Neurontin: Two Questions

[muddywaters]

Hi "Gang". I have two questions that I hope can be answered. Thank you.

1. I feel like a zombie on 1800 mg. I am stupider and bump into things where I used to be coordinated/nimble. Will this "Morontin" effect go away in time or must the physician/PA lower my dose. (I need to be cognitively intact in school/life). (I am under the impression that Lyrica too has a "moronic" component and I can't take Topomax ).

2. I am taking Azinza/long-acting morphine sulfate. I was told that this Rx will help my insane, nonstop back pain and diminish my *tolerance* to Azinza that is rather high. I doubted that this Rx meat for neuropathic pain could help discogenic/mechanical back pain but I hope he's right. (I do not understand this in medical terms re: nocioceptive and propriopioceptive [or other?] nerve fibers, eg. the physiology). Not that I need to but I am curious.

Be well people. :thumpup:

ans

[ajj1001]

Hi,
1,I've been on a similar dose for past two years. I had a really bad two weeks when I first started and the dose got ramped up quickly.
I'm not sure whether the side effects (brain fog, bad co-ordination, speech problems) have got that much less or I have got better at dealing with them. I find typing much easier than talking due to the lag that happens from me thinking something to being able to say it. However despite the issues from taking it, it is worth it know I would not cope with the nerve pain otherwise. My co-ordination is good enough to sew and paint.

2. I had the same curiosity as the terminology of pain and did some reading up so it wouldn't all be such gobbledegook. It is worth getting a couple of books and ploughing through them if you are interested. Your brain will definitely hurt from it though.

[dalhousie]

Haven't taken Neurontin before but have taken Lyrica after both my spine surgeries. The first time round I was on a higher dose than 2nd time round. It was pretty tough going with the zombification side effects for 10-14 days but once I got through that period I was OK & enjoyed the benefits of pain relief.

[muddywaters]

Thank you Two Brits for your answers/help. I can't stand it when I can't say what I mean and there's a dumb silence. It makes my fiancee' crazy and scared e.g. what happened to the relatively intelligent guy she's been with for years. I mean freaked-out.

I guess the adaptation responses are different for everyone and w/give this a two-three week trial. I cannot function in school like this.

I do note weird mood changes, albeit subtle.

Hoping you "guys' feel 100% again; appreciate your time. Alison: I hope you get fused soon (wow, ADR fusion in situ) and Ruth, you're to young for this and I hope that your ADR is successful forever.

Best - ans

[Kokanee]

I was put on Neurotin to see if it would help diminish the pain in my neck. Unfortunately I reacted rather strongly to it; I was alert and didn't have the "zombification" most people complain about, but I did experience alarming and severe memory loss.

It got bad enough that I had to stop taking it as it was affecting my work quite a bit.

[SemperFi]

1. NOCICEPTIVE PAIN - Examples include sprains, bone fractures, burns, bumps, bruises, inflammation (from an infection or arthritic disorder), obstructions, and myofascial pain (which may indicate abnormal muscle stresses).
Nociceptors are the nerves which sense and respond to parts of the body which suffer from damage. They signal tissue irritation, impending injury, or actual injury. When activated, they transmit pain signals (via the peripheral nerves as well as the spinal cord) to the brain. The pain is typically well localized, constant, and often with an aching or throbbing quality. Visceral pain is the subtype of nociceptive pain that involves the internal organs. It tends to be episodic and poorly localized.
Nociceptive pain is usually time limited, meaning when the tissue damage heals, the pain typically resolves. (Arthritis is a notable exception in that it is not time limited.) Another characteristic of nociceptive pain is that it tends to respond well to treatment with opioids.
2. NEUROPATHIC PAIN - Examples include post herpetic (or post-shingles) neuralgia, reflex sympathetic dystrophy / causalgia (nerve trauma), components of cancer pain, phantom limb pain, entrapment neuropathy (e.g., carpal tunnel syndrome), and peripheral neuropathy (widespread nerve damage). Among the many causes of peripheral neuropathy, diabetes is the most common, but the condition can also be caused by chronic alcohol use, exposure to other toxins (including many chemotherapies), vitamin deficiencies, and a large variety of other medical conditions--it is not unusual for the cause of the condition to go undiagnosed.
Neuropathic pain is the result of an injury or malfunction in the peripheral or central nervous system. The pain is often triggered by an injury, but this injury may or may not involve actual damage to the nervous system. Nerves can be infiltrated or compressed by tumors, strangulated by scar tissue, or inflamed by infection. The pain frequently has burning, lancinating, or electric shock qualities. Persistent allodynia, pain resulting from a nonpainful stimulus such as a light touch, is also a common characteristic of neuropathic pain. The pain may persist for months or years beyond the apparent healing of any damaged tissues. In this setting, pain signals no longer represent an alarm about ongoing or impending injury, instead the alarm system itself is malfunctioning.
Neuropathic pain is frequently chronic, and tends to have a less robust response to treatment with opioids, but may respond well to other drugs such as anti-seizure and antidepressant medications. Usually, neuropathic problems are not fully reversible, but partial improvement is often possible with proper treatment.


Proprioception: The ability to sense stimuli arising within the body. Even if you are blindfolded, you know through proprioception if your arm is above your head or hanging by your side. The word "proprioception" was coined in 1906 by the English neurophysiologist Charles Sherrington who received the Nobel Prize for Physiology or Medicine in 1932 for research on the function of the neuron and study of reflex action.

Definition: Proprioceptors are specialized sensory receptors on nerve endings found in muscles, tendons, joints, and the inner ear. These receptors relay information about motion or position and make us aware of our own body position and movement in space. Proprioceptors detect subtle changes in movement, position, tension, and force, within the body.


