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Gabapentin is one of the drugs that in epilepsy (epilepsy) and nerve pain (neuralgia) are used. It is used since 1995 as an antiepileptic. Shortly afterwards it was discovered in addition its good efficacy against neuralgia. In this area, Gabapentin is now used mainly. Here you can read everything about Gabapentin.
Mechanism of action
The human nervous system is activated or inhibited by certain chemical messengers. Normally, these messengers are released according to the external circumstances and ensure an adequate reaction of the body to various situations such as injuries, stress or rest.
Nervous system this controlled balance is disturbed. Through a genetic predisposition or by injuries to the brain, the excitement intensified or inhibition may be reduced. The nervous system of the brain is hyperexcitable and can lead to seizures.
Also, prolonged irritation of the nerves in the back and in the limbs (peripheral neuropathy) by severe forms of diabetes (diabetes) or viral diseases of the nervous system, for example by herpes viruses lead to hyperexcitability of the nerve endings. These send signals by constantly cause irritation to the brain, and the patient sentient ongoing pain. The so-called nerve pain (neuralgia) can not be dealt with normal painkillers. To alleviate the symptoms of peripheral neuropathy and it therefore requires drugs that normalize the excitation of the nervous system.
The Gabapentin effect is that the stimulus is effectively reduced to the nerve pathways. On one hand, the drug prevents the release of activating neurotransmitters. On the other hand, it promotes the breakdown of indirectly activating neurotransmitters and thus lowers addition their concentration in the nervous system. It then bind less messengers to their docking sites (receptors) – Voltage and pain state is released
The full effect of the drug develops only after a certain treatment period (approximately one to two weeks).
The drug Gabapentin is excreted unchanged by the kidney. In people with kidney weakness, therefore, the dose should be reduced.
When is Gabapentin used?
The fields of application (indications) of Gabapentin are:
- various forms of epilepsy
- nerve pain, as can occur in diabetes and after virus diseases
How Gabapentin is applied
Gabapentin is usually applied in the form of tablets or capsules. The drug may be taken with or without food, but always with sufficient liquid (best with a large glass of water).
The Gabapentin dosage for adults is 1800-3600 milligrams per day. The active substance is absorbed by a special transporter (amino acid transporter) in the intestines, which can be saturated at high amounts of active compound. The daily dose should be divided in three single doses, therefore, so a full recording is ensured.
In order to achieve a uniform effect, the individual doses should always be taken in the same temporal spacing. For children, a lower dose is selected.
At the beginning of therapy Gabapentin is einschleichend dosed. This means that the dosage is increased gradually until the desired daily dosage is achieved. This so-called “Titration” can vary depending on individual tolerability take several weeks, especially because the doctor needs to find a specially matched to the patient dose, which brings a sufficient efficacy and the least possible side effects.
The Epilepsy typically requires long-term therapy, since it is curable only in rare cases.
In neuropathic pain Gabapentin can be discontinued after a certain period of treatment, but not abruptly, but by gradually reducing the dose over at least a week.
What are the side effects of Gabapentin?
Very common (ie in more than ten percent of those treated) it comes to viral infections, sleepiness (somnolence), fatigue and dizziness. With one to ten percent of patients Gabapentin causes side effects such as altered eating habits, changes in blood count, abnormal behavior (especially in children), convulsions, insomnia, and / or rashes. Even more rare (in less than one percent of people) there is water retention in the body tissues (edema).
What is to consider when taking this medicine?
The amount of absorbed drug is reduced by aluminum and magnesium-containing medications to neutralize the stomach acid (antacids). Gabapentin should be taken at intervals of at least two hours after ingestion of such antacid, therefore, that it can work.
In concurrent use of morphine (strong pain killers) should the dose of Gabapentin be reduced.
Pregnancy and lactation
In pregnancy may stop taking Gabapentin lead to deformities and adjustment disorders of the newborn. If possible, the patient should be treated during pregnancy with another active ingredient (Lamotrigine in epilepsies and Amitriptyline in neuropathic pain). If this is not in question, the dose of Gabapentin should be selected as low as possible.
In an inflammation of the pancreas (acute pancreatitis) may not be taken Gabapentin.
How to obtain drugs with Gabapentin
Gabapentin is available on prescription and only with a prescription from a doctor in pharmacy.
What you should know about Gabapentin
Due to lack of efficacy of Gabapentin is not the first choice antiepileptic drug, but is considered to be so-called reserve funds. However, it may well make sense to combine with other antiepileptics Gabapentin.