Gabapentin: Return of side effects

In October 2020 I began taking low dose Gabapentin - 200 mg - in an attempt to address chronic insomnia. The insomnia is a lifelong problem that was addressed by Clonazepam, which I am now discontinuing. For the first couple of weeks on Gabapentin I experienced the good - improved sleep - with the bad - headache and nausea. The next few weeks were great, side effects subsided and sleep was improved. Unfortunately, the sleep benefit from 200 mg Gabapentin didn't last beyond those first few weeks. The plan had been to increase to 300 mg, so that's what I did a couple weeks ago. There was no increased sleep benefit this time, but there was an increase in the side effects of headache and nausea. After just 3 days I went back down to 200 mg, b/c with holidays approaching I didn't want to feel sick through the whole time. So here I am at 200 mg Gabapentin, and curiously the side effects of headache and nausea, which had subsided completely on this dosage, are back. Why? I'm taking a tiny dose, all side effects had subsided - unless these are Clonazepam withdrawal symptoms, which I have a hard time believing since the only symptoms I've felt during my very slow taper are worsening insomnia and, if its even a side effect, a burning tongue. So strange. I haven't made any Clonazepam reductions in 2-3 weeks. Any ideas about the nausea and headache? I know people who take 10 times the amount of Gabapentin and do not have these side effects.

thanks, Laura

 

I don't know much about gabapentin, but I've read from other members that it's best not use it more than twice a week to avoid developing tolerance.

There's always a possibility that a drug will have paradoxical effects. They don't affect everybody the same way. In fact, they don't even affect the same person in the same way on different occasions, a lot of the time. Out of all classes of drugs, benzos tend to have a fairly uniform effect on people relative to other drugs. But even then, there are a minority of people who have drastically different experiences.

 

There are a few things counting against you this time. First, your nervous system already being sensitized due to the clonazepam cuts you have made makes it harder still to predict how you'll respond to introducing a new med. Second, unlike benzos, gabapentin is well renowned for having quite a wide range of possible side effects that differ from person to person. Some people really agree with it and some people absolutely hate it. Finally, 200mg and 300mg are tiny doses. You will notice the effect and if you take it in the evening it will help you sleep but in terms of masking benzo withdrawal symptoms, I don't think it's going to do that. All of that said, I wouldn't recommend taking enough to mask your benzo withdrawal symptoms. It's really quite a toxic drug and no solution at all to insomnia (IMO). If you did want to go this route, though, 300mg three times a day instead of just once is more likely to work.

 

Personally, I'd drop it while you still can if it's making you feel that way. But then, I don't think meds are a good way to go in general, so there's that. I think eventually you'll come to realise that the best way is to get off all your meds in a measured way, mind your health and tough it out for however long it takes to function normally. If you work hard at this, you may find over the long run that sleep is easier to come by. The main reason people get insomnia is due to lifestyle factors... including the choice to take medications that disrupt sleep. It might take upwards of a year or more of terrible sleep before things level out but your life will be better. Juggling drugs for sleep is not a good way to be. It seems like admitting defeat to me. Even if you get longer sleep, the quality of it is terrible. It's also not the only way they are terribly unhealthy.

 

I'm sorry if my suggestion isn't welcome. It's just that I'm not at all surprised by the issues you're having with it and I don't think it's wise to try and force it anymore. If you can get it to work for you, it's still not worth it, because at best it'll buy you a few more years before you have the same problem. Except then you'll be in worse condition than now for having taken the drug for longer. I think you'd be far better dropping the gabapentin completely and holding your clonazepam dose where it is until you start to feel a lot better than now.

 

I'm sorry you struggle with sleep. I know how it can create despair but the lack won't kill you. I want you to know that.

Thanks for feedback. Unfortunately, when I'm so sick from sleep deprivation that I can't think or function, the fact that it won't kill me is of little comfort. It actually feels like it's slowly killing me. Insomnia has affected my physical, emotional and social health profoundly.

I too would rather not be taking any medication; it was desperation that motivated me to take Clonazepam. And why is it that when we have a known physical illness like thyroid or heart disease there are very well studied and effective medications we're told we'd be foolish not to take, but when it comes to something as vital as sleep, and we are born with something that does not allow us to get what we need, we're encouraged to toughen up, control our thoughts, learn to live with it. The lack of medications to treat serious soul crushing life altering primary insomnia is shameful. Anyway - I do wonder if taking so much less Clonazepam than I once did has an effect on the way I handle other medications, which is almost always poorly. 300 mg 3 times a day? haha I could barely function on 300 mg one time a day. I agree I should probably stop taking Gabapentin before my body gets dependent on it, if it hasn't already in 3 months.