The proprioceptors of the musculoskeletal system are found in the tendons and in the muscle fibers. These proprioceptors include:

• Muscle spindles (stretch receptors). These are the primary proprioceptors in the muscle that are sensitive to changes in muscle length.
• The golgi tendon organ. This proprioceptor in the tendon near the end of the muscle fiber is sensitive to changes in muscle tension.
• The pacinian corpuscle. This proprioceptor is responsible for detecting changes in movement and pressure within the body.

How Proprioceptors Protect Us From Injury
In addition to providing information about the movement and positioning of our body, head, arms and legs, the proprioceptors can trigger certain protective reflexes. The "stretch reflex," for example, is activated when the proprioceptors sense too much stretch or force on a muscle or tendon. To resist an unsafe change in muscle length that may lead to a torn muscle or tendon, the reflex causes the stretched muscle to contract, shorten and protect the muscle or tendon from injury.


Allan~ just a bit of googling, cutting and pasting. Tho must admit that reading more in depth explanations of all this brought back fond memories of years of studying back in the day when I actually think and remember/recall information!!!

At first you may sound and feel drunk on this medication... a clumsy bumbling tripping near stuttering slobbering fool however after some time you may adapt. In my case the pain relief far outweighs the inability to think more clearly yet I do miss this aspect of my life however my neuropathic pain was just far too severe and diffuse to turn away from using something that worked so well for me.

[muddywaters]

Thank you Semper Fi! You rock!

Ahh, now I can sort these terms out.

I'd like to understand why and if Neurontin can help with nocioceptive pain.

I had a positive response to a facet injection where I felt no back pain which struck me as totally weird as years ago, the injection did not work and that drill-bit nonstop pain was there (S-1 to L-5 positive to discogram). So I wonder if the pain is all or now mostly neuropathic pain from the facets - which would be a mindblower as it's like a blow torch when not medicated.

Just curious. Thanks again!

My best, m

[Justin]

Thank you Semper Fi! You rock!

Ahh, now I can sort these terms out.

I'd like to understand why and if Neurontin can help with nocioceptive pain.

I had a positive response to a facet injection where I felt no back pain which struck me as totally weird as years ago, the injection did not work and that drill-bit nonstop pain was there (S-1 to L-5 positive to discogram). So I wonder if the pain is all or now mostly neuropathic pain from the facets - which would be a mindblower as it's like a blow torch when not medicated.

Just curious. Thanks again!

My best, m

Hi Ans,

Neurontin is not indicated for nociceptive pain. Nociceptive and neuropathic pain are mediated by two different physiological processes.

Nociceptive pain responds well to NSAIDs and opioids. However, long-term therapy on both are undesirable.

Pain from your facets would be neuropathic in nature. If your facet injection helped in the past, have you thought about working up your facets at multiple lumbar levels, and if positive, pursue facet ablation?

Good luck.

[SemperFi]

Justin,
I've been using Neurontin since 1998 and even with all the surgical consults I had back in 2000-2006 I was told that I would likely need to remain on the Neurontin or a drug like it for the rest of my life. Now I'm sure no one really knows if that is true or not however so far the drug seems to still work very well for me so I continue my 1800mg dose/day.

I've asked my PM if I should get off it or try Lyrica but he says if it works for me why would I want to switch and apparently it does very work very well for me at least to date. I have tried weaning myself off the Neurontin but the pain was incredibly severe so after a few days I went back up to my regular dose and all was good re blissfully obliterating the horrible burning diffuse burning pain felt in lower extremities bilaterally.

Benefit outweighs risk at this point I guess and all labwork is good to date as well.

[WPKat]

Justin,
I've been using Neurontin since 1998 and even with all the surgical consults I had back in 2000-2006 I was told that I would likely need to remain on the Neurontin or a drug like it for the rest of my life. Now I'm sure no one really knows if that is true or not however so far the drug seems to still work very well for me so I continue my 1800mg dose/day.

I've asked my PM if I should get off it or try Lyrica but he says if it works for me why would I want to switch and apparently it does very work very well for me at least to date. I have tried weaning myself off the Neurontin but the pain was incredibly severe so after a few days I went back up to my regular dose and all was good re blissfully obliterating the horrible burning diffuse burning pain felt in lower extremities bilaterally.

Benefit outweighs risk at this point I guess and all labwork is good to date as well.

I have the same experience with Neurontin (Gabapentin) as you, SemperFi. I tested it's effectiveness (not on purpose). Because of all the medications I was on and some unpleasant side effects I was experiencing, I decided to wein myself off of it (along with a few other meds) for two months. I started to wake up once again in the middle of the night with severe pain in both my legs - often ... every hour on the hour. It got to the point where I could not go back to sleep without taking additional pain medication and/or muscle relaxer, and even then I woke up frequently. The lack of sleep increased my pain the following day. I was exhausted and in a boat load of pain. I decided to start taking the Gabapentin again over a week ago. I was so incredibly grateful when the leg pain subsided enought at night to where I was able to get a decent night's rest.

In 2008, my urologist started me on 300 MG of Gabapentin at night because of bladder pain. Once my back problems were finally diagnosed, my pain specialist bumped it up right away to 1200 MG, then later to 1300 MG a day. I knew she was planning to increase it again when I decided to wein off of it. Although initially it was a low dose, it really didn't seem like such a big adjustment (300 MG to 1200 MG). Other than being a little tired when I first started taking it, I did not and still do not suffer from any other side effects. From my past experience, I know it won't take long for my body to adjust to it to where I will no longer feel tired when taking it. I guess I lucked out for once.

There is no doubt in my mind that Gabapentin works for me and I am going to keep taking it. Although it does not help with all of my relentless radiating and intense aching back and leg pain, it sure helps calm things down so I can sleep at night.

K