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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jimmygold70 on June 30, 2001, at 14:57:53
1. What is the typical daily dose for Neurontin when treating anxiety (Social Phobia and Panic Disorder in my case ?)
2. What is the starting dose ? How fast should I go up ? I want to be on the safe side, though !Thanx,
Jimmy
Posted by SalArmy4me on June 30, 2001, at 15:03:10
In reply to How much Neurontin for SP ?, posted by jimmygold70 on June 30, 2001, at 14:57:53
Gabapentin.
Pande, Atul C. MD, FRCPC et al. Treatment of Social Phobia With Gabapentin: A Placebo-Controlled Study. J of Clin Psypharm. 19(4):341-348, Aug 99.
{NOT FROM MEDLINE}
"This study has shown that gabapentin produced a significantly greater decrease in the symptoms of social phobia at 800 mg or more than did placebo as measured by the LSAS. Treatment response seemed to be influenced by age and gender, an observation for which only speculative explanations can be offered. Because women exhibited greater responses to placebo, the drug-placebo treatment difference was smaller for women than for men. Despite the influence of these variables, gabapentin seems to have anxiolytic activity, which confirms the anxiolytic profile seen in preclinical behavioral experiments."
Posted by PaulB on June 30, 2001, at 16:08:57
In reply to How much Neurontin for SP ?, posted by jimmygold70 on June 30, 2001, at 14:57:53
> 1. What is the typical daily dose for Neurontin when treating anxiety (Social Phobia and Panic Disorder in my case ?)
> 2. What is the starting dose ? How fast should I go up ? I want to be on the safe side, though !
>
> Thanx,
> JimmyPaulB writes >
It is difficult to give guidelines on the dosing of Gabapentin for social anxiety because its manufacturer gave up on its trials for the disorder so there are no guidelines to adhere to. Starting dose overwise is 300mg a day. Gabapentin is usually taken three or four times a day in bipola depression and the dosage given for bipola depression would be much higher, even up to 4800mg in some cases.
However I did read that 1600 mg was used for anxious patients but it might be that your best bet is via a trial and error process and then you can work out whats right for you. Maybe 300mg 2xdaily to start. If its not enough then adjust your dose.
It is also worth noting that Gabapentin is not like a benzodiazepine. More of it will not produce a greater anti-anxiety effect until the point where you just fall to sleep for hours. The receptors will 'shut-down' until enough Gabapentin has been cleared so you dont what this drug to build up and up in your body because it wont be to your advantage. Whats good about Gabapentin though is that it has a short half-life-6 hours so this becomes less of a problem. People with epilepsy and bipola depression who dotake the high dosage find the anxiolytic and sedative effects subside after a few days.
This is just from what ive read though I have never taken Gabapentin but I hope this information helps.
Posted by Rick on June 30, 2001, at 18:13:08
In reply to How much Neurontin for SP ?, posted by jimmygold70 on June 30, 2001, at 14:57:53
I have a copy of the original journal article reporting on the placebo-controlled study for Neurontin (gabapentin) in Social Phobia. Dosage ranged between 900mg and 3600mg a day. 77% of the subjects got up to at least 2100. While the higher doses tended to show greater responses, this was not systematically investigated. That question was cited as a possible follow-up study -- one I'm sure will never happen now that pregabalin is on the way.
The researchers started everyone out at 600 mg/day split into two doses. By the end of the first week they were all up to 900 mg/day, split into three doses. (I couldn't understand why one of the doses was at bedtime, given Neurontin's very short half-life. I e-mailed one of the article's authors and he agreed that this might not have been the optimal approach.) Thereafter, the dosage was increased by 300 mg a day until 3600 mg or the emergence of limiting side effects, whichever came first.
Of course, just because the research was done this way doesn't necessarily mean that that's the optimal approach for you. But it should help allay your concerns over moving up too fast. Neurontin's a very safe med.
At the end of 14 weeks, 32% of the gabapentin users were considered responders, vs. 14% response for the placebo. The article also talks about differences in theraputic responders and placebo effect by age and sex.
I got up to about 3200 mg (four 800 mg tabs)before I gave up on it because of some unusual side effects. So it never got a fair trial for me.
If you'd like to order the full article, The Journal of Clinical Psychopharmacology charges an amazingly low fee -- $3. Go the the link below and request this document: Volume 19, number 4 pages 341-348, "Treatment of Social Phobia with Gabapentin: A Placebo-Controlled Study".
Rick
http://www.psychiatrist.com/order.htm
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> 1. What is the typical daily dose for Neurontin when treating anxiety (Social Phobia and Panic Disorder in my case ?)
> 2. What is the starting dose ? How fast should I go up ? I want to be on the safe side, though !
>
> Thanx,
> Jimmy
Posted by Rick on July 3, 2001, at 1:43:48
In reply to Re: How much Neurontin for SP ? » jimmygold70, posted by Rick on June 30, 2001, at 18:13:08
CORRECTION:
The link I gave originally leads the the Journal of Psychiatry rather than the Journal of Psychopharmacology (which published the article on Neurontin in Social Phobia).
However, not long ago the Journal of Psychiatry had a complete supplement dedicated to "Advances and Emerging Treatments in Social Phobia."
This excellent collection of articles can be ordered online for $10. Go to the link I gave before:(http://www.psychiatrist.com/order.htm)
and request Volume 62, Supplement 1.There's a lot more that might be of interest as well, as listed on their "Recent Table of Contents" page at: http://www.psychiatrist.com/toc.htm
This is a good psychiatry journal that has such reasonable prices and easy online ordering compared to the others. Obviously you get much more detail from the full articles than from those brief Medline abstracts.
Rick
(Jeez, I never thought I'd end up sounding like a spammer! Maybe I should offer a fake "opt-out" option with a bogus e-mail address??)
> If you'd like to order the full article, The Journal of Clinical Psychopharmacology charges an amazingly low fee -- $3. Go the the link below and request this document: Volume 19, number 4 pages 341-348, "Treatment of Social Phobia with Gabapentin: A Placebo-Controlled Study".
>
> Rick
>
> http://www.psychiatrist.com/order.htm
>
>
>
>
>
> ----
> > 1. What is the typical daily dose for Neurontin when treating anxiety (Social Phobia and Panic Disorder in my case ?)
> > 2. What is the starting dose ? How fast should I go up ? I want to be on the safe side, though !
> >
> > Thanx,
> > Jimmy
This is the end of the thread.
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