Gabapentin

[StuckinLA]

Gabapentin

spiritwolf333;1617025 wrote: Sounds like you and NE have gabapentin covered. Someone should inform Dr. George Koob -new director at the NIH-Alcohol and Abuse of your and Ne's Wiki findings.

Dr. Koob headed up the research for gabapentin at the Scripps Institute. Furthermore, Dr. Koob and Dr. Ameisen had several conversations regarding Baclofen. Dr. Ameisen was well pleased that Dr. Koob was aware of baclofen and that Ameisen had done a self-study. Also, Scripps has performed research regarding alcoholism using both baclofen and gabapentin.

No I totally get that - and am not trying to start an argument. Just saying that I know enough of the brain chemistry to know that baclofen is the ONLY thing to do what it does. Baclofen removes cravings for alcohol, I've experienced it, but it doesn't really do much else now does it? Gabapentin, from what it sounds like, works in treating alcoholism by treating the SIDE EFFECTS of NOT DRINKING, the depression, anxiety, insomnia, etc. And so makes it easier to remain abstinent because the person is not feeling all the crap that generally leads to (re)lapse. So by removing some of the triggers that lead to drinking and the effects of not drinking, people don't drink so much, and if their goal is abstinence then that's all that much easier.

[spiritwolf333]

Gabapentin

squeezed;1617431 wrote: It's easy to over-focus on brain receptors and what not, but alcohol hits lots and lots of neural pathways. It seems unlikely that addressing one specific receptor would be a magic bullet.

It is also simplistic to say that alcoholism is a problem with brain chemistry, since everything we do affects brain chemistry. As humans, we have vastly more extrinsic input into our behavior than ,say, rats; it is difficult to extrapolate rat behavioral experiments to humans.

Bottom line about bac, or gabapentin, or anything else works for alcoholism or not: large clinical studies are needed. In the meantime, we are all free to try them for ourselves (after due diligence). I have used several myself.

Even the best results for alcoholism meds aren't that great. People enthuse about the headline 60%, or 75%, or whatever success rate of a study or claim. Underneath the hood the results are less spectacular.

One example: As-needed nalmefene (basically TSM) was approved in Europe last year on the basis of its 60-65% success rate in large trials. But the success on placebo was 50%. So the Number-Needed-to- Treat (NNT) was close to the 9 for Antabuse, naltrexone (non-TSM), Campral, and even the latest gabapentin study from Scripps. That is: the vast majority will not benefit more than placebo.

Also, the typical follow-up for these studies is mere months. Would the results be better or worse after a year? Who knows? When I was doing TSM, there were posters on their forum insisting that people should keep going even after 9 months without much difference.

People should try meds for alcoholism, because they do work. But they shouldn't expect miracles in all - or most - cases. And don't blame yourself if a particular med doesn't work for you.

Hi Squeezed -you know, you seem like a highly intelligent person. Your information appears both valid and insightful. Seems as though you can (and do) add a lot to the medical side of the forum. What I don't get is some of your more provocative posts. No, not individual posts directed at anyone -just ... well you get it. It almost appears as if you are somehow disgusted with the former direction of the forum and are taking some type of stand? This, in and of itself is not a bad thing -especially if its purpose is to enlighten and not harm. Anyway, thank you for your solid input.

[spiritwolf333]

Gabapentin

Hi JD -I just found this video on youtube from the Scripps Institute regarding Gabapentin. Thanks.

http://www.youtube.com/watch?v=ty91VxjEHpc[/video]]

[AJ22]

Gabapentin

Hey all,

I thought I give a little input to this conversation, as I rarely post. However, this thread interested me and so did the Scripps study. I tried Topamax, the TSM method, and baclofen. I was way too doped up feeling on Topa, TSM had no real impact on me one way or another, no side effects either. Baclofen, at times I felt like my drinking diminished a bit. I got up to around 275mg/day and unfortunately, the side effects ultimately were just too much to handle. I got a script from Dr. Levin (if I remember correctly) and even consulted with him regarding the side effects. He had never heard of some of the side effects I was experiencing. To me it was like the worst allergy attack ever. Constant eye watering, nasal congestion, along with the other common complaints like tiredness. I also vomited during the day twice at the higher dosages. This may have occurred from a double does, as I sometimes couldn't remember if I had taken a does or not. Or maybe, I'm just allergic to the stuff. So, here I am getting all excited about Gabapentin. I order like a month supply at the 1800mg/day level. I started last week. Titrated up adding 300mg/day until 1800mg. I've been at 1800mg/day for about a week now or 4 or 5 days. I ordered from gold pharma, the Park Davis Neurontin 300 caps (same drug gabapentin). I can say without a doubt I am experiencing no side effects. I feel exactly the same. I don't know how long one might have to continue before they see some benefits. Who knows, maybe it takes a month. But for now I think any reduction in my drinking is modest at best. I'm even fooling around with dosage times. For me 4pm is the time of day I get the itch, so now I am trying 600mg/morning, 900mg at 3PM, and 300 and bedtime to see if I get any reduction during drinking hours. That's it. I'll post more if I begin to see some value. Otherwise, I hope your brain chemistry has better luck.

