NEURONTIN® (Gabapentin) is indicated for:
- Management of postherpetic neuralgia in adults.
- Adjunctive therapy in the treatment of partial onset seizures, with and without secondary generalization, in adults and pediatric patients 3 years and older with epilepsy.
The active component in NEURONTIN capsules, tablets, and oral solution is gabapentin,which includes the chemical name 1-(aminomethyl) cyclohexaneacetic acid.
Neurontin is a really effective antiepileptic, in constant availability at a low price. Neurontin helps prolong remission. Feel like a full member of society, independent of epilepsy.
March 26 is world epilepsy day or Purple day. It was invented in 2008 by nine-year-old Cassidy Megan, who decided to prove to society that despite her illness, she is no different from all ordinary people. Now there are about 55 million people worldwide struggling with epilepsy, which is considered one of the most ancient and common neurological diseases. About the disease, patients and methods of treatment say different things, often people are at the mercy of stereotypes, myths and misconceptions.
At the beginning of treatment dose is 900 mg/day three times a day, the initial dose of 900 mg/day three times a day. Depending on the effect can be increased to a maximum of 3600 mg/day.
But it is necessary to consider that at reception of preparation in a dosage above 1800 mg/day of the best efficiency was not observed.
Treatment can start at once with a dose of 900 mg/day (300 mg 3 times per day) or you can increase the dose gradually to 900 mg/day for the first 3 days of the following scheme: 1-St Day-300 mg of the drug 1 time/day; 2nd day-on 300 mg 2 times per day; 3rd day-300 mg 3 times per day.
In adults and children over the age of 12 years effective dose of 900 to 3600 mg/day. Therapy can start with a dose of 300 mg 3 times per day on the first day or increase gradually to 900 mg according to the scheme described above (see subsection "neuropathological Pain in Adults").
In the subsequent dose can be increased to 3600 mg/day (divided into 3 equal admission). Good tolerance of the drug in doses up to 4800 mg/day. The maximum interval between doses with three times admission of the drug should not exceed 12 hours to avoid the recurrence of seizures.
dosage for children
In children aged 3-12 years, the initial dose of the drug varies from 10 to 15 mg/kg/day, which is prescribed by equal doses 3 times per day and increase to an effective approximately 3 days.
Effective dose of gabapentin in children aged 5 years and older is 25-35 mg/kg/day equal doses in 3 admission. Effective dose of gabapentin in children aged 3 to 5 years is 40 mg/kg/day equal doses in 3 admission.
Good tolerance of the drug in doses up to 50 mg/kg/day with prolonged use. The maximum interval between doses of the drug should not exceed 12 hours to avoid the recurrence of seizures.
in the treatment of neuropathic pain:
- The most frequent side effects occurred in less than 1%:
- In the digestive system: dyspepsia, diarrhea, nausea, constipation, flatulence, vomiting, abdominal pain, dryness of the mucous membrane of the oral cavity.
- In the nervous system: Drowsiness, disturbance of thinking, tremor, headache, gait disturbance, coordination violation, amnesia, ataxia, confusion, dizziness.
- In the respiratory system: shortness of breath, pharyngitis.
- On the skin: skin rash.
- In sensory organs: conjunctivitis, middle otitis.
Other: Fatigue, back pain, accidental trauma, flu-like syndrome, infection, peripheral edema, increased body mass, hyperglycemia, pain of various localization.
in the treatment of partial cramps:
Gabapentin as an additional tool was studied by more than 2,000 patients; Portability of it was good.
Gabapentin is most often used in combination with other anticonvulsant means, so it is impossible to establish which drugs cause side effects.
Other: Back pain, fatigue, fever, viral infection, peripheral edema, increased body mass, fatigue, general malaise, swelling of the face, erectile dysfunction.
With a single admission gabapentin in the dose of 49, the following symptoms were observed: dizziness, double vision, speech impairment, drowsiness, lethargy and mild diarrhea.
Anti-epileptic drugs, for example gabapentin, can increase the risk of suicidal thoughts in a state of depression.
It is recommended to monitor patients and control the occurrence or worsening of depression, the emergence of suicidal thoughts, as well as for any changes in behavior.
In the case of the development of pancreatitis from the admission of Gabapentin, may have to stop taking the drug.
What happens if I stop taking gabapentin
It happens that the syndrome "cancellation", accompanied by the development of seizures, but in the treatment of Gabapentin this syndrome is not noted, a sharp cessation of therapy anticonvulsant drugs in patients with epilepsy can provoke the development of epileptic status.
What is epilepsy? How is epilepsy treated?
What are the mistakes of many of us when faced with a diagnosis of epilepsy? How does epilepsy affect people's social life? What to do if you cannot avoid irritating factors that provoke epileptic seizures?
