Marsha asked
My doctor put me on 300 mg gabapentin at bedtime for nerve pain in my foot. Since I started it, I have been experiencing dizziness loss of balance and just a weird feeling in my head. I've been on it for 6 weeks and I haven't seen much improvement in the pain in my foot. How can I taper off this medicine since I'm on such a low dose? Will it hurt to go ahead and just quit taking it?
Answer
Gabapentin, brand name Neurontin, is a commonly used medication for the treatment of neuropathy (nerve pain). While effective, it can be difficult to use. It generally needs to be tapered up to a fairly high dose and needs to be taken at least three to four times daily in order to achieve appropriate relief. In addition, it is well known to cause a variety of CNS side effects such as headache, dizziness and sedation.
In most cases, it is recommended to taper off gabapentin, as opposed to stopping it immediately, to lessen the chance of withdrawal symptoms that may occur. Common withdrawal symptoms on gabapentin include:
- Anxiety
- Insomnia
- Nausea
- Sweating
- Pain
- Irritability
- Agitation
- Dizziness
- Headache
- Flu like symptoms
- Weakness
You can expect that you won't experience most of these symptoms, but you certainly may have problems with a few.
While you haven't been on gabapentin for an extended period of time, 6 weeks of consistent dosing is long enough for blood levels to be at a steady state been, increasing the risk of withdrawal effects if you stop cold turkey. If withdrawal effects do happen, they typically occur one to two days after stopping.
There isn't one recommended way to successfully taper gabapentin and it is simply recommended to discontinue slowly and adjust based on the reactions you are having. At the very least, it is recommend to decrease slowly over one week. If you are having side effects while you decrease over that one week period of time, consider tapering more slowly, over four to six weeks.
Be sure to discuss with your doctor the best options available to you to discontinue the medication.
