How Can Peripheral Neuropathy Be Treated?

Hello, May I know some information about your husband s medical condition. • How much is your husband blood glucose? Is it controlled? Have he checked HbA1c recently? • What kind of antidiabetic does he consume and does he use it regularly or not? Did he use other drugs along with Gabapentin that may have interaction with it? Firstly, Gabapentin is an anticonvulsant medicine as GABA analog. In adult, it is used for nerve/neuropathic pain such as in postherpetic neuralgia (PHN) after herpes zoster infection, and in diabetic polyneuropathy. The dosage given in diabetic neuropathy is up to 900 mg initially, and may increase gradually up to 1,800 to 3,600 mg/day divided in 3 times, depends on patient s condition and response to Gabapentin. Of course, increasing or dose titration can t be done by patient himself, it should be evaluated by doctor to avoid any harmful side effect. There are many side effects of Gabapentin because it works on central nervous system, e.g., drowsiness (5% to 21%), dizziness (16% to 20%), ataxia/incoordination of movement (1% to 13%), fatigue (11% to 15%), hostility and aggressive (5% to 8%), depression (1% to 5%), nervousness (1% to 5%), hyperkinesia (3% to 5%), anxiety, insomnia, anorgasmia, etc., more side effects come with increasing dosage. Any anticonvulsant drugs such as Gabapentin increase risk of suicidal thoughts or behavior, so please keep an eye and monitor closely your husband for emergence or worsening depression, unusual mood changes, or any weird behavior. If these happen or his symptoms now worsen, please contact your treating doctor, he may need dosage adjustment, time of consuming drug modification, or change the drugs for neuropathy. Another drug can be given for neuropathy is another anticonvulsant (Pregabalin) and antidepressant (Amitriptyline, etc.). Here some info to be your concerns: • Gabapentin may impair your husband s thinking or reactions. Please be careful in driving or anything that requires alertness. • Avoid taking antacid within 2 hours before or after taking Gabapentin. Antacids can make your body harder to absorb Gabapentin. • Avoid drinking alcohol while on Gabapentin in case of increasing side effects. • Do not stop Gabapentin abruptly, contact your local doctor to tape over, minimum in 1 week. Do not take it more often or increase your dose without consulting your doctor. Your husband s condition won t improve any faster and the risk of serious side effects may increase like what happen in your husband now. • Your husband may need to consume 300 mg or 400 mg pill forms than 2x100 mg pill. It s better with food, and in the evening, to avoid bigger side effects, but it s wiser to discuss with your doctor. • Please regularly check his fasting plasma glucose and HbA1c. Neuropathy pain gets worse if the level of blood glucose is higher and uncontrolled. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Asti Yuliadha