I don't know that anyone has worked harder than I have to overcome my trouble with sleep, my whole life! Just in the past 18 months I have consulted with specialists at a sleep clinic, had cognitive behavioral therapy for insomnia, retired several years early, tried multiple meds, herbs, supplements, etc.

I thought I finally had something when I began to sleep normally after initiating Gabapentin, but it was ultimately just another dead end that has left me feeling sick and deeply disappointed. I disagree passionately that insomnia is due to lifestyle choices. I was born with it, so I'm told, and my earliest childhood memories involve not being able to sleep all night and feeling sick all day because of it.

Since I'm only taking 200 mg, I plan to drop down to 100 mg tonight and see if any improvement is noted in my head and stomach.

I think holding Clonazepam for now is a good idea. Thanks

 

 

Now I don't know what to do because I'm seem to be out of options.

 

I'll add that I agree it is no consolation that lack of sleep won't kill you. I don't even think that's true.

Narcoleptics are on Xyrem for life, dependency on it doesn't appear to create tolerance to its effects.

Two nights ago I decreased Gabapentin from 200 mg to 100 mg, nausea and headache were gone yesterday. Last night I took 100 mg again. Multiple soaking night sweats woke me so many times that sleep was a bust. (Coincidentally, I had noticed that the night sweats I have experienced off and on for years largely went away upon initiating Gabapentin, and they are back as never before upon reduction) Today has been spent in what I call a "hit by a truck" state of extreme zombie brain, headache, digestive distress, crippling fatigue. So it's a damned it I take it and damned if I don't take it right now. I would be very hesitant to take Seroquel, as it acts as antihistamine. Mirtazapine and Hydroxyzine also act as antihistamines, and they both made me feel very sick for the short time I took them. Ironically, the only med that helps with sleep and doesn't make me sick is Clonazepam, and that is the one med I am told will hurt me in the long run with respect to balance and cognition. So a doctor will give me carte blanche to all these other extremely toxic drugs which totally mess with my balance and thinking, but same doctor tells me Clonazepam is bad for my long term health. In my efforts to get off Clonazepam I have effectively destroyed my physical/social/emotional health. I just don't know what to do any more. For those considering Gabapentin, do your research, but also be aware that this is just me with all this trouble on a baby dose - my sister takes at least 2000 mg per day for spinal pain and has no side effects, only relief.

I'll probably stay with 100 mg until I talk to my doctor next week about stopping altogether. Because it's an anticonvulsant you do have to be careful about discontinuing.

I had a horrible time stopping gabapentin!  I did also stop it too quickly and at too high of a dose(per doctors orders). I think that medication is the devil!  The gabapentin withdrawal is horrible!!!!

A few years ago, I was given Gabapentin for perh neurophathy pain in both wrist for what turned out to be misdiagnosed carpal tunnel syndrome, for close to 1 year.  My doctor said to stop it abruptly, once I had surgery to correct my wrist. Within a day or so, I had increased anxiety and panic.    I wondered what could be going on and did internet research.  Well, it was the Gabapentin.  I had to call my now fired doctor  and suggest that abrupt stopping this drug might be causing my symptoms.  He apologized and said, he didn't "think about that".  I went back on it and tapered off in 3-4 months.  Not to scare you, but provide my experience as information.

 

I personally will never take it again. (or any meds if possible, unless I do research first!).  I know it has worked for several people here at a variety of dose levels.

 

Please be mindful, informed and careful 

Thanks for feedback. Unfortunately, when I'm so sick from sleep deprivation that I can't think or function, the fact that it won't kill me is of little comfort. It actually feels like it's slowly killing me. Insomnia has affected my physical, emotional and social health profoundly.

I too would rather not be taking any medication; it was desperation that motivated me to take Clonazepam. And why is it that when we have a known physical illness like thyroid or heart disease there are very well studied and effective medications we're told we'd be foolish not to take, but when it comes to something as vital as sleep, and we are born with something that does not allow us to get what we need, we're encouraged to toughen up, control our thoughts, learn to live with it. The lack of medications to treat serious soul crushing life altering primary insomnia is shameful. Anyway - I do wonder if taking so much less Clonazepam than I once did has an effect on the way I handle other medications, which is almost always poorly. 300 mg 3 times a day? haha I could barely function on 300 mg one time a day. I agree I should probably stop taking Gabapentin before my body gets dependent on it, if it hasn't already in 3 months.

