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Gabapentin vs Hydrocodone
Quick background: I've been on Hydro for the last 1.5 yrs with a 2 month break because I moved and also wanted to see if I could deal with the pain. I had a Pain Mgmt Dr(1st 8 months) and now have a general Dr(last 8 months) who wants me to switch from Hydro to Gabapentin. I dont remember the exact diagnosis(spinal strain syndrome & myofascial syndrome sounds familiar) for the pain in my neck and upper back(thanks to car wreck), but MRIs of my entire back and neck show nothing "abnormal". I do know that I had ligaments/tendons torn in my neck. I have tried Ultram, which made me sick and didnt work for pain; percs which actually worked great but in the mornings and whenever it wore off, the pain would be thru the roof. I reread most of my phys therapy reports and never once was pain due to a "nerve" problem reported, yet Gabapentin works only on nerve associated pain.
Has anyone used Gabapentin successfully? If so, for what types of pain?
Hi Siestakeys, I have had the exact same problem as you have. I am no longer on Lortab since I was getting addicted to it and once it wore off, the pain came back instantly! I know exactly what you are going through. I am taking gabapentin right now for pain from spine and neck injuries due to a car accident 4 years ago. I also go to a chiropractor to get my spine and neck realigned. But, the gabapentin has helped my pain immensely and it also helps anxiety. I have had good results with the gabapentin.
Thanks lindbws for the reply. What was your diagnosis from the accident? Do you have nerve damage? How much do you take per day? Rate on a scale of 1-100, with 100 being absolutely no pain, lortab vs gabapentin.
The hydrocodone has not given me "extra" pain when it wears off, only oxycodone. For example, when hydro wears off, my pain goes from a 2 to 5-6; however, with oxy, it goes from a 2 to 8-9. On a 12hr driving trip last year, a friend stole some of my pills before I left and repaid me with oxys cuz I wanted to rearrange his face. Thus, I had to take oxy during the trip but only had a few to last me til my next refill. All I can say is that I could not and did not want to move once we arrived at a hotel cuz my back pain was thru the roof.
I've used Gabapentin 3600mg/day for 9 months now for Postherpetic Neuralgia. All I can say is that it's a very good drug for all types of neuropathy.
Gabapentin and Hydrocodone
I would like to intervein here and say that I have been placed on gabapentin and also take hydrocodone 10/325. I take it to prevent/treat my chronic headaches. I initially was on 300mg of gabapentin/day. One tablet of (10/325) hydrocodone would be good for 4-5 hrs. It killed my pain. I had no headache/migraine. Then I was upped to 600mg 3X/day. The headaches would strike! The hydrocodone would not do pooie for my headaches. I even took oxycodone that my wife currently has and it was like drinking water...nothing. I do think with almost certainty that the gabapentin will help, it is to how much it will help, is the question. I have today attempted to see my neurologist, but he was too busy to see me. I have asked to go back down to my 300 3X/day and for him to prescribe my pain meds, but to this hour of the day I have not got a call. "When they don't call, call them, and when they say they will and do not, show up at their office and demand to see them." Lastly, if that don't work, FIRE HIS ASS ( This means find another Dr.)! Good luck. If you have advise for me please write...finding a good doctor these days is a challenge.
Originally Posted by SiestaKeys
I have used Gabapentin since January15 of this year. I take 3600mg a day. Gabapentin in my case is being used for Postherpetic Neuralgia associated with a bout of shingles back in January. Gabapentin is mainly used for neuropathy (nerve pain), and people who suffer from epilepsy. It has many other uses of which I am ignorant of. I know that it works exceptionally well in a lot of people for RLS(Restless Leg Syndrome). And there are many other conditions in which it works quite well. The strange thing is the medical community does not know how it works, but it does. It somehow blocks the neuroreceptors in the brain from receiving certain electrical signals put out from the affected area in certain conditions. So there ya go, bud. There's a website where you can read up on it : http://www.rxlist.com/script/main/hp.asp Take care.
