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Neurontin (gabapentin) was originally an anticonvulsant medication but now sees use in several areas:

• As a preventive treatment for certain types of seizures;
• As a pain relief treatment in neuropathic pain;
• Numerous off-label uses.

The medication is typically used long-term and is generally well-tolerated, with most side effects being mild and transient. Children between 3 and 12 years of age are somewhat more likely to experience mood-altering side effects. It is also safe for use in elderly patients, provided there is no significant renal impairment.

Neurontin as an Anticonvulsant

The medication may be used as a preventive treatment for epilepsy. Treatment is similar in all cases:

• Most patients are started on 900 to 1800 mg per day.
• Each daily dose should be divided into 3 smaller doses.
• Daily doses may be increased up to 2400 per day if lower doses do not produce good results.
• Rarely doses may increase to 3600 mg per day; do not exceed this amount.
• Time between doses should be at least 4 hours apart but not be more than 12 hours apart.

It may take several weeks for Neurontin to start producing a noticeable reduction in seizure frequency. The medication is not effective for everyone; if improvements are not noticed after several weeks of use, speak with a doctor about alternative therapies.

When Neurontin has been used long-term patients should be gradually tapered off if treatment ends, taking progressively lower doses over the course of several weeks. If other anticonvulsant medications are added or removed during treatment with Neurontin, this should also be done gradually to ensure no serious adverse reactions develop.

Neurontin for Pain Relief

Neurontin is only effective in certain types of pain; i.e., neuropathic pain, or pain caused by damage to the somatosensory system. The most commonly treated conditions are:

• Postherpetic neuralgia
• Central neuropathic pain
• Diabetic neuropathy

Treatment is similar in most cases, though duration of treatment may vary widely:

• On day one, a single 300 mg dose is taken.
• On day two, 600 mg is taken, divided into two 300 mg doses.
• On day three, 900 mg is taken, divided into three 300 mg doses.
• Dosage may be increased to 1800 mg per day if lower levels are ineffective, divided into 3 doses.
• Treatment may continue as long as needed to manage pain.
• Time between doses should be at least 4 hours apart but not be more than 12 hours apart.

Some patients notice pain relief right away; others may need to take Neurontin for several weeks before significant, lasting effects are experienced. Additional pain management measures may be utilized in the interim.

Off-Label Uses

Neurontin sees increasing use as an off-label treatment, including:

• Menopausal symptoms
• Uremic pruritus in liver failure
• Restless leg syndrome
• Insomnia
• Spasticity in multiple sclerosis
• Anxiety disorders
• Nystagmus
• Migraines

Treatment for the above conditions can vary widely, and use of Neurontin in many of them is controversial. There are no standard dosage & administration guidelines; patients will need to find a doctor or organization familiar with using the product for a particular affliction.

Side Effects

As mentioned above, most side effects are mild and stop occurring as the body adjusts to treatment. The most common side effects include:

• Dizziness
• Drowsiness
• Fatigue
• Appetite loss
• Nausea
• Weight gain
• Peripheral edema
• Mood swings
• Difficulty concentrating
• Hyperactivity

There is some association with anticonvulsant use and depression or suicidal thoughts, though this is disputed by many drug developers. Younger patients under 24 in particular should be alert for, or monitored for, symptoms of increasing depression.

The medication should be used with caution in patients who have liver or kidney problems. Since it may cause drowsiness and mild confusion, patients should not attempt to perform complex tasks until the effects are known. The effects on unborn or nursing babies are unclear; parents should discuss possible risks with a trusted doctor before use.