Life with epilepsy requires from patient enough serious self-control. Fortunately, most stimuli that induce seizures can be managed or avoided. In this help, drugs such as Neurontin. On our website it is easy to used Neurontin, at an affordable price.
Statistics and dynamics. How to detect the threat of epilepsy?
About epilepsy is known for a long time, it remains the oldest recognizable disease in the world. It began to describe a few thousand years ago. People with epilepsy and their family members preferred to hide their diagnosis - this often happens in our days. Experts of the World Health Organization know that for centuries epilepsy was surrounded by fear, misunderstanding, discrimination. In many countries, discrimination based on epilepsy, in some of its forms, continues to this day and can affect the quality of life of people affected by this disorder, as well as their families.
There are already over 55 million people suffering from epilepsy in the world. Epilepsy is considered a permanent brain disorder, manifested in people, in absolutely all states and strata of society. This disease is characterized by recurrent seizures. These seizures are expressed in the form of temporary involuntary convulsions, in some cases accompanied by loss of understanding, loss of control over the functions of the intestinal tract and bladder.
The basis of development, epileptic convulsive seizures, is considered non-observance of the balance of the two components of the brain - disturbing and blocking. Normally, these systems work synchronously, forming an ideal level of activity of neurons. With epilepsy, there is an increase in agitating activity, a lack of blocking activity. As a result, this leads to this, then that the single categories of nervous cells begin to simultaneously perform electrical discharges of enormous power. These discharges are sent to other parts of the nervous system, which leads to an attack. Antiepileptic substances such as Neurontin (Gabapentin) reduce the excessive dynamism of neurons, or completely suppress it. Immediately nervous attack is considered only the tip of the iceberg, visible, but not a detailed component of the disease. With the help of a fit, the mind "loses" unnecessary tension; a nervous attack is done by reducing the painful dynamism of nerve cells.
Signs and symptoms of epileptic seizures:
As the diverse clinical manifestations of epilepsy as well as its causes. Epileptic seizures may occur as a result of traumatic brain injury and a brain infection. In addition to these causes, epilepsy can cause tumors or stroke. If convulsive seizures appear after exposure to the human body of a particular factor, such epilepsy doctors call symptomatic. The list of causes of epilepsy is not limited to these, but there are attacks that cannot find a specific cause. The disease occurs as if by itself, and in its development a greater role played by genetic factors. This type of epilepsy is called idiopathic epilepsy. Another form of epilepsy, which is isolated by experts, is reflex epilepsy.
When it is an attack of the disease is provoked by an external stimulus. Most often it serves as a visual impact: for example, flashes of light from the TV screen or light music at the disco. In rarer cases, the attack can trigger intense thinking, listening to music or eating. One of the important principles of treatment of such attacks is to avoid factors that provoke seizures. The nature of convulsive seizures can change with the course of the disease: their duration and external manifestations in some patients do not remain stable throughout life.
A simple attack can precede a complex attack. Often characterized by short-term discomfort in the abdomen or head, for example, a sense of anxiety or elation, humming, unpleasant smell, or spots before the eyes. People who can learn to recognize the onset of an attack before it passes to other parts of the brain can use this as a warning to take action against possible injuries during the attack itself.
The most common seizures are seizures, these are complex seizures, and were previously known as temporal lobe or psychomotor seizures. Complex attack consists of three short phases:
- The person stops what he was doing and there is a dazed look and a freezing glance.
- Starts automatic, aimless behavior that lasts a few minutes.
- The man is regaining consciousness, does not understand what happened to him.
Despite these difficulties, doctors identified several permanent characteristic features of convulsive seizures. First, epileptic seizures always have a sudden onset. A person suffering from epilepsy cannot accurately predict when he will have a seizure. This feature of epilepsy can be considered one of the factors that have a negative impact on the psychological state of a person. The patient with epilepsy living in the tension, the constant anticipation of what he will attack.
WHAT neuroscientists say about epilepsy:
Many are convinced that attacks are the only possible scenario-a person loses consciousness, beats in convulsions, foam appears around the mouth. Not at all.
Dr. White (neurologist) said:
Any sudden events can cause an attack. His task-to see a doctor, and the task of the doctor-to qualify the event explain.
An attack of fading, freezing stop the look and speech without falling, but with a possible pronounced gesticulation. there may be attacks of twitching limbs. Also, can even fall out of the hands, there are squats with falls back
What can alert a person and make you think about epilepsy?
Characteristic features of seizures of epilepsy are changeable and are dependent on this, in which place the brain is a violation, and as much as it spreads. May have short-term signs, for example, loss of orientation or consciousness, and in addition movement disorders, sensations, including vision, hearing and taste, or other cognitive functions.
People, from which the seizures originate, often have other problems of a physiological nature fractures and bruises. They, in turn, are characterized by high characteristics of emotional States, including restless disorders and depression. The threat of early death among people suffering from epilepsy is 3 times higher than that of the General population.