Off Label Use
I have been through the ringer on this issue. Gabapentin is not FDA approved for use in pain management. Anyone perscribed gabapentin for off label use should do some investigateing (http://www.usdoj.gov/opa/pr/2004/May/04_civ_322.htm). I have had very little results except for some RLS releif. I have never met anyone who has had satisfactory results with this kind of therapy for pain, yet oddly enough the internet is full of anonomous posts on how well it works. It makes me wonder who is actually making these comments, perhaps the drug companies themselves, after all it is much cheaper than all the money they dumped on doctors and hospitals to push this product's off label use.
Do your home work, look for independant studies on these products and remember your doctor is supposed to be working for you, not some sales agent handing out freebees.
I have a multitude of problems. I test positive for lupus, but Dr's don't wanna diagnose it yet, they just check my organs and ana every 3 months. I am diagnosed with fibromyalgia for myofacial pain. I have 4 bulging disc in my back, 1 above and 1 below each shoulder blade, with a fissure @ the right neural foreman. I have degenerative disk disease in my lower lumbar. Currently I'm getting much much worse as my degen disk disease has progressed to begin irritating nerves, especially at L5.
I am 20 male. I stated seeing Dr's around age 16, was on lortabs for nearly 2 years straight on and off with an occasional flexeril script here and there.
After 2 months of lortabs, it did nothing for my pain.
Now I goto pain management. I have been in Fentanyl 25 mcg/hr - 1 patch every 48 hours for 15 months now. It is a miracle drug. Doesn't make you high, and blocks nearly all myofacial & back pain. I take Norco 10-325 up to 6 a day for break-through pain.
All a sudden I started getting terrible, agonizing pain in my right calf / upper ankle, felt like shin splint / bone spurs but my fentanyl + norco + muscle relaxers wouldn't even phase the pain.
I had been on lyrica before, and didn't like it. So my Dr. kept wanting me to try out gabapentin for the foot / ankle pain caused by degen disk disease at L5. I started it almost a week ago. I can honestly say that while my back still hurts at the physical spot of L5, the pain that nearly prevents me from walking at all, or makes me walk like an old man is pretty much completely eliminated within an hour of taking 300mg gabapentin.
So I will vouch, don't expect gabapentin to help with inflammation, bone pain, muscle pain, or anything like that. But if you are actually having pain caused by an irritated nerve which is usually caused by your disk in your back leading to pain elsewhere in the body, in my case my foot / ankle - gabapentin does truly work. It is astonishing that this drug has an incomparably better pain killing / eliminating effect on my nerve pain than does my fentanyl patch + norco + zanaflex + flexeril.
only problem is now I cant pee. which is most likely caused by the nerve just below L5
Originally Posted by Mike VG
That is exactly right, Mike. I also take gabapentin 600 mg/600 mg and 900 mg daily for chronic neck and back pain. I was in a car accident and had an abusive ex. Ive been diagnosed with bulging discs, herniated discs, stenosis, amother other things. Not sure if I have any nerve involvement. But I work for a neurologist and also see a neurologist and that is how they describe it. In simpler terms, they say that it "affects the way that the brain responds to pain", which is basically what you said. It really does help me. Its not like taking a narcotic but it does make the pain bearable.
I, like many of you suffer from chronic pain. I have a L-5 S-1 surgery and it wasn't sucessful. So I had to get on pain management. I started on Oxycontin. It worked ok for a while, but then I began to tolerate it and I was at the highest doseage I could take so they put me on the Duragesic patches. They worked in pairs, but the draw back was the adhesive it left on me everyday. In the summer time, when I sweated, they would stay on. They fell off and I didt know it until they pain came back and reminded me. Then, if I put on new ones, I would run out before the next prescription. When I had to go for three days without the patches, as I ran out before my prescription, I physically went through withdrawels. I became psychotic. My wife said that is the only time is our 29 year marriage, she was scard of me. I finally got the refill and was ok. But I didnt want that to happen again, so I told the pain manament Dr., I needed something different. He put me on Methadone. That did the trick. Now for the interesting part.
This all happened from 2001-2004. Then one day, the nerve that was trapped giving me all the pain issues, either broke or untrapped itself in the scar tisssue.
