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  • How long for Gabapentin to kick in?

    Just wondering, how long it took Gabapentin to start helping with joint pain for others?

    I am taking the maximum dose of my prescription (all be a very low dose of only 300mg/day - I know that some people take far more than that, up to 1,800mg/day, but the maximum I was prescribed was 300mg/day, and I am a stickler for rules and staying at that - supposed to go back to doctor in 10 days if it isn't helping - maybe he'll up it then or try something else). Anyways, I am on day 4, and nothing.

    So, has anyone else had to build up Gabapentin to make it effective? Or is it like a NSAID with almost instant relief?

    Thanks ^_^

  • #2
    Hi there

    I was put on gabapentin, starting very slowly at 100mg. I started to notice a difference from 200mg (after about ten days from start), continuing on with effect to 900mg which is a pretty "standard" dose according to the manufacturer. I stayed there for a while and I am now on 1200mg a day and doing pretty well there. Gabapentin has made a huge difference to my nerve pain, neuropathy and some other CNS issues.

    I found that it was good to work up slowly as with every dose change I was hit with a real "wall" of tiredness for about 3 days.

    I hope it works well for you :hug:



    • #3
      Hello there,

      They usually start you off on a lower dosage and up the dosage as needed.... It is one drug that you can take in higher dosages and has been very beneficial for me... I have been on this drug now for over ten years... I hope it gives you some relief...

      Love Penny


      • #4
        I have been on Gabapentin for 2 years. I currently take 900mg to 1200 mg per day. My neuro started me a 600mg per day for three weeks and then increased the dosage over the following month and a half to level off the nerve pain. I have been able to handle the current dosage without any side effects and it has been extremely helpful. Gabapentin is short acting so you may not feel any relief from such a low dose but once increased it should make a difference. Good luck and I hope you are pain free soon


        • #5
          Thanks guys! I hope it starts to kick in too! I did 100mg for 3 days, today is day 2 of 200mg, try that again tomorrow, and if nothing then I am supposed to go to the 300mg. Not sure if three days is enough time between increasing but so far I haven't really felt much of anything (could be also that it's the only med I have been given?). On Monday I go in for an allergy shot, which seems to set off my joint pains, so hopefully the Gabapentin works by then... or at least by then, I'll know whether it works or not ^_^ and I can more accurately report back to the GP if it's effective. Can be hard to tell sometimes for me because the pain is so transient. Some days it's very very low and then the next it can be almost intolerable. With NSAIDs it's pretty easy to tell that they work because they work so fast.

          Have been a little more tired lately, but I am not sure if it's the Gabapentin or Benadryl... or maybe the combination of both ^_^
          Last edited by FamiliarFaces; 02-14-2010, 06:24 AM.


          • #6
            First off, why are you getting allergy shots? You want to shut your immune system down, not boost it up. Your rheumy needs to be consulted on these.

            I've been on neurontin for 14 years now, but use it to control my migraine headaches. The neurologist put me on 1,600 mgs 5 times a day. I am down to 1,600 mgs twice a day, and this helps to slow my migraines down to 6 or 7 a year, from one that lasted 4 1/2 months. I also have a lot of scarring in my small intestine so have trouble absorbing meds and take a higher dose of just about everything.

            I hope it kicks in for you soon, or you may need to see your neuro doc sooner than expected.


            • #7

              The rheumetologist I went to see saw me for 15 minutes in the initial appointment and told me I didn't need to come back since there was nothing he could do for me ^_^ The only recommendation he made to the GP was to try me on Gabapentin, so, that's what I am doing. Oddly enough, since the appoinment to the rheumatologist was so short, I didn't really have a chance to tell him all of my symptoms, and he never got the blood work done from the walk in clinic that was seeing me for tingling of the hands and feet problems (so he never knew I even had those problems) so I am not certain where the idea of Gabapentin came in in the first place. It seems, to the best of my knowledge to be given to me, for pain caused by tendonitis (because any NSAID that has ever been affective for pain, caused stomach problems).