If there was an attack? How to provide first aid?
In the event that a person next to you, there is the most common type of epileptic seizure-with falls, convulsions and loss of consciousness– with a bite of the tongue, foam from the mouth, the most basic in this case – do not harm him.
Dr. Smith (neurologist) said:
To catch the period, and quickly the person needs to be laid on the side, under the head to put a soft object: clothes or handbag, definitely do not insert that in this case, it is in your mouth, unclench your teeth, to contain and pounce on the man to douse it with water. Seizures usually begin and end themselves, and the mind after the seizure can be confused. In some cases, it is necessary to call an ambulance, especially if the seizure is prolonged-most of a few minutes. But if there are the above-described seizures in the absence of falls with convulsions, in this case, it is quite easy to be with a person, to observe, so that he does not fall into a traumatic situation.
Diagnosis in treatment
Diagnosis of epilepsy should be based on very different data of brain electroencephalogram and neuroimaging. Anamnesis, physical examination of the patient. It is necessary to find the presence or absence of epileptic seizures according to the anamnesis, clinical examination of the patient, the results of laboratory and instrumental studies, as well as to distinguish epileptic and other seizures; to determine the type of epileptic seizures and the form of epilepsy. Tell the patient about the need for drug therapy, for example to buy Gabapentin its nature, and the likelihood of surgical treatment. Despite the fact that the diagnosis of epilepsy is based on clinical data, it is necessary to know that in the absence of clinical signs of epilepsy, this diagnosis cannot be made even in the presence of epileptic form activity detected on the electroencephalogram. The diagnosis of epilepsy does neurology. The main method of examination of patients diagnosed with epilepsy is electroencephalogram, which has no contraindications. Electroencephalogram is performed in all patients in order to recognize epileptic activity.
More often than others, there are such variants of epileptic activity as sharp waves, spikes (peaks), complexes "peak — slow wave", "acute wave — slow wave". Modern methods of computer analysis of electroencephalogram allow to determine the localization of the source of pathological bioelectric activity. During the brain electroencephalogram during the attack, epileptic activity is recorded in most cases, in the intricate period, the electroencephalogram is normal in 50% of patients. On electroencephalogram in combination with stimuli (photo stimulation, hyperventilation) changes are found in most cases. It should be emphasized that the absence of epileptic activity on the electroencephalogram (with the use of stimuli) does not exclude the presence of epilepsy. In such cases, a second inspection or monitoring conducted electroencephalogram.
In the diagnosis of epilepsy, the greatest value among neuroimaging methods of research is Magnetic resonance imaging of the brain, which is shown to all patients with local onset of epileptic seizure. Magnetic resonance imaging can detect diseases that affect the provoked nature of attacks (aneurysm, tumor) or other factors of epilepsy (mesial temporal sclerosis). In some cases, it is necessary to conduct additional studies: biochemical blood test, examination of the fundus, electrocardiogram. Epilepsy attacks should be differentiated with other States of non-epileptic nature (fainting, psychogenic attacks, vegetative crises).
Neurontin in the treatment of neuropathic pain.
Clinical characteristic of neuropathic and nociceptive pain.
Pathopsychologists share Nociceptive and Neuropathic pain in two groups. Nociceptive pain is caused by the action of any factor (mechanical trauma, burn, inflammation, etc.) Peripheral Pain Receptors. Neuropathic pain occurs in the organic lesion or disruption of the functions of the nervous System. The causes of neuropathic pain can be damage to the nervous system, from peripheral nerves and ending with the bark of large hemispheres. In neurology the term neuropathic or neuropathic usually indicates the lesion of the peripheral Nerve. In this connection, there may be a misconception that neuropathic pain is a pain arising exclusively from peripheral neuropathy or polyneuropathy. Here it is necessary to emphasize once again that the term neuropathic pain indicates pain syndrome, arising at defeat or violation of function of both peripheral and central nervous system at any level.
Neuropathic pain is extremely rare, only 1-2%, this figure has grown because it includes a whole complex of other pain syndromes. In general neuralgic pain and bone disease (scoliosis and Osteoporosis) create irradiation impulses and the source of pain to detect will be Difficult. Neuropathic pain as neuropathy is divided into poly-neuropathy and mono-neuropathy, the most common cause of aggravation is the problem with diabetic polyneuropathy. Postherpetic neuralgia (part of the group of Neuropathic Pain) at folk age is associated with skin diseases. Neuropathic pains include complex regional pain syndrome (local pain with swelling, trophic disorders and osteoporosis),
Neuralgia of the trigeminal nerve, Phantom pain, Post stroke central pain, pain syndrome in multiple sclerosis, syringomyelia, spinal cord lesions are typical examples of neuropathic pain.