I was pain free. So I stopped all prescribed and OTC pain meds. Then in 2007,
I reinjured that same area and according to the MRI, it now was worse than before the surgery. The pain wasn't as bad but needed narcotic pain meds. I was put on Darvocet this time. I am now on the maximum I can safely take. 6-a day. 3600mgs of Tylenol for my liver to process. When the liver's limit is 4000mgs a day. But along with the Darvocet, I was put on Gabapentin, 300mg 3x a day. It finished off the pain that the Darvocet could get to. Now for the big story. Gabapentin is cleared for use for seizure type of diseases. Unofficially, it is off labeled for pain management. But, now it is used to treat psychological problems that anti-deprressants can fix. With chronic pain, you are supceptable to depression all the time. So when you have to quit a job, because your back won't allow you to perform tasks, you get depressed. I DID! Deep depression. I tried almost every Anti-Depressant on the market. NO RESULTS! My friend that is Bi-Polar, who keeps up on the latest meds for said, Gabapentin has been used to treat depression that was Anit-Depressant resistant. WOW, I thought. So I self medicated myself and doubled my doseage of Gabapentin, which was in the normal relm for treatment of Bi-Polar, Uni-Polar, and other related psychological problems. with in TWO WEEKS, I stared to emerge from my depression. Within a month, I was back to my oldself, THAT WAS PRIOR TO MY BACK INJURY THE FIRST TIME. I had no idea that I was so chemically depressed for so long in my brain. Now I feel very well, pain only if I forget to take my Darvocet as prescribed and the Gabapentin. When you feel well, your endorphines help out with your mood and pain relief. So the Gabapentin, put me back to my oldself, I felt good again, as I didn't even know I felt that bad. By feeling very well, my own body system is helping to keep the pain down and me psychologically sound. I went back to work and then, went to work in Afghanistan, and now Iraq. The entire USA community needs to understand, that people who are injured and as a result, have to be on narcotic pain medications and related prescriptions, are not drug addicts, or addicted to painkillers. There is a huge diffference. The people that get the narcotic painkillers and use them to get high, a break the law in getting those painkillers, to feel the high, are the ADDICTS. The people who are injured and have to take the pain medication to ease or kill the pain, are DEPENDANT. That is not an ugly word. We depend on the painkillers, to relive our pain, first and foremost. When we are pain free or its at an acceptable level where we feel like we can get up, we depend on those drugs to give us our quality of life back! Most of us have painkillers left over at the end of the month, as we sometimes forget to take our medications, when we are feeling well. When we feel well, we work, play, go out, rejoin society, sleep better, and many other things we did, before the injury. We didn't choose to take painkillers, painkillers chose us, as a result of an injury or disease. We prefer not to put chemicals in our bodies. But we have to, so that we may get back or keep our quality of life as we knew it, before the painkillers. Do we, or can we, become addicted to painkillers? YES. If, you have an addictive type personality. Now the body can be addicted, while the mind isn't. They way to know is, Stop cold turkey, of taking the painkillers, and see how your body reacts. It should probably show some signs of withdrawels.They will be only physical reactions and not menntal. Naturally the best way to get off painkillers or any drug of that type, is to taper down, over 2-3 weeks or as prescribed by doctor.
So there it is. Gabapentin is not a painkiller in itself. While in lower doseages, as an adjunct to narcotic painkillers, it works on the central nervous system in ways they really don't understand. In high doseages, under 4500 mgs, with the average being aroiund 2000 mgs for psychological issues, it works very well alone. It is my belief, that the Gabapentin, works on the brains signalling receptors that are low on the chemicals it needs, to fire or send signals properly. When it gets the receptors firing corrrectly, we feel better. Then our body then helps fight the pain, along with the narcotic painkillers. The painkillers then become more effective in managing the pain. Thus, less pain or no pain, results in us feeling normal again. And isn't that what we all want back?????????
Ooops. I didnt preview the above post. I left off the n't off some of the words and misspelled a few. Forgive me, im trying to get ready to leave again for Iraq.
So I have tried NSAIDs, muscle relaxants, anti-depressant and physicall therapy for my neck. I had reconstructive surgery on my neck and fused 6-7 my doctor wants to put me on gabapentine but the side effects seem like a lot and I have a weak stomach because the last medication I got gave me an ulcer so should I try the medication or go to narcotics honestly I don't want to take anything but it's starting to effect my work and my moods and i have to get a hold of this