              Anyways, long story short, I can't really consult him about the allergy shots, because I am not his patient anymore. Failing getting relief/or having Gabapentin work in 10 days, I have to go back to the GP. I want to ask for a second rheumatologist opinion. I have never been to a neurologist. When I complained of constant tingling in the hands and feet, I think I went three or four times, they did bloodwork and the only thing they could come up with was slightly low VitB12, but they said that wasn't causing it... the tingling was caused by stress or pain.

              So, right now I am stuck with a diagnosis of "You'llgrowoutofititis"... which if it is right, would be fantastic! But not really strong enough evidence to support stopping the allergy shots. I have already, due to moving a lot, had to after reaching maintainence dose of my allergy shots had to be started on allergy shots three seperate times... if I just stop now, and they doctors decide to take a different approaoch to my joint pains etc. and I have to start up again I'm not sure I can handle it (it's quite a lengthy process, and you have to have a job that lets you miss work to get the shots, etc.)


              • #8

                I remember you GP said something about a possible referral to an Immunologist. That might be a really good idea, they seem to be the detectives of the medical world and will methodically go about unravelling the causes for your ill health. They could also advise you on your allergies and the best approach to that given your circumstances. I actually see a Professor of Immunology who specialises in autoimmune conditions. He was the one to diagnose me and continues to treat me - so it might be a good move for you.

                You also mentioned in another post about being mildly deficient in Vitamin B12 - this is most likely the cause of your tingling hands and feet and they should be treating you for it. If you are deficient in B12 it can have far reaching effects, not the least of which is fatigue too.

                The allergy shots 'could' be a bit of a worry if you do indeed go on to be diagnosed with Lupus.

                First, some who receive allergy shots (immunotherapy) will experience a lupus flare following treatment.
                • In 1989, the World Health Organization recommended that people with autoimmune diseases should not receive certain types of allergy shots.
                • Allergy shots might cause the person to make more anti-DNA and other lupus-related antibodies in addition to making antibodies against the agent causing the allergy.
                • People with lupus are advised to consult their rheumatologist before receiving any type of allergy immunotherapy.

                Just throwing out some ideas here I hope the Neurontin helps you once it builds up.



                • #9
                  Thanks for your advice Lily and Sally,

                  My journey to where I am am now, started when I noticed that every time I restarted my allergy shots new joint pain started up... and there was a two year period where I was living out of hte country (and couldn't get allergy shots) where I almost had not joint pain. So I did an internet search for multiple joint pain and allergy shots... and eventually I found an article about polyarticulate joint pain. Up until then when I asked about having so much tendonitis doctors said it wasn't anything to worry about. But now I had real proof that having so much joint pain was a real thing.

                  After that I went to the doctor to ask about it. I had at that time pretty much forgotten about the allergy shots... until I did come across what the WHO had said about allergy shots and autoimmune diseases (I had then begun doing research on all of the disease that caused polyartiucate jiont pain - lupus being one of them). When I mentioned it to the doctor he did say, that maybe it was autoimmune, and I should go to the immunologist.

                  I think I will have to be more insistant when I go to the doctor on Friday. And ask to see the immunologist (he was the one who prescribed the allergy shots... but that that time - which is the third time I started allergy shots - my other symptoms were no where near what they are now, and I still had not connected anything)... can't hurt to see what he says.

                  I also would like to see another rheumatologist to get a second opinion as well (and have them know all my symtoms)... not sure if going to two specialists at one time would be okay or not.

                  But, if they found out what I had was autoimmune then I would ask the doctors about stopping the allergy shots. But right now, I don't know if they know at all what I have.

                  I am supposed to get retested for VitB12 in 6 months. Until then, just eat foods high in VibB12. When my sister was diagnosed with inability to absorb B12 she did the 24-hour urine test... seems much easier to me that being retested in six months, but what can you do? That's what the doctor said. (Well, the one doctor thought I should be given injections, but the next doctor vetoed that).