[Balboa45]

Gabapentin

I kinda got here late, never heard of gabapentin, the stuff was prescribed for my restless leg syndrome that I only get after prolonged drinking and then back to sobriety. All I can say is that for me this stuff works great, no restless legs, sleeping very well, feel great, still looking forward to a few beers next month, but no jonesing of any kind. I've been at about 600 to 900 milligrams a day for the last 3 months...I like this cheap very mellow drug, and 27 straight days AF so far this time around.

[spiritwolf333]

Gabapentin

squeezed;1618026 wrote: I don't have an agenda. I've tried many of the meds advocated here, and none of them worked for me. (Well, Bac dropped my drinking, if I was willing to stay in bed all day and not work.) Also, no AA for me. So, basically I am pretty cynical about all these miracle cures (having read the studies).

After reading the newer posts (in other threads), I think I will just step back. It is exciting though to see the unbridled enthusiasm of the newbies.

Good luck.

Squeezed -thanks for the reply. Did you ever try not drinking while taking baclofen? I know, sounds like bullshit -but really, did you? And many of us do understand about the AA thing. And just having read the studies -well, don't stop there. You seem a hell of a lot smarter than me so I think I will just stop. But I do believe one thing; when you do find what works for you, then you will make one heck of proponent for that chemical.

[spiritwolf333]

Gabapentin

AJ22;1617860 wrote: Hey all,

I thought I give a little input to this conversation, as I rarely post. However, this thread interested me and so did the Scripps study. . For me 4pm is the time of day I get the itch, so now I am trying 600mg/morning, 900mg at 3PM, and 300 and bedtime to see if I get any reduction during drinking hours. That's it. I'll post more if I begin to see some value. Otherwise, I hope your brain chemistry has better luck.
Looking forward to your updates

Balboa45;1618275 wrote: I kinda got here late, never heard of gabapentin, the stuff was prescribed for my restless leg syndrome that I only get after prolonged drinking and then back to sobriety. All I can say is that for me this stuff works great, no restless legs, sleeping very well, feel great, still looking forward to a few beers next month, but no jonesing of any kind. I've been at about 600 to 900 milligrams a day for the last 3 months...I like this cheap very mellow drug, and 27 straight days AF so far this time around.

Balboa - congrats on the 27 days. Please keep posting regarding you Gabapentin progress. I know JD is very interested also.

[Balboa45]

Gabapentin

spiritwolf333;1618322 wrote: Looking forward to your updates



Balboa - congrats on the 27 days. Please keep posting regarding you Gabapentin progress. I know JD is very interested also.

Your quite welcome Wolf, the way I look at it anything that's good is good. I'm going to keep the gabapentin around as just another useful tool, really like it so far, I can't even tell I'm taking it except for the fact I'm more mellow, it has no side effects and doesn't have any effect on my intense exercise routine. I'm going to have a few pops next month, maybe 3 or 4 days of drinking, I have a case of Heineken out in the garage and some Maker's Mark that I'm looking forward to then hopefully another 25 or so sober days for February. My AF goal for 2014 is 240 days, and I need a good head start.

You guys keep posting up the progress as I'm interested as well.

Thanks B-45

[spiritwolf333]

Gabapentin

squeezed;1618688 wrote: I did tried to cut down on alcohol during my bac phase. Did I try for abstinence? No. Is there a difference? I don't know.

When I read papers on alcoholism studies, what really strikes me is how many subjects on *placebo* get better: 25-50% ! Granted, the follow-up periods are short, but we don't know what happens to the med groups 2-5 years either.

Actually, I do drink much less now. No meds. No AA. Nothing. Something to do with getting older : ) .

LOL -On the getting older -drinking less part. I can only post from my experience and that was: Remaining abstinent while titrating up on baclofen was well worth the effort. Don't get me wrong; it was still hell -the not drinking, the feeling lost, the depression, -all, were calling on me to have a drink and all would be ok. Once thru this stage, life began to take on a new meaning and baclofen took over -allowing me to stay calm thru the extreme ups and downs.

