I am today years old when I learned that humans can take this medicine too.... My vet gives us gabapentin fish oil for our cats to give them before their appointments so she can take blood. I thought this med was only for animals lol
Okay but it is a godsend for my cat when it’s time to go to the vet or trim nails!! Gabapentin is my favorite drug because it saves us so much stress and scratches!
At the risk of making a name for myself defending idiosyncratic drug reactions...
I find gabapentin has some anti-depressive and anti-manic properties, at least in conjunction with the rest of my regimen. Specifically my baseline is now closer to euthymic than dysthymic, and when I do get hypomanic the instances are shorter and less intense. It was prescribed for a different purpose (an anxiolytic in the context of AUD) and I was surprised by this outcome but my doc endorsed that in her experience some bipolar people find it a useful adjunct for residual symptoms, "rough edges" I think she said. The QoL increase and reduction in functional impairment were not trivial for me--those residual depressive symptoms, which didn't respond to a basketful of other treatments, were keeping me from a lot of living.
Now where's that shruggy little emoticon man so no one mistakes this for countervailing medical advice...
At the end of the day, studies are about aggregates, not individual people and their responses! There are plenty of people for personalized reasons who may have benefit from one treatment or another and we just can't subgroup them out appropriately to run a trial to demonstrate that.
I remember getting gabapentin prescribed for alcohol withdrawal, and it helped so much with the shakes. But then my doctor tried to have it be a part of my mood stabilization for bipolar. That shit did NOT work haha
I'm in the UK and have been on pregabalin since 2017 for severe RLS. Neurologists consider pregabalin as the gold standard but most people in UK will never see a neurologist over RLS. Most only get as far as their GP who presecribe dopamine agonists.
I developed RLS in my 20s. It runs in my family. At 37 I was diagnosed with bipolar and given quetiapine which was like rocket fuel for my RLS. Imagine having RLS in all 4 limbs, with pain, and akithesia, and having a psychiatrist who doesn't believe in RLS and states quetiapine has no side effects. My GP managed to force my psychiatrist to prescribe something for RLS which, unfortunately, was pramipexole. Two years later I develop augmentation so the pramipexole is actually giving me RLS. I was only on .375mg max a day. It also made me psychotic and I was hospitalized because I was fixated on ending myself in a very gruesome way (which my psychiatrist brushed off by telling staff I have a weird sense of humour).
I accidentally ended up on pregabalin for RLS in the hospital. My psychiatrist cuts my pramipexole off and my RLS is left untreated for 5 days. It was horrific. It was start at midday and not let up till 7am so I did not sleep for 5 days (my psychiatrist prescribes trazadone as she now thinks I have insomnia. I don't). My psychiatrist is at a seminar by a pharma rep for pregabalin the day before she prescribes me it for the anxiety, which I don't have, but she always insists I do. But it worked wonders for RLS. Life changing.
My psychiatrist got one last kick in. I found out from my occupational health doctor at my work that my psychiatrist changed my diagnosis. Three years after being discharged from her service I found out she changed it to recurrent depression. In the 5 years I was under her "care" I was never treated for depression. Only an episode of rapid cycling which she treated with sertraline and more quetiapine both of which worsen RLS. My mother had died due to a medical error and I had a delayed and prolonged grief reaction. She thought that was recurrent depression. Although apparently I'm not significant enough for her to tell me.
As she was the one who prescribed the pregabalin I asked to be referred to neurology so that I could "protect" my prescription. Neurology wrote a seperate prescription so that I would at least keep 75mg of pregabalin. My RLS is the symptom I dread most. Some people still think it is a joke diagnosis but I could not continue without the pregabalin. I already had RLS but that woman has left me with this superjacked version if this atrocious condition.
Incredibly fun fact, I have the same problems. I have RLS, and I have bipolar disorder, and I experienced the same side effect when I took Seroquel that you're talking about. It is a nightmare. This is a really important overlapping symptom cluster that is commonly overlooked! I'm sorry for what you went through, and I'm grateful you shared it.
Thank you! I cannot express how much it means to have someone actually hear my words. RLS has been the extra complication in my life. It's the one thing above all that I can't tolerate but so many different meds make it worse.
I've seen the case studies on quetiapine and RLS indicating that there are higher rates of RLS induced by quetiapine vs other in class, and that RLS may be higher in bipolar vs schizophrenia populations. I feel a little vindicated despite my dr denying RLS-quetiapine connection
Quetiapine is especially bad because of the exacerbation of rls being due to dopamine blockers and antihistamines--and seroquel is strongly antihistaminic!
