Gabapentin dosage for trigeminal neuralgia?

Posted by pointeofview @pointeofview, Sep 14, 2021

I am currently on 1800 mg/day of gabapentin, but am still having a fair amount of pain. On a scale of 1 to 10, the background level is about a 2 with occasional flares to a level of 5 or 6.
Does anyone have luck with gabapentin, and if so, what dosages?

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roninaustin | @roninaustin | Sep 4, 2023

In reply to @debbie2721 "Interesting, I hope it works." + (show)

carbamazepine lowered my sodium too much. switched to duloxetine 60mg and sodium ok

roninaustin | @roninaustin | Sep 4, 2023

In reply to @debbie2721 "Interesting, I hope it works." + (show)

After 25 -30 years treating TN with All meds they stopped working, Had cyberknife procedure and it worked -- only for a few months!.
Dr. suggested pain clinic---No WAY.
After several months of personal research I found a few clinics offering a number of other procedures. I found the following to be helpful: Mayo (Rochchester), UT Southwestern(Dallas), Cleveland and Johns Hopkins (Baltimore). Chose Johns Hopkins, and, after consultation, Dr. recommended very simple procedure of injection of sterile gycerol thru cheek. Half day out patient procedure. About 1 year I have no TN pain or side affects.
note: I am 86 years old and in excellent physical condition, no compromising health conditions (except age!)

jimliberty | @jimliberty | Sep 5, 2023

Thanks so much for providing this helpful info. My TN pain is not a sustainable way to live.

roninaustin | @roninaustin | Sep 18, 2023

In reply to @mpeters "I had an adverse event with carbamazepine. I was in the hospital for four days, then..." + (show)

carbamazepine caused low sodium levels. In hospital several times.
After trying unsuccessfully other meds and cyberknife procedure I finally had a shot of glycerole to the TN nerve thru my cheek and 60 mg Duoxetine pill twice daily, Shot was in Feb, and I have not had any TN pain since. Procedure done at Johns Hopkins in Baltimore

mpeters | @mpeters | Sep 18, 2023

Thank you for giving me hope. I had low sodium too. I was on restricted liquids. Are you no longer taking meds? Ggabapentin was prescribed for me and Mayo says it doesn’t cause low sodium.

minadude | @minadude | Oct 26, 2023

I'm on 2400 mg gabapentin a day for idiopathic TN (over three doses) and I am not pain free. I also have a background level of 2 with flares of up to 7 or 8 out of a pain scale of 10. On top of that, I live with the side effects: for me, gabapentin kills my short-term memory (anything that isn't pinned down in my phone or computer, or on a piece of paper, is gone), makes me light-headed and affects my balance, making me more likely to fall over; it also causes problems with my digestion and flattens my emotions whilst sometimes causing an increase in anxiety (usually when I am late with a dose; missing a dose entirely leads to jitters). However, compared to getting necrotic skin conditions (carbamazepine) or being left unable to sleep (oxcarbazepine), my neurologist considers the side effects "livable". My neurologist insists I can go up to 3600 mg a day, but possible and desirable are not the same thing. I usually hold off increasing until the next bad attack and then my resolve weakens and I do increase. The aim was originally to get to a dose where I am pain free but this doesn't seem to be happening. However, gabapentin allows me to continue to work - I really couldn't without it. My neurologist suggested combining gabapentin with baclofen but did admit that it would make the short-term memory problem worse (!), so I'm not doing that one. I'm afraid I can't offer any solutions or any advice other than keep going as best you can, don't let it become the whole of your life. And settle on a dose that suits you best.