[spiritwolf333]

Gabapentin

squeezed;1618719 wrote: I am very happy that baclofen is working for you, and others.

I am going to give it a rest. TSM, or gabapentin, or AA work for many people too. So does doing nothing but just deciding not to drink anymore. Is HDB better? By pointing out that *no* med regiment - yes, including HDB - has been shown to be much good, I get vitriol directed my way.

Thanks for being a reasoned poster here. I wish you the best of luck.

Again, thanks for the post. I do understand, or least I think I understand, where you are coming from. I can only speak for me as far as HDB working -and yes it did and does work. As you say, the other methods can and do work also -those methods just did not work for me.

The last method you mentioned -just do nothing and stop drinking; well, that option lost its chance with me many-many years ago. Someone who has progressed to the unfortunate realm of "alcoholism" lost that choice many moons ago. Unfortunately, the real fact (at least for an alcoholic like me) for me was that death was a much a better option than stopping alcohol. And that is the reality of for most "real" alcoholics and that is the sadness the world and its families must deal - and that is one reason that MyWayOut is so potentially beneficial to those in the final stages of alcoholism.

[bear100]

Gabapentin

:new:Hey, I really appreciate reading all of your posts. I'm taking 300mg gabapentin 3X's a day, naltrexone and 10mg abilify. I've been on the gaba and the naltrex now for 6 days and find that this combo is working. I was on Campral w/ the gaba but didn't like the SE's from the Campral. The Campral does work though. I went from drinking 12-14 vodkas and or a combo of vodka and wine a night to having only 2. I feel as if I could take it or leave it, don't have that squirmy feeling any more that the naltrexone alone didn't address. My Doc wants to titrate me up to 1800mg of the gabapentin per day, he is going for complete abstinence, hopefully one day I'll get there, but for right now this is a huge change for me. Tried rehab and AA didn't work for me, just wasn't my thing.

[terryk]

Gabapentin

squeezed;1617431 wrote: It's easy to over-focus on brain receptors and what not, but alcohol hits lots and lots of neural pathways. It seems unlikely that addressing one specific receptor would be a magic bullet.

It is also simplistic to say that alcoholism is a problem with brain chemistry, since everything we do affects brain chemistry. As humans, we have vastly more extrinsic input into our behavior than ,say, rats; it is difficult to extrapolate rat behavioral experiments to humans.

Bottom line about bac, or gabapentin, or anything else works for alcoholism or not: large clinical studies are needed. In the meantime, we are all free to try them for ourselves (after due diligence). I have used several myself.

Even the best results for alcoholism meds aren't that great. People enthuse about the headline 60%, or 75%, or whatever success rate of a study or claim. Underneath the hood the results are less spectacular.

One example: As-needed nalmefene (basically TSM) was approved in Europe last year on the basis of its 60-65% success rate in large trials. But the success on placebo was 50%. So the Number-Needed-to- Treat (NNT) was close to the 9 for Antabuse, naltrexone (non-TSM), Campral, and even the latest gabapentin study from Scripps. That is: the vast majority will not benefit more than placebo.

Also, the typical follow-up for these studies is mere months. Would the results be better or worse after a year? Who knows? When I was doing TSM, there were posters on their forum insisting that people should keep going even after 9 months without much difference.

People should try meds for alcoholism, because they do work. But they shouldn't expect miracles in all - or most - cases. And don't blame yourself if a particular med doesn't work for you.

squeezed;1618026 wrote: I don't have an agenda. I've tried many of the meds advocated here, and none of them worked for me. (Well, Bac dropped my drinking, if I was willing to stay in bed all day and not work.) Also, no AA for me. So, basically I am pretty cynical about all these miracle cures (having read the studies).

After reading the newer posts (in other threads), I think I will just step back. It is exciting though to see the unbridled enthusiasm of the newbies.

Good luck.

squeezed;1618688 wrote: I did tried to cut down on alcohol during my bac phase. Did I try for abstinence? No. Is there a difference? I don't know.

When I read papers on alcoholism studies, what really strikes me is how many subjects on *placebo* get better: 25-50% ! Granted, the follow-up periods are short, but we don't know what happens to the med groups 2-5 years either.

Actually, I do drink much less now. No meds. No AA. Nothing. Something to do with getting older : ) .

squeezed;1618719 wrote: I am very happy that baclofen is working for you, and others.

I am going to give it a rest. TSM, or gabapentin, or AA work for many people too. So does doing nothing but just deciding not to drink anymore. Is HDB better? By pointing out that *no* med regiment - yes, including HDB - has been shown to be much good, I get vitriol directed my way.