I was moved onto the XL version after a few weeks. The rls wasn't as bad but after 12 months on it I was also getting akithesia too. So, procyclidine was added, which was very effective at combating the akithesia. But procyclidine exacerbated the cognitive impairment I had. After about 18 months of treatment I'd had enough and stopped the quetiapine cold turkey. The rebound rls and akithesia was horrific. I was rolling around on my carpet. Unfortunately it turned out that the quetiapine was cancelling out a certain aversive effect of pramipexole. I developed a "quasi-psychosis" about 4 months later - it had to be "quasi" because my psychiatrist didn't believe that me restarting quetiapine at 100mg could be enough to bring me out of it. Then 5 months later I went hypomanic, then mixed episode, then psychosis & wanted to pour glue over myself & set myself on fire, and ended up in hospital. All while having augmentation from the pramipexole too.
I always say that I loved pramipexole as it had no side effects except for that pesky psychosis & self immolation issue 😄 My psychiatrist dismissed all this as my weird sense of humour. Wasn't aware I'd ever been humouress around her!
I find it concerning that dopamine agonists are still the 1st line treatment for rls in UK by family doctors.
When you say self immolation, do you mean it literally? I wrote an entire article about the experience of having unexpected withdrawal from pramipexole lead intrusive thoughts around self immolation, when the issue was really 50% reduction in dose as part of a planned taper! Dopamine agonist withdrawal syndrome is no joke.
qua my article: the dosing was once daily! so it might be that one reason it's hard to prove gabapentin does something in research trials is that compliance with dosing is already so hard in TID dosing that we muddy the Waters. This trial used (it looks like) once daily dosing!
It does appear to work for perimenopausal and menopause symptoms at night… particularly for women with breast cancer who cannot take hormones. We have seen good success with hot flash reduction and night sweats.
I am today years old when I learned that humans can take this medicine too.... My vet gives us gabapentin fish oil for our cats to give them before their appointments so she can take blood. I thought this med was only for animals lol
Okay but it is a godsend for my cat when it’s time to go to the vet or trim nails!! Gabapentin is my favorite drug because it saves us so much stress and scratches!
I just mentioned that I use this for my cats too! I didn't realize that people sometimes take this med.
At the risk of making a name for myself defending idiosyncratic drug reactions...
I find gabapentin has some anti-depressive and anti-manic properties, at least in conjunction with the rest of my regimen. Specifically my baseline is now closer to euthymic than dysthymic, and when I do get hypomanic the instances are shorter and less intense. It was prescribed for a different purpose (an anxiolytic in the context of AUD) and I was surprised by this outcome but my doc endorsed that in her experience some bipolar people find it a useful adjunct for residual symptoms, "rough edges" I think she said. The QoL increase and reduction in functional impairment were not trivial for me--those residual depressive symptoms, which didn't respond to a basketful of other treatments, were keeping me from a lot of living.
Now where's that shruggy little emoticon man so no one mistakes this for countervailing medical advice...
At the end of the day, studies are about aggregates, not individual people and their responses! There are plenty of people for personalized reasons who may have benefit from one treatment or another and we just can't subgroup them out appropriately to run a trial to demonstrate that.
Not yet! I have faith we'll eventually parse out some endophenotypes that shed light on the heterogeneity.
I remember getting gabapentin prescribed for alcohol withdrawal, and it helped so much with the shakes. But then my doctor tried to have it be a part of my mood stabilization for bipolar. That shit did NOT work haha
It does some things. Not others. :). Humility in all things!
I'm in the UK and have been on pregabalin since 2017 for severe RLS. Neurologists consider pregabalin as the gold standard but most people in UK will never see a neurologist over RLS. Most only get as far as their GP who presecribe dopamine agonists.
I developed RLS in my 20s. It runs in my family. At 37 I was diagnosed with bipolar and given quetiapine which was like rocket fuel for my RLS. Imagine having RLS in all 4 limbs, with pain, and akithesia, and having a psychiatrist who doesn't believe in RLS and states quetiapine has no side effects. My GP managed to force my psychiatrist to prescribe something for RLS which, unfortunately, was pramipexole. Two years later I develop augmentation so the pramipexole is actually giving me RLS. I was only on .375mg max a day. It also made me psychotic and I was hospitalized because I was fixated on ending myself in a very gruesome way (which my psychiatrist brushed off by telling staff I have a weird sense of humour).
