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Is Neurontin Good For Opiate Withdrawl?

Posted on Sat, 22 Nov 2014

Question: I heard Neurontin is good for opiate withdrawl. Is tthis true and what about Neurontin addiction?

Answered by Dr. Chintan Solanki (55 minutes later)

Brief Answer:
not used for opiate withdrawal,not addictive

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

I cannot understand from where you heard that neurontin(gabapentine) is good for opiate withdrawal.Main indications for Neurontin are epilepsy and Nerve origin pain(neuropathic pain). It is not at all used for treatment of opiate withdrawal.

And for your information neurontin is also not addictive like opiate or benzodiazepines. It causes just reemergence of pain symptoms which it treats, if it is stopped.No specific dependence and tolerance.

And to more for your info, opiate withdrawal treated mostly by substitutes of opiate like methadone or buprenorphine.

Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Chintan Solanki (33 minutes later)

I read it on the internet, several places. Just google. I would send them but I9 don't know how.

Answered by Dr. Chintan Solanki (20 minutes later)

Brief Answer:
just copy link and paste it in question

Detailed Answer:
Hello,

Thanks for follow up.

Please send me link so I can comment. I have never read or used in any patient for opiate withdrawal.

Regards,

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Chintan Solanki (3 hours later)

have no idea how to do that, im really not that computer literate. Just type in Neurontin for opiate withdrawl and youll see all the [links?].

Answered by Dr. Chintan Solanki (16 minutes later)

Brief Answer:
You read it right, but there is no evidence

Detailed Answer:
Hi,

Thanks for follow up.

I have did search as mentioned by you. Following links I have visited which you might come across with.

http://luxury.rehabs.com/neurontin-gabapentin/opiate-withdrawal/
http://www.drugs.com/forum/featured-conditions/gabapentin-neurontin-opiate-withdrawal-62096.html
http://www.drugs.com/answers/neurontin-imodium-wds-withdrawal-opiates-hints-521447.html
http://www.ncbi.nlm.nih.gov/pubmed/0000
http://www.addictionrecoveryguide.org/message_board/index.php?s=08d6fc0afa0492bb4631c4de0000&act=ST&f=19&t=70724
https://www.drugs-forum.com/forum/showthread.php?t=170385

No links mention specific indication for opiate withdrawal. Yes there is some example of treatment of pain symptoms in some individual patients. But those are just experimental. Even one site has clearly mentioned that it is not approved for opiate withdrawal by FDA .Whenever it has been used, it is with methadone or buprenorphine most of the times.

So according to evidence based medicine protocol and guidelines neurontin cannot be used for opiate withdrawal, but yes if someone has persistent pain and no improvement we can give a trial of it.

I am thankful to you for adding to my knowledge because of your question.
Ultimate conclusion is Neurontin may be used for opiate withdrawal in some resistant cases.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Chintan Solanki (1 hour later)

granted, its not gonna help like suboxone, but people are swearing by it, and who knows what further rsearch will turn up. I personally got addicted to both my vikes and benzos, I went to rehab thinking I get suboxone and a nice easy withdrawl, but being that I was onbenzos, all I got was some Librium. I would have been better off just taking my klonopin, [yes I know about the longer half life and all that], but still. I basically went through the ope withdrawls cold turkey. It was hell, sick, dry heaves , diharea, couldn't eat, shakes, hot and cold sweats.Checked out after a week. Felt better when I got home, but still feeling like shit all the time. Im almost down to my prescribed dosage of both drugs, plus I have my trazadone that they also wouldn't give me. Not supposed to be addicting but there are withdrawls from that, too. Anyway, im taking 300 Neurontin bid, seems to be helping, hope im doing the right thing. don't want to go any higher, reason for my original question.

Answered by Dr. Chintan Solanki (30 minutes later)

Brief Answer:
You can continue neurontin.Even can stop in future

Detailed Answer:
Hi,

Yes , you are right. But here I think issue is, not being able to get suboxone.
So withdrawal is so sever and you need to take something for withdrawal symptoms. Benzo help in some symptoms but not in pain symptoms of opiate withdrawal.
We also used to prescribe tramadol when suboxone is not available with us. Gabapentine in same way can help in pain symptoms. Dose depends on individual's quantity of intake of opiate in past and withdrawal severity due to that.
If you feel better, you can continue with same dose.
If not. you can increase also.
But if you can get suboxone, it can be taken in small doses and gradually tapper off.

However from my clinical experience I can say, you can stop Neurontin also in future by gradually tapering off starting decreasing it after 6 months of complete stability.

If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki

Regards and wish you early stability.
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Chintan Solanki (13 hours later)

But why would I need it for 6 months? Withdrawls are not gonna take that long[?] Just threw away a bottle of tramadol, afraid of serotonin syndrome, my daughter was taking it with an ssri and had a seizure. don't forget I am still taking klonopin and vicodin, just trying to get back to my prescribed doses. Great if I could stop altogether but for now I would be happy with that. Took 300 gab and only 5mg. vike so far today, its almost 5 pm. and a little nauseus but best I have done so far. I think a lot of it is nerves. Going through big time problems here. Really think the gab is helping, maybe got something here. Wish I was a doctor or scientist, this would be a huge breakthrough and who knows what for the person responsible for it. Wanna get together , doc, I'll be the test subject and you do the professional stuff. Get some clinical trials going, LOL. we could be famous.