I don't know that anyone has worked harder than I have to overcome my trouble with sleep, my whole life! Just in the past 18 months I have consulted with specialists at a sleep clinic, had cognitive behavioral therapy for insomnia, retired several years early, tried multiple meds, herbs, supplements, etc.

I thought I finally had something when I began to sleep normally after initiating Gabapentin, but it was ultimately just another dead end that has left me feeling sick and deeply disappointed. I disagree passionately that insomnia is due to lifestyle choices. I was born with it, so I'm told, and my earliest childhood memories involve not being able to sleep all night and feeling sick all day because of it.

Since I'm only taking 200 mg, I plan to drop down to 100 mg tonight and see if any improvement is noted in my head and stomach.

I think holding Clonazepam for now is a good idea. Thanks

I'm sorry you're hurting. Please don't think that I don't understand the nature of your suffering. For all I said, lack of sleep is horrible and I know the despair that it can bring.

 

I do think that you have some misunderstandings that are helping you back, though. The idea that people with heart issues and thyroid problems and the like just get put on a med and are sorted for life is simply not the reality. People who take thyroid medications have all kinds of issues and side effects to contend with, often developing mental health conditions. Someone I know very well is medicated for a thyroid issue and it's really not pretty sometimes.

 

Similarly with heart conditions. The medications are dirty as hell and cause all kinds of complications. People get swapped from one med to another when something safer comes along, because they're not so great for your health. It's BS that you'd be foolish not to take them. If you're not motivated to make real lifestyle changes to improve your health, then yes you had better take the med. But such as high blood pressure, get some exercise, cut out sugar, do breathing exercises, take cold showers, etc. Stuff that nobody wants to do but which can significantly improve help including bringing blood pressure into the normal range. You're told to take the med because the companies that make the pills fund the schools that teach the doctors how to treat conditions. Pills, pills, pills! This is how the world works.

 

"we are born with something that does not allow us to get what we need, we're encouraged to toughen up, control our thoughts, learn to live with it."

 

This mindset is not helping you at all. You were not born as an insomniac. It doesn't work like that and it's harmful to think it because then it becomes a part of who you are. Maybe you are aware that you didn't sleep well as a child and that is what makes you think it's just who you are? If that is true, then the cause of your insomnia is probably rooted in childhood trauma. I don't mean that someone did something bad to you, it's pretty normal to have unprocessed trauma from childhood. It's just the nature of human beings.

 

What I'm trying to help you see is that you wanting there to be a good medication for sleep doesn't make it so. You're on a quest to find something that doesn't exist and all these attempts at treatment are contributing to the issue more than you probably realise. But your doctor isn't going to tell you about the dangers of going on and off, up and down different meds. By your own account, you took clonazepam is desperation and it didn't work out in the end. That was predictable. Taking gabapentin is going further down that road. It ends in tears, I am sorry. So I'm offering you the view that the torture of doing the hard yards to get off this junk is better than trying to juggle meds that are hardly effective. At least then you can have some hope. I think you're searching for something that deep down you know not to exist.

 

You can perpetuate the cycle of broken, drugged sleep with all the daytime side effects of these meds to boot... or perhaps you can remember a day when you didn't have to deal with that BS and do what it takes to get back to that. I'm sorry if I seem unsympathetic, it's not like that. I just recognise in your struggle elements of what I have been through and I want to help you to get out of it, rather than digging in deeper. My suggestion is not that you endure little sleep forever but rather just for the amount of time it takes to stabilise and normal nerve functioning to return. It's not about whether it's fair or unfair to go through this, I just think it's the right thing to do for the sake of your happiness and health.

 

I hope you're alright and I won't push my argument any further. I think you are stronger than you allow yourself to believe, though. I doubt you really need to depend on a med, it just seems too normal 

You said you had a sleep study done, correct?  What were the results?

diaz-e-BAM: If you're anticipating a big thank you for trashing every single thing I wrote, not gonna happen. I am in serious distress here. I was under the impression that this is a place to interact with others in benzo recovery in kind of a safe and welcoming space. Guess I was wrong.