                  Lily, ideas are great. Because right now, I am just lost, kind of floating around in a giant sea. So,v anyone who can point me in any direction right now is much appreciated ^_^v


                  • #10

                    If your joint pain etc surfaced with the allergy shots it's important to tell the Immuno. Also tell him about your other stuff and treat it like you would a Rheumy appt. Does he or the Rheumy know your sister has a lack of intrinsic factor (I assume because of Pernicious Anemia) ? That is autoimmune in nature because the immune system attacks your body and renders you unable to process Vitamin B12. Important to mention any AI condition in your family history. It won't hurt to update the Immuno on all of this, they are good at putting puzzles together and let's face it AI diseases are puzzles.

                    Lupus is a disorder of the immune system and many Immunologists treat it very successfully. I did go for a second opinion during diagnosis to a Rheumy, he diagnosed me with Fibro because at that time my bloods were negative. He didn't even do a pressure point test So on follow up I challenged him (nicely) and said about all my other Lupus specific symptoms and asked if they fell under the umbrella of Fibro - he was stumped of course because they didn't. He did however write to my Immuno with test results (MRI etc. lumbar puncture) he had run and I think it helped the Immuno get moving a bit faster I also saw a Dermy, who confirmed it was some kind of connective tissue disease (wasn't sure which one) and wrote to the Immuno to tell him his opinion. It all helped.

                    Good docs work together - bad docs have an ego problem - so you will have to suss out which category they fall into and take it from there - whether to tell each of them you are seeing someone else. Good idea to get all test results copies to take to your appointments. Of course by presenting copies of tests it will be obvious you have been elsewhere, but in reality that should only demonstrate your determination in improving your quality of life. Not something that should bother them. It also enables them to see what has and hasn't been tested which is helpful. Negative tests for certain things are good, it's all part of solving what it is or isn't.



                    • #11

                      Hmmm, I did not know that the Vit B12 deficiency thing my sister had was autoimmune (I am going to assume that what she has is Pernicious Anemia because, she described it to me as not a dietary deficiency but an inability to absorb Vit B12 - resulting in her having to have Vit B12 shots for life). The first time my blood came back it was labeled as having a "moderate chance of Vit B12" causing my problem (tingling of hands and feet) and the doctor was concerned about this, and she did some more bloodwork because of the bloods (and my diet is a little different as I can't eat a lot of red meat or fortified grain products - which could be th cause of my low Vit B12, and because my sister can't absorb Vit B12). She even suggested I should be put on shots myself. Next time it came back as a "low chance that Vit B12 was causing my problems" and the other (becuase this was a walk in clinic) doctor got mad at me for coming back to get my results - which they called me to come in for.

                      Hmmm, a diagnosis for fibromyalgia without testing the pressure points... that's like diagnosing a rash over the phone really, isn't it? It's almost funny how sometimes you have to lead a doctor down a path without telling him/her where you are taking them, so they can see things for what they really are.

                      I made an appointment to see the doctor on Thursday. I think I am actually going to be glad to get off the gabapetin, because, it does not seem to be helping my joint pain, but is causing me to be very groggy, and not really with it. I hope that he does not suggest upping the dose because I think it is causing mood changes, and I don't really like having drugs influence how I feel mentally. I think I will ask him to refer me to a different rheumatologist and to the immunologist, hopefully one of them can work things out for me. Also ask for copies of my bloodwork... not sure that will make him all that happy though...


                      • #12

                        I just wanted to say that i just started on this drug like a week ago and currently taking 100 mgrams a day but tomorrow going up to 300 a day.I am so hoping it does help me with the pains.My doctor is one that does not put you on another med unless she feels it will help.I cant say i have seen a huge differance but did not expect it just yet but so glad to read so many others are taking it and it is helping.I had not heard of this meds before and was sop glad to see this post about it and i do feel much better about it helping me.thanks everyone as ussual everyone in here is a huge help for sure.



                        • #13
                          Went to the doctor on Thursday... still on the Gabapentin, and increasing it more... supposed to get up to 800 or 900 before going back to the doctor and seeing how it goes (or stop earlier if it starts to work... no point going all the way up if something smaller works). Still continuing to build it by 100mg every three days, but if I am feeling groggy or wierd (not sure how to describe it, but I felt when I went from 200 to 300 a kind of flatlining of my emotions, but that was only lasted a while, and hasn't started up since I have been on 400... hopefully that was it and my body is over that!).

