Gabapentin and Mirtazapine

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I've been prescribed Gabapentin for pain 300 mg three times a day if needed - I'm also on 30 mg Mirtazapine for depression and anxiety.   I've been on this regime quite a while and tolerated it well, I then decided I would reduce my gabapentin over a few months which i did but the pain came back so I'm slowly returning to the prescribed doseage.  However, I'm experiencing dizziness and feeling faint . . . has anyone else experienced this on this combination . . . I'm not entirely sure that it is the combination of drugs causing this as I've tolerated it well in the past.  Thanks, Sue

 

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  • Posted

    I have just had breast surgery a few days ago, I have been on Gabapentin 75mg in the morning and 300mg at night, while I was in hospital one of the doctors gave me different meds. He crossed Gabapentin off and I was given Tramedol, as I was still bed ridden, I was very sceptical about the Tramedol. When eventually I wass able to walk around, I had instant pain relief. I had no back ache when getting up from the sitting position, and my legs felt like new again. When I got home I had no script for Tramedol, so went back on Gabapentin, the pain returned to my legs hands and feet, going to my GP tomorrow to ask for a script for Tramedol. After being on Gabapentin for over 5 years, I was told by my former GP, that I would need to be on Gabapentin or an opertion costing over $20,000?? I am not prepared to spend the rest of my days on Gabapentin.  
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  • Posted

    Hi Sue,

    Gabapentin attaches to the brain in a way that it depends on the medication to function normally. There are numerous side effects of Gabapentin, and especially tapering down. It takes six days before the medication leaves your body from any taper, so you may not feel the full effects of stopping a dose until six days later. I don't know how slow or fast you tapered down, but the side effects or discontinuation effects might be what you are experiencing. How far down did you go with Gabapentin, how much did you drop at a time and how long did you wait for the next drop? If you drop or taper down too fast for your system and brain, the symptoms will be much stronger. I had to taper down by 10 mg every 21 days in order to handle the discontinuation symptoms. Others can taper down by 100 mg and be fine or have minimal side effect symptoms. Dizziness and feeling faint are two very common side effects of coming off of or going onto Gabapentin. I have not taken the other medication you mentioned, so I cannot speak to the combination of those drugs.

     

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    • Posted

      That's very helpful Shammah - it may have been the gabapentin taper which caused the dizziness in the first place, I tapered by one level per 14 days so perhaps that was way too quick!
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    • Posted

      Ohhhh... yeah. If you tapered down by 300 mg every 14 days, that is way to fast. Also, once a person is below 1200 mg, the taper needs to be slower, and the lower you go, the slower you need to taper. If you were at 3600 mg, you could drop by 300 mg and be okay because it is not as bioavailable to be all be absorbed into your body. The lower the dose, the more bioavailable the medication is... meaning the more of it is absorbed and used by your brain, nervous system and body. So, the more dependant your brain is on the medication to function. At 900 mg, you want to taper off one dose at a time over several weeks. If you only have 300 mg tablets, you can get 100 mg tablets instead. When you are ready to go off it, you might have to switch to liquid and taper off 100 mg slowly. It all depends on your body, how sensitive you are to medication and what you can handle. Everyone is different. Best wishes to you!  :-)
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  • Posted

    Yes, I experience light headedness and terrible lethargy the day after I take 15 mg Mirtazapine and 500 mg Gabapentin at bedtime.  This combo of meds helps me sleep at night, but I am so lethargic the ENTIRE day  & evening afterward.  I initially was prescribed 300 mg Gabapentin to help me sleep, and it worked beautifully for the first 5 months, then stopped working.  My Dr. increased dosage to 600 mg. and that worked beautifully for a year or so, then it stopped working.  Dr. added the Mirtazapine to the 600 mg, Gabapentin, and I was finally sleeping through the night again, but the daytime lethargy is so bad that I have no motivation to do anything.  Does anyone else experience this?

    I am slowly tapering the Gabapentin by 100 mg. per week, to see if this helps.  So far, I am down to the 500 mg. and sleep is okay, but energy is still very low.

    I need to sleep, but I also need to function.  Dr. does not know what else to do for me.  Is anyone out there in the same predicament?

    Darbird

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