If that was some kind of tough love you fancy you gave me in that missive, that is not at all the way it came across. It came across as an attack, and I resent it. Very much. This is the second, and last, time I've come to this site in a bad way looking for some simple advice and got a lecture about everything that's wrong with what I'm thinking and doing. I need that crap right now like I need a hole in the head. So I'm done here. I can make myself feel terrible all on my own, don't need a so-called sympathetic listener to do that.

I do think it's time to give up the gabapentin, for what it's worth. If it was consistently improving sleep, without side effects, I most definitely would take it, indefinitely. Because I'll tell you what, I will not live as I am for several more years. I'm not living, I'm existing, and that's not acceptable to me. I'm getting to a place where I'd prefer the alternative.

 

But before I go, I'd like to clear up a couple of things I wrote that may not have been crystal clear. I did not mean to suggest that folks with heart or thyroid disease simply have to go on a pill and they're good for life. Certainly one has to be continually monitored and adjustments made or meds changed if and when better ones come along. I didn't think I suggested one pill would sort someone out for life. I've had thyroid disease myself for many years and have taken a med for it most of those years. I decided for a while that I didn't need to take the med because I wasn't feeling any effect. A blood test revealed my thyroid function was far worse than it had been, and it was my doctor who said to me I needed to get back on the med and continue taking it. Period. No, I don't always do what my doctor tells me to do just because she's a doctor. But serious thyroid disease is not really something you adequately address through lifestyle, as I have addressed a cholesterol concern through strict diet, daily 6 mile runs and weight lifting. It worked, but guess who can't even run these days with this sleep deprivation and muscle soreness. I don't need a lecture about healthy lifestyle choices. I do think there is a place for both lifestyle and med approaches to health woes. My point was that I find it very frustrating that there are appropriate pharm. approaches to a host of serious physical ailments, but for sleep deprivation, not so much. And who are you to tell me that I was not born an insomniac?! Were you there? My mother was there, and she told me I didn't sleep as an infant, and I remember not sleeping as a very young child. It has in fact been a problem my whole life. No trauma. I was born that way, and it is a part of who I am. I don't care if you believe that or not, it's my reality. I didn't come here to have the very facts of my life doubted.

By by own account I did take clonazepam out of desperation, after a lifetime of not sleeping and a demanding profession that required someone more than a zombie. I asked my doctor for help, and clonazepan is what I got. And I slept. No side effects. My sleep for once in my life was not broken. I was at peace. I am where I am because I have been told I should stop taking the only thing that ever helped me, because it's bad for me. So that's what I am doing. Like where I am right now isn't bad for me. "That was predictable"?? Your language is SO condescending!! Your message gives no hope, it borders on pompous. So you ripped me a new one and now you hope I'm alright?? I couldn't be further from alright. You won't hear from me again, but in the future, may I suggest for others' sake that you put on some kid gloves. This isn't about the argument, for God's sake! It's about asking for and receiving compassionate words of caring and help and advice. You have done none of that.

Trade, so in my opninon, you should adress one thing at the time , probably by tapering clonazepam you Will find distress, problems to sleep, etc, If you are aware of some sort of drug that helps your overall condition adressing your WD From benzos , you should keep on It until your main problems related tô your benzo WD , when you reach a better place in subject of benzo WD you could adress the other drug(s) , If your Willing to stop them later its your choice  , If your not willing to quit them after the benzo WD , then stick with It, with any drug, to stop any drug the best thing is to do is to Go Very slowly, they can give you withdrawals , any psych drug can lead you to WD, they can be disturbing tô quit , probably its not the same of WD From benzos, IM aware of WD From ADs for my own( its not good for me) but its not as bad i cant compare as a benzo WD ... Other drugs like im on like pregabalin ( similar to gabapetin) have some bad side effects of WD , so If my Will after some time recovering From benzos, be to stop , i Will do It Very slowly, but probably i Will take It for years until i feel more prepared,  and a year more to taper . Do what you can , do your researchs , and find the best option you can to handle your benzo WD , again this is only my opninon and the drugs i found for relief, i found by trials .. its my experience, IM not advising you to take something or not to take, this is something each person must to choose by himself

diaz-e-BAM: If you're anticipating a big thank you for trashing every single thing I wrote, not gonna happen. I am in serious distress here. I was under the impression that this is a place to interact with others in benzo recovery in kind of a safe and welcoming space. Guess I was wrong.