Thanks for being a reasoned poster here. I wish you the best of luck.

Because this thread was bumped.... My response to this on another thread:

squeezed;1618848 wrote: Neophyte:

What is the claimed efficacy for HDB anyways? Give it to us in easy terms: NNT

Everyone knows that the RCTs for HDB haven't concluded yet (even this guy - he's just being antagonistic). This article says that some results will be published in the 2nd half of 2014. Maybe these trials will confirm an efficacy that will encourage more doctors to prescribe baclofen, maybe not. Either way, here's some food for thought regarding why finding the answer might not be that simple (sort of the same drug, but a different malady-for which baclofen is proven effacacious):

From Multiple Sclerosis Research: XenoPort to drop Arbaclofen for MS spasticity:

"This study shows that even in late stage development (phase 3), with a drug that has more than a fighting chance, things can go wrong and you get a negative result. The Home - ClinicalTrials.gov trial entry (NCT01359566) suggest they did not use an enrichment design. Why? GW Pharma have shown so elegantly in their Sativex trials that this is the only way to do spasticity trials. In addition, the study used a co-primary outcome; i.e. (1) change from Baseline in maximum Ashworth scale score (6 hour post-dose time point) and (2) a Patient Global Impression of Change (PGIC) score. We now know that the Ashworth is not a good outcome measure; it is not responsive to change and unreliable. At first glance 228 MSers seems to be massively underpowered for these outcomes; there appears to have been 4 arms (placebo vs. 15mg vs. 30mg vs. 45mg) or 57 MSers per arm. For the Ashworth scale you need several hundred per group. I would be very keen to do a post-mortem of this study to see if we can learn something useful from this failure. I sincerely hope that this drug did not fail because of poor trial design."

"Is this another story of a baby being thrown out with the bathwater?"

But getting back to Number Needed to Treat....

squeezed;1614676 wrote: Antabuse, naltrexone, Campral, TSM, bac, gabapentin - they all work. At the level of NNT of 9 or so.

Turns out many commonly prescribed anti-depressants have similar (or worse) nnts and yet the conclusion in this article is that they are indeed efficacious:

Antidepressants versus placebo fo... [Cochrane Database Syst Rev. 2009] - PubMed - NCBI

Antidepressants versus placebo for depression in primary care.
Arroll B, Elley CR, Fishman T, Goodyear-Smith FA, Kenealy T, Blashki G, Kerse N, Macgillivray S.
Author information
Abstract
BACKGROUND:

Concern has been expressed about the relevance of secondary care studies to primary care patients specifically about the effectiveness of antidepressant medication. There is a need to review the evidence of only those studies that have been conducted comparing antidepressant efficacy with placebo in primary care-based samples.
OBJECTIVES:

To determine the efficacy and tolerability of antidepressants in patients (under the age of 65 years) with depression in primary care.
SEARCH STRATEGY:

All searches were conducted in September 2007.The Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Controlled Trials Register was searched, together with a supplementary search of MEDLINE, PsycINFO, EMBASE, LILACS, CINAHL and PSYNDEX. Abstracts of all possible studies for inclusion were assessed independently by two reviewers. Further trials were sought through searching the reference lists of studies initially identified and by scrutinising other relevant review papers. Selected authors and experts were also contacted.
SELECTION CRITERIA:

Studies were selected if they were randomised controlled trials of tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) versus placebo in adults. Older patients (over 65 years) were excluded. Patients had to be recruited from a primary care setting. For continuous outcomes the Hamilton Depression scale of the Montgomery Asberg Scale was requred.
DATA COLLECTION AND ANALYSIS:

Data were extracted using data extraction forms by two reviewers independently, with disagreements resolved by discussion. A similar process was used for the validity assessment. Pooling of results was done using Review Manager 5. The primary outcome was depression reduction, based on a dichotomous measure of clinical response, using relative risk (RR), and on a continuous measure of depression symptoms, using the mean difference (MD), with 95% confidence intervals (CI).
MAIN RESULTS:

There were fourteen studies (16 comparisons) with extractable data included in the review, of which ten studies examined TCAs, two examined SSRIs and two included both classes, all compared with placebo. The number of participants in the intervention groups was 1364 and in the placebo groups 919. Nearly all studies were of short duration, typically 6-8 weeks. Pooled estimates of efficacy data showed an RR of 1.24, 95% CI 1.11-1.38 in favour of TCAs against placebo. For SSRIs this was 1.28, 95% CI 1.15 to 1.43.. The numbers needed to treat (NNT) for TCAs ranged from 7 to 16 {median NNT 9} patient expected event rate ranged from 63% to 26% respectively) and for SSRIs from 7 to 8 {median NNT 7} (patient expected event rate ranged from 48% to 42% respectively) . The numbers needed to harm (NNH for withdrawal due to side effects) ranged from 4 to 30 for TCAs (excluding three studies with no harmful events leading to withdrawal) and 20 to 90 for SSRIs.
AUTHORS' CONCLUSIONS:

Both TCAs and SSRIs are effective for depression treated in primary care.

