Gabapentin in epilepsy

The active ingredient gabapentin is used to treat epileptic seizures and to relieve neuropathic pain. Unlike many other antiepileptic drugs, it is considered to be well tolerated but still has a number of side effects. The most common ones include headache, fatigue, dizziness and nausea. If the drug is suddenly discontinued, further side effects may occur. Read here how gabapentin works, how to dose the active ingredient correctly and what you have to consider when taking everything.

Effect of gabapentin

The active ingredient gabapentin belongs to the group of anticonvulsants (antiepileptics). These are used to treat or prevent epileptic seizures. Gabapentin is suitable for patients in which only a certain part of the brain is affected by the epileptic seizure (focal seizure). In addition, the drug can be used in so-called secondary generalized seizures, in which the attack emanates from a point in the brain and only later engages the entire brain.

In addition, gabapentin is also used to relieve neuropathic pain. These can occur, for example, in the context of shingles or diabetic polyneuropathy. The active substance is also suitable for the treatment of phantom pain. The exact mechanism of action is still unclear.

Side effects of gabapentin

There may be a number of side effects while taking gabapentin. Nevertheless, the drug is considered to be better tolerated than many other antiepileptic drugs. Headache, tiredness, dizziness, nervousness, insomnia, nausea and vomiting are some of the most common complaints while taking it. In addition, it can lead to an increased appetite and weight gain, but also to loss of appetite and anorexia.

Other side effects associated with gabapentin treatment include respiratory infections, otitis media, memory disorders, speech disorders, and leukoemic or thrombocytopenia. In addition, the treatment can also have an impact on the psyche, which manifests itself in symptoms such as anxiety, confusion, hallucinations or depression. For a complete list of all side effects, please have a look at the leaflet of your medication.

In case of doubt to the doctor

If you experience more severe side effects, it is always a good idea to see a doctor. This is especially true if you notice any of the following symptoms:

  • Severe skin reactions
  • Constant abdominal pain, coupled with nausea and vomiting

Also, if symptoms such as fever, itching, glandular swelling, swelling of the lips and tongue, yellowing of the skin or eyes, constant fatigue, muscle aches and frequent bruising or bleeding should definitely consult a doctor.

In some patients, suicide tendency or desire to hurt themselves increased during treatment. Therefore, patients should be monitored closely at the beginning of the intake.

Dosage of gabapentin

Gabapentin comes in the form of tablets, capsules and hard capsules. These are dosed differently - there are drugs with 100, 300, 400, 600 or 800 milligrams. Which dosage is right for you, must be determined individually by your doctor. It is important that the medication be taken with sufficient fluid.

In adolescents and adults, the dose of gabapentin is often 300 milligrams once a day. This will be increased to 300 milligrams three times a day in the next two days. If necessary, the dose can then be gradually increased by 300 milligrams until a maximum daily dose of 3600 milligrams is reached. The intake is usually three times a day, with no more than twelve hours between two receipts.

Children under six should not be treated with gabapentin. In older children, the dose depends on body weight. A typical dose is 25 to 35 milligrams per kilogram of body weight. This amount is usually divided into three divided doses, taken in the morning, noon and evening. It is still unclear whether long-term treatment with this drug over nine months can have a negative impact on development. For children and adolescents, a careful risk-benefit analysis must therefore be carried out.

Deposition gabapentin

If you take too high a dose of gabapentin, you should immediately consult your doctor or, alternatively, the nearest hospital. An overdose may be manifested by symptoms such as dizziness, drowsiness, double vision, and a blurred language. If you forget to take a dose, get it as soon as possible. However, do not take a double dose: If it is already time for the next dose, stop taking the dose.

Do not stop using gabapentin without first consulting your doctor. In no case should you just abruptly discontinue the active ingredient overnight. To stop the therapy, gabapentin has to be slowly discontinued step by step - this process should last for at least a week. If the drug is suddenly discontinued, side effects such as anxiety, insomnia, sweating, nausea and pain may occur.

Contraindications

You may not take any medicine with gabapentin in certain circumstances. This is the case, for example, when there is hypersensitivity to the active ingredient. Likewise, the drug must not be used in acute pancreatitis.

In certain pre-existing conditions, the anti-epileptic drug should only be taken with special care. These include:

  • kidney problems
  • Chronic pancreatitis
  • Primary generalized epileptic seizures
  • psychosis

pregnancy and breast feeding period

During pregnancy, medicines containing gabapentin should not be taken or should be taken only on the express instructions of the attending physician. While no studies have been conducted with the drug itself, other antiepileptic drugs have been found to increase the risk of malformations. This was especially the case when more than one antiepileptic drug was taken simultaneously.

Gabapentin passes into breast milk. Whether he can thereby affect the baby, is not yet known. Therefore, you should not take the drug while breastfeeding. If treatment is absolutely necessary, you should stop breastfeeding first.

Interactions with antacids

Taking gabapentin may interfere with various other medications. Affected include antacids that contain aluminum or magnesium. Taking it at the same time may slow the uptake of gabapentin. Therefore, you should take the antiepileptium no earlier than two hours after the antacid. Unlike antacids, taking cimetidine, which is used on too much stomach acid, can increase the duration of gabapentin.

Alcohol and analgesics with morphine should not be taken concomitantly with the antiepileptic drug, as otherwise the effect and side effects may increase. Please also note that gabapentin may interfere with the protein content in urine tests. Therefore, if you are taking a urine test, it is important that you tell the doctor that you are currently being treated with the anti-epileptic medicine.

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