If that was some kind of tough love you fancy you gave me in that missive, that is not at all the way it came across. It came across as an attack, and I resent it. Very much. This is the second, and last, time I've come to this site in a bad way looking for some simple advice and got a lecture about everything that's wrong with what I'm thinking and doing. I need that crap right now like I need a hole in the head. So I'm done here. I can make myself feel terrible all on my own, don't need a so-called sympathetic listener to do that.

I do think it's time to give up the gabapentin, for what it's worth. If it was consistently improving sleep, without side effects, I most definitely would take it, indefinitely. Because I'll tell you what, I will not live as I am for several more years. I'm not living, I'm existing, and that's not acceptable to me. I'm getting to a place where I'd prefer the alternative.

 

But before I go, I'd like to clear up a couple of things I wrote that may not have been crystal clear. I did not mean to suggest that folks with heart or thyroid disease simply have to go on a pill and they're good for life. Certainly one has to be continually monitored and adjustments made or meds changed if and when better ones come along. I didn't think I suggested one pill would sort someone out for life. I've had thyroid disease myself for many years and have taken a med for it most of those years. I decided for a while that I didn't need to take the med because I wasn't feeling any effect. A blood test revealed my thyroid function was far worse than it had been, and it was my doctor who said to me I needed to get back on the med and continue taking it. Period. No, I don't always do what my doctor tells me to do just because she's a doctor. But serious thyroid disease is not really something you adequately address through lifestyle, as I have addressed a cholesterol concern through strict diet, daily 6 mile runs and weight lifting. It worked, but guess who can't even run these days with this sleep deprivation and muscle soreness. I don't need a lecture about healthy lifestyle choices. I do think there is a place for both lifestyle and med approaches to health woes. My point was that I find it very frustrating that there are appropriate pharm. approaches to a host of serious physical ailments, but for sleep deprivation, not so much. And who are you to tell me that I was not born an insomniac?! Were you there? My mother was there, and she told me I didn't sleep as an infant, and I remember not sleeping as a very young child. It has in fact been a problem my whole life. No trauma. I was born that way, and it is a part of who I am. I don't care if you believe that or not, it's my reality. I didn't come here to have the very facts of my life doubted.

By by own account I did take clonazepam out of desperation, after a lifetime of not sleeping and a demanding profession that required someone more than a zombie. I asked my doctor for help, and clonazepan is what I got. And I slept. No side effects. My sleep for once in my life was not broken. I was at peace. I am where I am because I have been told I should stop taking the only thing that ever helped me, because it's bad for me. So that's what I am doing. Like where I am right now isn't bad for me. "That was predictable"?? Your language is SO condescending!! Your message gives no hope, it borders on pompous. So you ripped me a new one and now you hope I'm alright?? I couldn't be further from alright. You won't hear from me again, but in the future, may I suggest for others' sake that you put on some kid gloves. This isn't about the argument, for God's sake! It's about asking for and receiving compassionate words of caring and help and advice. You have done none of that.

It was predictable that long term benzo use wouldn't work out in the end. It's literally the reason why we're talking on this thriving online community called Benzo Buddies. It's not an attack on you, it's just how it goes. It's predictable because it is not in your power to guarantee a long term supply and in any case, they often become ineffective after a period of time. It could be after just a few months, like in my case. Or, they may become ineffective after a period of several years. I didn't mean that it was predictable to you, with the information that you had available. I meant that it was predictable because what happened to you is a common occurrence. And I would point at that I started taking benzos in desperation too and they worked great for me too for some time.

 

I'm sorry that you didn't like my suggestions. I'm not often accused of lacking compassion and I accept that my timing was probably off. I try to give my honest opinion based upon my experiences. Gabapentin exaggerated my symptoms of anger/rage when I was withdrawing from benzos. It improved my mood and made me sleep more but the trade off wasn't worth it. If you don't want to see a full range of views, then posting on an open forum might not be for you. If you don't want to see posts like mine, then perhaps it would be a good idea to state that you're only interested in talking to people who agree with you.

 

FYI I didn't have any expectation of receiving your thanks. I anticipated that perhaps it wasn't exactly what you'd want to hear and tried to explain where I was coming from. I hadn't accounted for being received quite as poorly as I was and for that I apologise. I don't know what it's like to have suffered with insomnia to the extent that you have and to the extent that I have been insensitive, that would be why.