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Topic: Neurontin VS. Verapamil (Read 433 times) |
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BILLY
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I'm seeing posts about Neurontin & possible worsening of certain SUNCT-like symptoms with verapamil tx for CH symptoms & came across the below abstract & wondered if Neurontin or lamotrigine (which reportedly alleviates not worsens SUNCT & CH) would compare to verapamil?
I hear at 900 mg/day doses Neurontin is very well tolerated & so is lamotrogine but lamotrogine carries the anticonvulsant rare but risk of serious rash that Neurontin doesn't seem to.
Anyone ever try Neurontin (gabapentin) or lamotrigine & compare tolerability & efficacy to verapamil? Should it remain only for refractory patients?
Here's the interesting abstract that is admittedly an open trial (not double blind placebo-controlled).
Cephalalgia 2001 Sep;21(7):744-6
Drug-resistant cluster headache responding to gabapentin: a pilot study.
Leandri M, Luzzani M, Cruccu G, Gottlieb A.
Dipartimento di Oncologia, Biologia e Genetica, Universita di Genova and Centro Interuniversitario per la Neurofisiologia del Dolore, Genova, Italy. cind@unige.it
Prompted by the results of gabaergic drugs, such as valproate and topiramate, we performed this pilot study to assess the effect of gabapentin in cluster headache. Eight patients suffering from episodic cluster headache and four suffering from chronic cluster headache were studied. All of them had failed to respond to traditional prophylactic drugs. The design of the study was an open trial. The main parameter for effectiveness was the number of daily attacks. Gabapentin was given at the daily dosage of 900 mg. All patients were pain free after a maximum of 8 days after starting therapy, with a bout duration thus reduced to 16-40% of the average previous bouts (only applies to episodic cluster patients). We hypothesize that the gabaergic action of gabapentin, perhaps combined with other mechanisms, such as calcium channel blockade, may be responsible for its remarkable effects on cluster headache.
Publication Types:
* Clinical Trial
PMID: 11595003 [PubMed - indexed for MEDLINE]
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cbolony
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Re: Neurontin VS. Verapamil
« Reply #1 on: Apr 10th, 2003, 3:35pm » |
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Billy i been taken Verapmil 240mg 2x aday i still getting shadows after my cycle which ended march 6.Went to the neuro tue. give me Neurontin 100mg 2x aday to take with the Verapamil lets see if the shadows go away
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BILLY
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Re: Neurontin VS. Verapamil
« Reply #2 on: Apr 10th, 2003, 7:02pm » |
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Interesting cbolony but that dose sounds minimal. The lowest effective dose I've seen in the literature is 600mg (300mg 2x/day) & 900mg/day (300mg 3x/day) is generally the lower end of effective doses (some go up to 1800-3600mg or even higher) but perhaps it will work along with the verapamil. I have a feeling a verapamil & gabapentin combo for CH may be more common in the future.
Let us know how you do.
Too early to say anything about lamotrigine, haven't seen anything published on it yet for CH but positive SUNCT reports.
Below are the other gabapentin (Neurontin) references.
Reg Anesth Pain Med 2001 Jul-Aug;26(4):373-5
Gabapentin for the treatment and prophylaxis of cluster headache.
Tay BA, Ngan Kee WD, Chung DC.
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. tabenai@cuhk.edu.hk
BACKGROUND AND OBJECTIVES: Cluster headache is an uncommon debilitating condition for which effective management remains a challenge. We describe the use of gabapentin in the treatment and prophylaxis of cluster headache in a patient who was refractory to other treatments. CASE REPORT: A 38-year-old man had a history of intermittent right-side headaches for 24 years, diagnosed as cluster headache. He received only partial relief from a range of conventional treatments. A trial with gabapentin 300 mg twice daily was tried and found to be effective in treatment and prophylaxis of his headaches. CONCLUSION: Gabapentin was effective in the treatment of a patient with cluster headache. Further investigation of gabapentin compared with conventional treatments and placebo is warranted.
Also but no abstract:
PMID: 11464360 [PubMed - indexed for MEDLINE]
Cephalalgia 2000 May;20(4):252-3
Chronic cluster headache responding to gabapentin: a case report.
Ahmed F.
Publication Types:
* Letter
PMID: 10999675 [PubMed - indexed for MEDLINE]
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cbolony
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Re: Neurontin VS. Verapamil
« Reply #3 on: Apr 11th, 2003, 11:25am » |
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Billy the neuro just wanted to try a low dose of the
neurontin with the verapamil combo to see what will happen with a lot of the shadows i been getting after the cycle.If iam still getting the shadows after a month
he wants to up neurontin then we will see what happens.Everything as you know is trial and error
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Nathan
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Re: Neurontin VS. Verapamil
« Reply #4 on: Apr 11th, 2003, 8:46pm » |
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gotta add my 2 cents....
i have cronic chs and i am on neurontin 900 mg 3 times a day (2,700 mg) and it doesnt do shit.. when i first started on the neuro i had a 5 day break from the attacks but then went right back to every other day. i guess once again, meds work different on different people.
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MarkV
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Re: Neurontin VS. Verapamil
« Reply #5 on: Apr 11th, 2003, 9:11pm » |
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Nice to hear I'm not the only one with SUNCT symptoms brought out badly by verapamil !!!!!! Took me a year to find out what was going on. 
I'm finally winding out of my 3 month CH cycle and I'm not sure if my new med of topamax is helping with the SUNCT ice pick hits throughout the day or its just a coincindence. Over 150 pins in my temple a day for 3 months straight.
Its over for at least the last 2 days. Thank god for day light saving time. ahhhhhhhh, ITS MILLER TIME again !!!!!!!!!!!!!!!!!!!!!!
MarkV
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