I accidentally ended up on pregabalin for RLS in the hospital. My psychiatrist cuts my pramipexole off and my RLS is left untreated for 5 days. It was horrific. It was start at midday and not let up till 7am so I did not sleep for 5 days (my psychiatrist prescribes trazadone as she now thinks I have insomnia. I don't). My psychiatrist is at a seminar by a pharma rep for pregabalin the day before she prescribes me it for the anxiety, which I don't have, but she always insists I do. But it worked wonders for RLS. Life changing.
My psychiatrist got one last kick in. I found out from my occupational health doctor at my work that my psychiatrist changed my diagnosis. Three years after being discharged from her service I found out she changed it to recurrent depression. In the 5 years I was under her "care" I was never treated for depression. Only an episode of rapid cycling which she treated with sertraline and more quetiapine both of which worsen RLS. My mother had died due to a medical error and I had a delayed and prolonged grief reaction. She thought that was recurrent depression. Although apparently I'm not significant enough for her to tell me.
As she was the one who prescribed the pregabalin I asked to be referred to neurology so that I could "protect" my prescription. Neurology wrote a seperate prescription so that I would at least keep 75mg of pregabalin. My RLS is the symptom I dread most. Some people still think it is a joke diagnosis but I could not continue without the pregabalin. I already had RLS but that woman has left me with this superjacked version if this atrocious condition.
Incredibly fun fact, I have the same problems. I have RLS, and I have bipolar disorder, and I experienced the same side effect when I took Seroquel that you're talking about. It is a nightmare. This is a really important overlapping symptom cluster that is commonly overlooked! I'm sorry for what you went through, and I'm grateful you shared it.
Thank you! I cannot express how much it means to have someone actually hear my words. RLS has been the extra complication in my life. It's the one thing above all that I can't tolerate but so many different meds make it worse.
I've seen the case studies on quetiapine and RLS indicating that there are higher rates of RLS induced by quetiapine vs other in class, and that RLS may be higher in bipolar vs schizophrenia populations. I feel a little vindicated despite my dr denying RLS-quetiapine connection
Quetiapine is especially bad because of the exacerbation of rls being due to dopamine blockers and antihistamines--and seroquel is strongly antihistaminic!
I was moved onto the XL version after a few weeks. The rls wasn't as bad but after 12 months on it I was also getting akithesia too. So, procyclidine was added, which was very effective at combating the akithesia. But procyclidine exacerbated the cognitive impairment I had. After about 18 months of treatment I'd had enough and stopped the quetiapine cold turkey. The rebound rls and akithesia was horrific. I was rolling around on my carpet. Unfortunately it turned out that the quetiapine was cancelling out a certain aversive effect of pramipexole. I developed a "quasi-psychosis" about 4 months later - it had to be "quasi" because my psychiatrist didn't believe that me restarting quetiapine at 100mg could be enough to bring me out of it. Then 5 months later I went hypomanic, then mixed episode, then psychosis & wanted to pour glue over myself & set myself on fire, and ended up in hospital. All while having augmentation from the pramipexole too.
I always say that I loved pramipexole as it had no side effects except for that pesky psychosis & self immolation issue 😄 My psychiatrist dismissed all this as my weird sense of humour. Wasn't aware I'd ever been humouress around her!
I find it concerning that dopamine agonists are still the 1st line treatment for rls in UK by family doctors.
https://open.substack.com/pub/thefrontierpsychiatrists/p/the-time-i-almost-set-myself-on-fire?r=1ct8f&utm_campaign=post&utm_medium=web The link
When you say self immolation, do you mean it literally? I wrote an entire article about the experience of having unexpected withdrawal from pramipexole lead intrusive thoughts around self immolation, when the issue was really 50% reduction in dose as part of a planned taper! Dopamine agonist withdrawal syndrome is no joke.
More on gabapentin and menopause symptoms… https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4076904/
thanks for sharing!
qua my article: the dosing was once daily! so it might be that one reason it's hard to prove gabapentin does something in research trials is that compliance with dosing is already so hard in TID dosing that we muddy the Waters. This trial used (it looks like) once daily dosing!
It does appear to work for perimenopausal and menopause symptoms at night… particularly for women with breast cancer who cannot take hormones. We have seen good success with hot flash reduction and night sweats.
It does "appear to work" for a lot though...so that sentiment is essentially what I'm wary of, given the history of this medicine.