Posted by Dr. Gary A. Mellick on August 21, 1998 at 21:52:13:
In Reply to: Neurontin posted by Carl on August 21, 1998 at 20:05:13:
Carl,
I have a lot of experience prescribing gabapentin (Neurontin). Neurontin is a safe anticonvulsant. When you first start the drug, your side effects might be drowsiness, vertigo, or have short-term memory loss. It has been shown to be of some value in migraine headaches. I think you may find that it helps reduce pain associated with the headache but I don't believe it will stop them or it may do nothing at all. I am not optimistic that it will help your cluster headaches. Besides seizure disorders, it is third most commonly used anticonvulsant for restless legs syndrome, depression, bipolar disorders, and severe neuropathic pain and RSD pain. It is effective in treatment of these conditions but has not yet been discovered useful for cluster headaches. I was fortunate enough to be the first to publish its value in the treatment of restless legs and its use in RSD in two different medical journals. Since then, doctors have started prescribing it for just about everything. doctors ask for "double blind studies" is because Ritalin is a schedule II controlled substance. To protect their medical licenses, they wish to everything else before writing for Ritalin. Ritalin has street value and that is too bad for cluster headache sufferers. A new treatment takes a long time to gain acceptance, especially if it is a controlled drug like Ritalin. Neurontin, was easier to prescribe but it still took lecturing on the subject to convince doctors to try it for anything but epileptic seizures. I doubt that CIBA will start a lecture series for Ritalin. Interestingly, just today one patient informed me that the generic Ritalin causes nausea and vomiting in her child and that the kids can tell if the methylphenidate (Ritalin) is generic or not! The reason Ritalin does not always work may be due to use of the generic or there may be more than one mechanism causing cluster headaches.
Good News cluster sufferers, a gentleman from Los Angeles emailed me that Ritalin relieved his cluster headache in less then 10 minutes after prednisone failed him in the middle of the night. He was starting on Ritalin SR and would get back to me.
Dr. Gary A. Mellick