For the context see: https://www.mywayout.org/community/f2...ml#post1618362

-tk

[spiritwolf333]

Gabapentin

bear100;1620907 wrote: :new:Hey, I really appreciate reading all of your posts. I'm taking 300mg gabapentin 3X's a day, naltrexone and 10mg abilify. I've been on the gaba and the naltrex now for 6 days and find that this combo is working. I was on Campral w/ the gaba but didn't like the SE's from the Campral. The Campral does work though. I went from drinking 12-14 vodkas and or a combo of vodka and wine a night to having only 2. I feel as if I could take it or leave it, don't have that squirmy feeling any more that the naltrexone alone didn't address. My Doc wants to titrate me up to 1800mg of the gabapentin per day, he is going for complete abstinence, hopefully one day I'll get there, but for right now this is a huge change for me. Tried rehab and AA didn't work for me, just wasn't my thing.

Really looking forward to hearing future reports. Thanks

[supesharisuto]

Gabapentin

Funny, I just started a thread on pregabalin the other day. I am starting on pregabalin tomorrow, which from what I have read is some kind of stronger (but nicer in terms of side effects) cousin of gabapentin. Not sure of the differences beyond that but they seem to be very similar. I was prescribed baclofen for the last year, but the doc wants to move onto pregabalin, using it as a kind of transitioning drug in the meantime (I will be taking both for a while, gradually reducing the bac).
I seem to read great things about it (when prescribed for a specific reason). I'd love to know how it works out for you, I'll try and update too!

[emc]

Gabapentin

Great thread JDizzle! thanks!
Few days ago i found the Scripps Institute Study "Gabapentin treatment for alcohol dependence: a randomized clinical trial" already linked here... and get really interested about it.

I'm actually on Baclofen from over a year with really great results.
I drink just few beers occasionally but, as many others said, i can feel that i don't have anymore interest on alcohol 'cause it does not have the same effect as before, or maybe (together) i'm not interested anymore on being stoned by a substance...
Great results for an alcoholic mind drinking over 10 beers a day just a year ago! no? ;-)

But... even if satisfied w Baclofen there are few things that keeps me searching for some others alternatives "anti-alcohol-drugs":
- the relative difficulty to manage Baclofen (dose/hours/ - how long on that dose, how fast titrate up and/or down etc etc) that every Baclofen user knows.
- the also well known SE
- the obvious "fear of relapse" (that i know happens if you stop take the pills or if you titrate down too fast or whatelse?... and this is the unknown point...).

In the beginning and for quite all treatment i was not searching for complete abstinence but from few months is just happening... i often (quite always) really don't feel like drinking at all (even annoying sometimes... ;-) but i'm not planning to stop my therapy..no no no!!! ;-)
The only SE i still have (i'm titrating down on 70mg/day) is the disturbed sleep that is f*****g really annoying.
Little better now than on higher dose but anyway i'm dreaming of a full night of 8 hours!!!

So few questions to Gabapentin users:
- does it works the same way on you? Or does it work for you just as a "limiter" of quantity of alcohol?
- from how long you're on it?
- really no SE? this would be great!
- can you make a brief resume of your previous Baclofen therapy (if you tried)?

It seems undoubt that the GabaB deficiency its on the base of different kind of addictions - Baclofen works well too on food addiction and on cocaine because they all "affect" the same receptors... really simplified but kind of...
There is no other med until now that have the same % of good results as Baclofen has but i think is lacking a bit of longer term confirmations (a know lot of cases, yes, but even a lot of relapses...)
Ok, alcohol addiction is a complex subject, we all knows, and the "physical" side is just one of this.

Maybe Gabapentin is the next one, maybe better than Baclofen???
Maybe used together they can give a better results than used alone?
I really would like to see a clinical trial not with placebo but a "face to face" with this 2 medicaments (or Baclofen vs something else)...
Would be great.

Wait to read more (i'm going to Pubmed to read a bit about results of this query "Gabapentin and alcohol" ;-)