Answered by Dr. Chintan Solanki (6 hours later)

Brief Answer:
yes for at least 6 months

Detailed Answer:
Hi XXXXXXX

I can understand your fight with problem as well as medicines.

I am treating currently 45 patients of opiate withdrawal since 6-8 months. We use buprenorphine+naloxone combination (suboxone like) sublingual preparation. For initial 10 days for withdrawal we also use benzo and clonidine as well as pain killers. After 10-15 days almost all patients stay only on buprenorphine. We encourage the patients to decrease the dose of buprenorphine also. Till date only 3 patients have been able to stop buprenorphine also. This suggests severity of physical dependence of opiates. Because of this clinical experience I suggested to continue Neurontin for at least 6 months. And please do not forget that you are on vicodin/percoret which contains oxycodone, an opiate, so you are not in total withdrawal state. Gabapentine is helping you for pain symptoms due to decrease in dose of vicodin. In future you need to decrease dose of vicodin also and you need support of Neurontin for that.

There is not at all any harm to take gabapentine if you feel that it is helping.
Let see in future can neurontin prove any evidence based role in opiate withdrawal. I will think to put some of my patients of opiate withdrawal; on gabapentin. If I do and succeed, I will think to do research on that. Thanks for idea.

Hoping for your early recovery and wish you can live good life without such medicines in future.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Chintan Solanki (2 hours later)

Still don't understand the 6-8 months treatment. How do rehabs get people totally clean after 21 days? [personally I think that is too quick], but I thought opiate withdrawls, at least physically, only lasted 7-10 days. I also only have a limited supply of Neurontin and my doc is very conservative in prescribing anything stronger than nsaids. I can deal with the physical pain, its the nausea and anxiety that are hard for me. My agoraphobia is gotten bad again, too. Took all I had to take out the trash tonight. And the benzo withdrawls are even worse, I don't have to tell you. Could probably get my psych doc to give me clonidine because I have tourettes, but im already on 2 bp meds.

Answered by Dr. Chintan Solanki (24 hours later)

Brief Answer:
Paxil(Paroxetine) is good alternative

Detailed Answer:
Hello,

Sorry for delayed response.

Please do not be so confused.In reality opiate dependence is very strong and withdrawal lasts long.However it depend on type of opiate, total duration and quantity of intake.Only 10% of patients can get rid of opiate in 2-3 weeks.

If you can tolerate pain, it is good.Role of neurontin will be more for that. Fore the symptoms of anxiety and phobia , benzodiazepines are best. But as you afraid of taking, in my opinion paroxetine (paxil) cr preparation 12.5 is good alternative. It will help to reduce anxiety and phobia as well as to clear low mood.

The best way is to get admitted if feasible to stop vicodin as you are low dose now. You can continue klonopin for long, it can be gradually tapper off.

Please ask your doctor to review your case and give you sufficient time to clarify your confusion and she is the best possible approach to deal with your problem.

I will be glad to answer more of your queries.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Chintan Solanki (36 minutes later)

not afraid to to take benzos, I am taking them, but I have to get down to my prescribed dosage, 1mg tid. I have begged my shrink to raise my dose to qid, because of 25 years of use I have built up tolerance to them. Tried paxil, too, no better than everything else. same with the vicodin, have to get back to 5mg bid. been at it for about 6 months now, I have only taken 1mg klonopin twice and 5 mg vicodin twice and its almost bedtime. gonna try not to to take anymore, just another 300 gab, but might need 1 more klonopin, maybe half of a 7.5 vike. even if I do I am back at my prescribed benzo dose and only 2.5mg over my vike dose. not really worried about getting completely off, just back to my prescribed dose and keep it there without attacks and phobias, as that's why they were given to me. think im doing pretty good considering 2 addictive meds at once, especially a benzo?

Answered by Dr. Chintan Solanki (23 hours later)

Brief Answer:
Continue with both, some altrenatives are there

Detailed Answer:
Hello,

Again sorry for delayed response.

I think you are getting relief through gaba in benzo withdrawal more than that of opiates. As you are on medicines since more than 20 years, it is really difficult to stop them. Yes you can continue in required dose which can control your symptoms. After long period of stability on these medicines, say for 6-8 months, you can try to reduce dose by 10-20%.

In long term benzo have effects on memory and for which you need to be checked for XXXXXXX mental status examination (MMSE- a scale to check memory disturbance).

Pregabalin/ carbamazaine/oxcarbazapine are also useful alternative for benzo withdrawal, just discuss with your doctor.

I will be happy to answer if still any query.
All the best & Regards,
Dr.Chintan Solanki.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju