It’s not exactly a drug commonly used in anxiety treatment but is nevertheless considered a good option to tackle anxiety, coupled with bipolar disorder. Neurontin, the brand name for Gabapentin, is seen to work quite well in the alleviation of anxiety symptoms in those suffering from bipolar condition. So it’s not really a medicine for bipolar disorder; rather, it’s a drug that’s well suited to minimize the anxiety related symptoms that are usually seen in bipolar disorder patients.
Medically speaking, Gabapentin is an anticonvulsant which has no chemical relationship with any other anticonvulsant medication or with drugs that regulate the mood. Interestingly, in fact, the drug’s original use was in prevention of epileptic seizures. Its transformation from an anti-epilepsy drug to an anti-anxiety drug for those with bipolar disorder came much later. But, despite its accepted use in treating anxiety symptoms linked bipolar disorder, Neurontin is not approved by the US Food & Drug Administration (FDA) for this use. The FDA approved Gabapentin in 1993 for use as an anticonvulsant and for the treatment of certain pains, tremors, and other psychiatric problems.
Efficacy of Neurontin in Anxiety Treatment
Neurontin (which has a chemical structure similar to that of GABA but doesn’t seem to have any effect on GABA receptors) works well in helping cope with anxiety if supplemented with other treatments. By itself, Neurontin appears generally to give mixed results in the treatment of anxiety symptoms but does seem to be effective in providing relief from bipolar disorder related anxiety. The drug is seen to control rapid cycling and mixed bipolar conditions in people who are prone to high levels of anxiety or agitation, and don’t seem to respond to carbamazepine or valproate, or even a combination of both. Considering its effectiveness in treating mood disorders in bipolar patients, it’s widely believed that Neurontin may prove to be a useful therapy for other anxiety problems in unipolar patients as well as victims of depression. But research on this is yet not complete. In any case, it’s best to go by your doctor’s advice before taking recourse to this medication in the treatment of anxiety, even if it’s linked with bipolar disorder.
Side Effects of Neurontin
Unfortunately, like most other anti-anxiety drugs, Neurontin also comes with a multitude of side effects, some of which can be seriously detrimental for your health. Dizziness, drowsiness, fatigue, insomnia, weight gain and nausea are commonly seen in people taking Neurontin. The side effects are more pronounced among the elderly. A serious problem with the use of Neurontin is its addictive effect. Use of Neurontin seems to lead to some kind of dependency, which is difficult to get rid of. So it’s not uncommon to see withdrawal symptoms among people who stop taking the drug. An even more severe implication of Neurontin use is the increased suicidal tendencies witnessed among users. The ideal thing to do would be to take the medication under your doctor’s guidance and supervision. In rare cases, it can also lead to manic effects, paranoia, agitation, reduced sex drive and detachment.
Considering the seriousness of the side effects of Neurontin, it’s advisable not to take it for anxiety alone. For those suffering from anxiety without bipolar disorder, it’s best to explore other treatment options. In any case, this medication should never be taken without being supplemented with some other kind of anti-anxiety treatment approach, such as diet, lifestyle changes etc.
Precautions in Taking Neurontin
Adequate precautions are naturally a prerequisite for taking any potent drug. Neurontin should also be taken only with due precautions. It’s generally advisable to go for a complete medical evaluation before taking recourse to this medication. Urine and blood tests should be done to rule out any medical conditions that can aggravate an anxiety or mood condition. Patients suffering from thyroid problems are generally asked to avoid taking Neurontin.
It’s also important to go slow with the dosage, starting with just 300 mg at bedtime, and then progressively increase it every 3-5 days. While some patients respond well to a 600 mg a day dosage, others may need as much as 4,800 mg a day before they start showing some positive signs. The dose should ideally be spread through the day, in 3-4 installments.
Neurontin, incidentally, is safe to take along with valproate, carbamazepine and lithium, showing no signs of a harmful interaction with these drugs. The only way in which it’s seen to interact with certain drugs is by a decrease in its absorption when taken with antacids. There’s also a slight increase in the concentration of certain oral contraceptives if used with Neurontin. But these interactions are not deemed very significant or important.
Alcohol, however, should be avoided by those taking Neurontin as it can aggravate the side effects of the drug. It’s generally considered safe to be taken by pregnant women, and even children and adolescents, though the U.S. doesn’t allow its use for those under the age of 12. However, the dosage may need to be minimized in kidney patients.
The time-frame for the positive effects of Neurontin to start manifesting usually varies from one individual to another. In some patients, the treatment begins to show results within a week or two, while in others it may take up to a month to show signs of change. While waiting for the results to show, an efficient self-help program to relieve anxiety is recommended to quicker start the recovery process and to bring better results in the end. Continuous monitoring and supervision by a qualified medical practitioner is also important before and during the use of the drug, as well as at the time of stopping its use. Only in cases of severe side effects should Neurontin usage be stopped abruptly; ideally, the patient should be slowly and gradually weaned away from it.