Grayman asked
I’m currently taking 600 mg/day (2 x 100 mg Gabapentin 3xs a day) and would like some help weaning off of this. Would you recommend to 1. Take 400 mg/day (2 x 100 mg Gabapentin 2xs a day) or 2. Take 300 mg/day (1 x 100 mg Gabapentin 3xs a day)? What would be the step after that?
Answer
Tapering certain medication is often a prudent idea to prevent withdrawal symptoms or a worsening of your disease state. In most cases, there is no single recommended way to appropriately taper a medication and methods employed are individualized based on a variety of factors including:
- Dose of medication
- Duration of treatment
- Severity of disease
Neurontin (Gabapentin) Tapering Recommendations
Potential gabapentin withdrawal symptoms include:
- Anxiety
- Insomnia
- Nausea
- Sweating
- Pain
- Agitation
- Palpitations
- GI symptoms
- Flu-like symptoms
The above symptoms are simply potential side effects. If they do occur, they are often mild and transient, typically resolving on their own within a few days.
Specific tapering recommendations for gabapentin vary. If using gabapentin for epilepsy, some studies recommend to decrease your dose slowly (over months) to avoid recurrent seizures. Data indicates that seizures most often occur in the first six months after beginning to taper.
If using gabapentin for other indications, it is recommended to taper gabapentin for at least one week. Other sources recommend to taper more slowly, employing a 25% dose reduction every week. Whatever method you employ, it is prudent to be conservative in your dose reduction and go slowly.
In your case, please speak with your doctor to come up with an appropriate plan as they have your complete medical history and they are in a better position to guide your therapy. In most cases, you want to start dosage reductions slowly and starting the first dose decrease at 500 mg or 400 mg per day (from 600 mg) is in line with that. From there, decreasing 100 mg every week (or every few weeks) based on your response could be one method to employ.
When tapering your medication, it is important to stay in contact with your doctor to discuss how you are progressing and if you are experiencing side effects. Often times, small adjustments need to be made based on your response to your tapering method.
