdrawal of Gabapentin.

Regardless of all, I am just thankful that alcoholics will soon have real choices regarding real medications for alcoholism. I am looking forward to the outcome and the approval of the extended-release Baclofen. I am also looking forward to the extended-release Gabapentin (which is being modified in other ways as well) -for those who are unable to tolerate Baclofen.

The French studies (regarding Baclofen) will soon be released and, as we know, will be overwhelmingly positive. The current French studies with Baclofen are only a formality for political purposes. GPs world wide will now get on board. I think the biggest disappointment that we might see will be the non tolerability issue by patients and then you we will a total loss of interest by the medical community. Hopefully, this will not be the final result. However, I do believe that modified forms of Baclofen will have a real chance of being one of the real answers to AUD.

Perhaps what we might end up finding out is the fact that not one pill works for everybody. Several other drugs are now being researched that may almost instantaneously remove mental cravings (the recovery industry is extremely worried about these medications).

Anyway, again -thanks for the informative posts.
SW



Additional Info:
http://www.ncbi.nlm.nih.gov/pubmed/24549170
J Psychosoc Nurs Ment Health Serv. 2014 Jan 6:1-4. doi: 10.3928/02793695-20131217-01. [Epub ahead of print]
Gabapentin for Substance Use Disorders: Is it Safe and Appropriate?
Abstract

Gabapentin is effective for the treatment of alcohol dependence and can be used for treating anxiety, insomnia, headaches, and/or pain in patients who have comorbid substance use disorders (SUDs) or who are at high risk of substance abuse. Deaths from unintentional drug overdoses are increasing, are the leading cause of injury death in the United States, and are mostly attributable to prescription drugs, in particular opioid agents. Compared to other psychotropic drugs, gabapentin is not especially harmful or lethal. Gabapentin misuse is possible, similar to other medications not typically considered drugs of abuse, but it should be considered safe and appropriate for use in patients with all types of SUDs, including patients who take opioid drugs. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

[Flute]

Hi, I am new on this forum. Just wanted to contribute with my experience with Pregabalin (Lyrica). I started taking this medication six months ago and my craving stopped immediately. I have not had a drink since. After two months I upped the dose from 75mg x3 a day to 150 mg x3. After four months I upped again to 300mg x2.

I was prescribed Lyrica after having been diagnosed with Generalised anxiety disorder by a neuropsychologist. Lyrica took care of the anxiety. And without the anxiety the cravings disappeared. Or rather, my brain stopped sending the impulses to get a drink, it did not need alcohol. Good thing, because I didn´t want to drink. My brain just wanted more GABA I guess.