                          More importantly though, I got a new referal to a rheumatologist. I had phoned the local lupus chapter here and asked them for doctor's that specialized in lupus and/or autoimmune. (I am not actually convinced that what I have is lupus, but, the doctors seem to feel it is autoimmune, so I figure, if a doctor specializes in lupus, which is quite difficult to diagnose, and is often diagnosed by eliminating other diseases, then that's a good place to start, because if I have lupus, they are experienced, but if I have something else, they might catch it in the ruling out process... plus lupus specialist is probably pretty good at problem solving). So, she metioned a couple. And the GP refered me to one of them, said that the list of doctors I brought to him were all excellent, but that I'd have to wait a really long time to get into any of them because they were so good. I'm fine with that. This thing I have, doesn't seem to be going anywhere real fast, so what else do I really have to do but wait for someone good, or just give up? Both are just biding time, but the first is more proactive.

                          Wasn't much response when mentioned getting sent back to the immunotherapist... I think I will have to wait and see how it goes with the rheumatologist, and if that goes no where then to the immunotherapist. More likely I will run out of allergy shots before then and have to be refered back to get retested and refill so I can always talk to him then... I have a feeling it will take about 8 months to get into see this new rheumatologist (normal is 3-4 months, but I have known people to wait 8-9 for a specific one before! I don't know my actual date yet though).

                          I went back to physio today for the first time since Dec (have not really felt up to it and since I haven't been doing all of my excercises, and spending so much time at doctor's officed, I didn't really have time for physio appointments, but now I should have more time ^_^) and told the physiotherapist what was going on, and when I mentioned the new rheumatologist I was being refered to... she almost squealed that he was the best rheumatologist in town, if not ever. So, I figure, that when the referal comes through, I will be in good hands. ^_^v Until then, I just keep at the gabapentin, and do my physio and massage therapy (and I guess go to see the GP if any new symptoms appear). All in all, things are looking up.
                          Last edited by FamiliarFaces; 02-20-2010, 05:05 AM.


                          • #14
                            Hi there,

                            Just a quick reply as the dog is pestering me for a walk...

                            There seems to be some confusion here. Lupus IS and auto-immune disease so, by your doctors saying that they feel it is something auto-immune they are not necessarily disagreeing with you - on the contrary. However, they are keeping their options open as auto-immune diseases are very complex and many have overlapping symptoms making it very hard to know exactly which one it is.

                            It's great to know that you should be seeing someone so well considered



                            • #15

                              Yes, sorry, you wrote that in a much more less confusing way ^_^ The GP seems to still think that it is autoimmune... I myself, would probably bet money (if I had any ^_^v) that it is something autoimmune. So, since we are under that umbrella, I figure, may as well start with a doctor familiar with lupus, since if it is lupus, it will likely be tricky to diagnose being that it will look like many of the other autoimmune diseases (or some combination thereof). I'm open to any diagnosis really (so long as it is the correct one!) and am trying very hard not to try to attach myself into thinking that it is an particular one (I feel that if I start to think it might be RA, or lupus, or what have you, I wouldn't really be able to present an unbias account to the rheumatologist when I see him).

                              Since, lupus is autoimmune (but also a great immitator) and I show many of the symptoms it's easy to slip into thinking, "Ah yes! That's what I have." But in the end it's as likely to be a dozen other things that also have similar symptoms. So I think a rheumatologist experienced autoimmune (including lupus) would be a good place to start ^_^

                              And also the GP is being very open minded about anything (which, in some ways can be frustrating... because as a patient, when you are so frustrated you just want to go to someone who will tell you an answer, sometimes any answer, just because you want one so badly. But a diagnosis that is incorrect can of course be a very dangerous thing in some cases). He no discounting any disease unless there is a firm reason to do so, which I really appreciate because he is willing to keep looking until we find out what it is.
                              Last edited by FamiliarFaces; 02-20-2010, 06:04 PM.