Tapering Off Gabapentin

I've been on 600Mg 3 times a day (1800mg total) for several years now to address chronic back pain. A recent review with a Pain Dr suggested tapering off over 6 months - reducing by 300Mg a month - starting with the middle dose - which I did for the last month with relatively few side effects. Any suggestions as to whether to drop the evening or the morning dose next?

Hi - thanks for sharing and updating your experience. I understand you're down to 600mg per day (2 x 300Mg) - what time of day did you find best to take your doses - both now and during your tapering process? thanks!

Hi @gabataper while you wait to hear from @margaretbob @guener @njp1013 and others, I wanted to take a minute and welcome you to Mayo Clinic Connect. You mentioned that you are currently taking gabapentin for back pain. As you taper, how is your pain being managed? Did gabapentin stop working for you? What time of day do you currently take your meds?

I've been on 1200 mg. each day, all at bedtime and it seems I need it to get to sleep. I think it only helps me a little w/ depression. This is the 1st time I've written in this blog. Hope they can identify me by my email. My name is Kathy. I take a tiny amount of Effexor and only every other day. Just to maybe give me a slight boost. With the pandemic, I've found that moving and walking has been the best benefit. So, I encourage you to do that.

Your tapering schedule sounds manageable. I was on a much higher dose for a while and tapered down quickly at the beginning, each week dropping by 300 mg, until I got down to where I feel comfortable and my anxiety (for which I take gabapentin) stayed under control. I take 300 mg in the morning and in the afternoon, having dropped the evening dose all together.

After searching online for days on this topic I am thankful to everyone in this thread for contributing. I was feeling pretty isolated before.

My psychiatrist and neruo-psychologist recommended taking Gabapentin as a mood stabilizer to ease the volatile roller coaster of emotions I was experiencing a year after a violent assault by a stranger who attempted manslaughter. In short, I suffered a TBI and needed facial reconstruction surgery. Needless to say my life has never been the same as I have had hundreds of medical appointments since. I was diagnosed with PTSD and have experienced so many health challenges since, some of which are anxiety, depression, suicidal ideation and as not often discussed, sexual dysfunction.

I was on Gabapentin for a total of 8 months. I started at 100mg/day (before bed) for the first month. Then it was increased to 200mg/day for the second month. Then it was increased to 300mg/day for the third month, but I had a very strong reaction to the 300mg as I am very sensitive and after 4 days my dr.'s reduced my dose back to 200mg for the remainder of my usage. For the most part, I couldn't tell a significant difference but my family said they could so I continued with the usage until the 7th and 8th month when I started waking up with headaches that would last a few hours and I was having difficulty sleeping. I believed it was caused by my medication so I asked my dr.'s when I could taper down to see how things would be. That was three weeks ago.

Because I was on a low dose, my dr.s said take a week to drop down to 100mg/day, then go off completely.

Give or take a day, I followed these instructions until I was completely off the medication.

Everything was pretty good for about 96 hours.

Then what seemed like out of nowhere between day 4 and day 8 post gabapentin, I experienced loss of arousal, low libido, sexual dysfunction, mild depression and had 1 very emotional day of crying.

After talking extensively with my mom, a good friend and feeling reassured from my girlfriend on day 8 I have been less emotional but still feeling sad and apathetic.

For whatever reason I wasn't killed that day and since I am still alive I am going to keep fighting by doing what I can control like my diet and exercise and meditation and give myself grace through this recovery process.

I hope that my story can provide some help and possibly hope to others.

And likewise, if anyone can offer any insight into how life was like immediately after or longer thereafter taking gabapentin, I thank you ahead of time.

Sincerely,
Caleb

@dreamchaser17 Welcome to Mayo Clinic Connect. Glad to have you.

What you have gone through is horrific. Not only was the event traumatic but all of the medical issues that resulted are traumatic to I imagine.

It sounds like you have a good support system. May I ask if you are seeing a therapist? Are you seeing a trauma focused therapist? Have you been referred to EMDR? Below I have a link describing EMDR. It has shown great efficacy for isolated trauma events.
- What is EMDR? https://www.emdr.com/what-is-emdr/

Regarding your Gabapentin question, members like @hopeful33250 @parus @artscaping have discussed this topic in the past and may be able to offer support.

Below I have linked a recent discussion in Chronic Pain that will likely be helpful and connect you with members that can help support you.

May I ask if there is a way to wean off more slowly from the medication?
- Gabapentin vs Side Effects https://connect.mayoclinic.org/discussion/gabapentin-vs-side-effects/

Hi Erika,
I am seeing a therapist. But that in itself was a difficult. It took 14 different therapists to finally find one who would agree to see me consistently and she has changed my life. It meant so much just to have someone who was willing to listen. Several of the previous therapists no showed several times, others agreed to see me and after a session or two they would step back and say my trauma was too complex. One retired and never left a referral.

Nevertheless after two years of counseling and many EMDR sessions things have improved. I found EMDR sessions to take a physical toll on my body so we spaced them out as needed.

Thank you for referring me to @hopeful33250 @parus @artscaping, I will be sure to review their contributions.
Thank you for the link as well.

I really appreciate your help.

Sincerely,

I had been taking 900 mg gabapentin at bedtime for many years. This was to treat RLS and pain from RLS.

I dropped it to 600 mg for six months and didn't have much problem with withdrawal. After six months, I dropped it to 300 mg and had some problems with anxiety for several days.

After two weeks at 300 mg, I dropped it entirely for five days. This was a mistake - hell of a week with high anxiety, some depression, and bad fatigue. Last night, I went back to 300 mg at bedtime. Feeling some better this morning and assume it will take three or four days to feel normal.

I'm thinking to stay at 300 mg for at least 30 days and then try 200 mg.

I really want to be through with this drug!

Yes! Take it slow! Go easy on yourself.
I was on 1200/day, I think, a few years ago for horrific nerve pain resulting from an infection in my toe which was allowed to go on too long because that toe is numb from nerve damage in my back.
I, too wanted to be done with the gabapentin which at least worked for me but I was gaining weight.
I tapered it myself, 100 mg at a time allowing at least a week for each step down. 4 days after each drop I felt very angry for a day or so. Then it passed and was easier to tolerate after learning to expect it. I had to go back up quite a few times on the way down, but don't give up!
Just keep at it and you'll get there.
Maybe you can get some 50 mg capsules if they exist. And maybe something else temporarily for the anxiety if you can't taper slowly enough.
Write down the dosage, date, and effects so you can manage the taper and go back up a little if needed.
Fast forward to now, I am again tapering from 400 prescribed for nerve pain and trouble sleeping from anxiety. Going slowly, 100 mg at a time, down to 200. I am now on a tiny dose- of Buspar which is working well. So far not much trouble with nerve pain which I now have intermittently all over my body.
400 mg of gabapentin was leaving me barely able to wake up, really dopey. I super dislike that and again have gained weight.
Best of luck getting off of it! It can be done! Your doctor might be helpful, too. (I struggled like crazy to get off sertraline, succeeded, and would NEVER take another SSRI. Buspar is an SNRI which is reported to be relatively easy to discontinue.)
You can do it!