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Gabapentin (Read 4527 times)
debim
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Gabapentin
Aug 18th, 2009 at 4:32pm
 
I am new to this site and I am so excited to get some feedback.  Has anyone tried Gabapentin for clusters? Did it work?   I was given the prescription but I haven't started it yet.  I didn't get any relief from Topiramate of Indomethacin so I am a little reluctant to try something else!  Thanks!
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Re: Gabapentin
Reply #1 - Aug 18th, 2009 at 5:00pm
 
Gabapentin isn't really a first-line preventative for clusters. I've usually seen it used after the usual suspects are dismissed. I even tried it for about 6 months and all I got was stupid.

Have you discussed verapamil or lithium with your doctor? These would most likely be the first drugs tried as a preventative.
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Bob Johnson
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Re: Gabapentin
Reply #2 - Aug 18th, 2009 at 5:22pm
 
Yes, agree! This class of meds has a very limited track record of testing and I don't see why one should not start with meds with a long record of success, reserving the newer meds as a fall back.
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This approach has wide acceptance; the med effective and safee.

Headache. 2004 Nov;44(10):1013-8.   

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).
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Re: Gabapentin
Reply #3 - Aug 18th, 2009 at 6:41pm
 
I tried neurontin and it did nothing for my ch.  I would recomend lithium, verapamil, combo of both, elavil, zyprexa, oxygen, and imitrex.  But with ch it is a long road of hit and miss of a long line of drugs to find the one that is for you.  Find a good dr knowlegable of ch and start going down the list.  Good luck finding something.
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Karla&&suffer chronic ch &&ch.com groupie since 1999&&Proud Mom of Chris USMC Semper Fi
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Re: Gabapentin
Reply #4 - Aug 18th, 2009 at 9:08pm
 
Since you asked, yes I tried it about 11 or 12 years ago as a part of an attack plan with Verapamil and Indocin.

Ramped up to (4) 800mg doses per day for about 4 weeks and never felt a thing, good or bad. (Stopping this drug while still taking the others didn't change the hits at all)
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Re: Gabapentin
Reply #5 - Aug 19th, 2009 at 8:43am
 
Didn't help me too.It was Neurontin in combination with isoptin the therapy i followed back then.
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Re: Gabapentin
Reply #6 - Aug 26th, 2009 at 7:38am
 
Hi debim.  I tried Verapamil on it's own, but didn't do much, I was up toy 480mg.  I was on that for a few months and nothing else, waiting for it to kick in.. while useing trex/zomig/o2 to abort.  The doc put me on neurontin (gaba) to along with the verap, and it became partially effective for me at (900mg) a day.  I went from about 5/6 hits a day to 1 or 2.  That's where I am now. Topamax (which I was on before the Gaba) was 100% effective for me at 75mg a day but the side effects became too much for me.

While the neurontin is helping, it is very dopey and I am weighing getting off of it and trying lithium or something else.  I feel pretty tired most of the day.  I'm going to give it a full 6-8 weeks to see if I adjust.

Good luck!
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« Last Edit: Aug 26th, 2009 at 7:39am by Joshua »  
 
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