Tapering Off Gabapentin

Hello @edematta

I see that this is your first post on Connect, welcome! I appreciate you joining this discussion. If you are comfortable sharing more about yourself, did you start taking Gabapentin for neuropathy pain caused by diabetes or something else?

To answer your question, I tapered to 100 mg. That works well for me if I'm having pain from neuropathy.

Have you just been taking Gabapentin for one month now?

I have been taking clonazepam, 500 micrograms once daily, for RLS for the last 4 years. I did not like the long term consequences of this drug and asked my Dr. to prescribe pramipexole in its place. He first said that would be unwise as clonazepam was addictive. When I said that was the main reason why I wanted to stop he agreed to take me off it, but gave no advice on reducing the dose gradually. I checked on the internet and found advice saying I should cut my dose by 25% a week. I did this and took the final morsel a fortnight ago. Withdrawal symptoms have not bee severe but troublesome (lack of sleep, stomach pain, loss of appetite, weight loss and mild depression). I now learn that the 25% taper programme is regarded as far too fast by experts. Would it be wise to start taking clonazepam again at a minimum 125 micrograms for some weeks before finally stopping altogether, in order to reduce or eliminate these side effects?

@ivan13za Welcome to Mayo Clinic Connect.

A few questions that came to mind as I read your post, so please bear with me! It sounds like you did not start pramipexole, correct? If your doctor agreed to take you off clonazepam, I am surprised he did not offer a schedule to decrease your dosing slowly. Now it seems you have weaned yourself off of the clonazepam, am I correct? If it has been 2 weeks since your last dose, it would be best to have a medical opinion from your doctor, as to starting a small dose again then weaning off again. It might do more harm than good. But your doctor can help you make that decision.

Will you check with him and get back to me with what you find out?
Ginger

Thanks for you interest Ginger. I started taking Pramipexole, minimum dose of 0.088mg at bedtime as soon as I stopped taking Clonazepam, without it the RLS is very troublesome. I have weaned myself off Clonazepam completely. Like you, I was surprised, in fact astounded, that I was given no advice and this has damaged my confidence in that particular doctor. Right now I think I will struggle on without returning to a minimum dose of C'pam but as a matter of interest I will see if I can get some advice re starting C;pam again on a micro dose before stopping completely.

@ivan13za If you feel your confidence is shaken with your current doctor, it might be time to seek out a new member to your medical team. Please let me know what you decide.
Ginger

Thank you Ginger. I had already decided to do that but it is not easy over here (Scotland where we have a NHS medical practice and you generally get to see/speak to the first available Dr.). I did speak to another Dr. today on an unrelated matter but raised the question of Cl'pam tapering. Her advice was stay off it and review in a week or two. She was not totally sure but did feel going back to a micro-dose might mean losing any ground gained. Much as you felt.
Ivan13za

Today, with the approval of my doctor, I'm starting to taper off gabapentin after daily use for 6 years. I've taken between 900 mg and 1600 mg (what I'm currently taking) per day for generalized anxiety and panic disorder. Over time I've been having more and more odd symptoms that are interfering with my daily life, and it isn't helping my anxiety at all anymore like it did at the start of taking it. Now I just feel foggy and out of it, my memory is much worse, I'm more anxious and have this unshakable feeling of "doom" that settles over me, I'm more irritable, I have blurry vision and burning, watery eyes, etc., and the weirdest of all: every single evening like clockwork, I start to feel really warm like I have a fever. Sometimes I have chills, but I don't have a temperature.

I've read some absolute horror stories about coming off this medicine and honestly, I'm scared. I really want to be off this, but I'm afraid the process is going to be too anxiety-triggering. Does anyone have any advice?

@rep333
Using a compounding pharmacy is your best bet. I use the 5-10% method. (The general guideline is to not exceed a 5% to 10% reduction of the current dose every four weeks. One study found that a “tapering” method used by many physicians—to reduce a benzodiazepine dose by 25% a week—was ineffective for at least 32% to 42% (that is, they failed to get off the drug).)
Taper slowly and if start to have withdrawals increase your dose and taper more slowly and you might want to increase the time between your
your cuts.
I had no problems going off it.
Good luck,
Jake

Hi @rep333 and welcome to Mayo Clinic Connect. I moved your post here:
- Tapering Off Gabapentin
https://connect.mayoclinic.org/discussion/tapering-off-gabapentin/?pg=4#comment-723955 so you can connect with others tapering.

Did your doctor talk to you about the likely side effects?

I have been taking 1200 mg per night for about a year now, and its been working very well for me overall. The only thing is--sometimes I feel it is a bit too much in terms of feeling groggy during the day, etc. and it takes me a while to get going and fully wake up.

I want to try decreasing to 900 mg or 600 mg over the next 6 months or so.

I currently only have 300 mg capsules. Would it be hard to try dropping to 900 mg from 1200 mg capsules (my doctor initially suggested that) but I am worried that 300 mg for one titration interval is too much.

Is it best to get 100 mg capsules for a taper? like dropping 100 mg a week or every two weeks?

Only problem is that then I would be taking up to 12 capsules a day for a while...