On the basis of these doctors, neuropathic pain occurs:
- Diabetic polyneuropathy - 45%
- Multiple Sclerosis – 28%
- Syringomyelia – 75%
- Cerebral stroke - 8%
- Nerve injury – 5%
Among all patients with neuropathic pain (about 50%) It falls on patients with diabetic polyneuropathy.
Nociceptive pain is the acute pain that occurs in response to pain receptor irritation, mechanical, inflammation and so On. The term "nociception" was proposed C.S. Sherrington in order to distinguish physiological processes, as well as the understanding of pain in general and the definition of the local Area. If neuropathic pain is a process of chronic disease of tissues, then nightly – arises spontaneously and vividly. Allodynia is the appearance of pain in response to stimulation, irritation, Allodynia is divided into groups and subgroups, mechanical and temperature and it is a process of interconnection in neuropathic pain, can be cited different examples – but in general it is the usual The life processes that surround us every day, the pain syndrome at Polyneuropathy caused by the interrelation of the nervous System. Allodynia is an increased irritability of a whole group of devices including mainly receptors, can be considered as a disease because in normal conditions in a healthy person irritants do not cause pain. Allodynia severe pain response, The pain level varies with the level of the disease, it is very high when the patient is experiencing pain from touching, This is a critical stage.
For example, consider in detail subgroups of neuropathic pain:
- 1. Hyperesthesia
- 2. Hyperalgesia
- 3. Hyperpathies
- 4. Neuralgia
Hyperalgesia - abnormally high sensitivity of the body to pain stimuli, or significantly higher than normal and appears as a result of damage nociceptors or peripheral nerves, possibly because of injury.
Hyperesthesia - is the increased sensitivity of the hard tissues of the teeth, mainly the temperature difference. Hyperesthesia is manifested in the form of painful sensations of short-term character, arising in response to the action of various Stimuli.
Hyperpathies - sensitivity disorder, which distorts the threshold of perception and there is a dysfunction to determine the place that is the source of Pain.
Neuralgia - lesion peripheral nerves, is determined by the bouts of pain in the area of the location of any nerve, occurs as a result of increased stress, hypothermia, trauma and so On. differs from neuritis, as the lesion of peripheral nerves does not occur together with physical changes or cannot be a process.
The patient can also be disturbed by spontaneous pain, and occur in the absence of any external influence, manifest stinging, super seal Painful sensations it is called dysentery.
Pathophysiological aspects of Neuropathy.
Pathophysiological mechanisms of neuropathy, are complex processes, at various levels of nervous system the manifestation of neuropathic pain occurs because of disturbances of interaction of nociceptive and antinociceptive receptors in the course of their defeat or violation of the function, much attention is paid to the study of the mechanisms of the central sensitization, the phenomenon, the insufficiency of antinociceptive descending influences on the spinal Cord.
Treatment of neuropathic pain
Treatment of neuropathic pain complex and includes drug and non-pharmacological methods, treatment for the patient is difficult and accompanied by various unpleasant stimulation (electrical stimulation of subcutaneous tissues), depending on the severity of the Disease. The most difficult but effective is the direct neuroendoscopic neurosurgery of the spinal ends. Of all this variety of therapies, the most harmless and non-bearing consequences of physical interventions is pharma-therapy, groups of drugs several:
- Anesthetic of local action
- Opioid Drugs
- antiarrhythmic Drugs
- Antidepressants and anticonvulsants
About the methods Used:
Do not use analgesics, they are not effective or give temporary deliverance from pain, neuropathic pain is not an inflammatory process, but as written-neuronal and receptor disorders.
Use anesthetics if there is a need, popular is lidocaine, applied to blockade peripheral nociceptors and acts certain subgroups of neuropathic Pain.
In extreme cases, use opioid analgesics: (morphine, codeine, tramadol, dextromethorphan, metodon) use central muscle: (baclofen) in the following articles we will write about them, read about Baclofen.
Use antidepressants in moderate doses, excess can contribute to the appearance of side effects: drowsiness, nausea, cardiac dysfunction, General Absent-mindedness.
Using anticonvulsants in the treatment of neuralgia has been working for more than 50 years, in other articles about anticonvulsants we will tell in Detail.
Antiepileptic drugs such as Neurontin can be effective when other medications are unsuccessful or contraindicated.
The emergence of a new drug gabapentin (Neurontin, firm Pfizer, USA) has opened new perspectives in the treatment of neuropathic pain.
Application of Neurontin in neuropathic pain
Neurontin refers to widely used antiepileptic drugs. In animal studies, It is shown to have modulating effect receptors, blocks sub Calcium channels, reduces the release of monoamine, reduces synthesis and transport glutamate, helps to reduce the frequency of potentials Action Peripheral Nerves. Probably the combination of the above mechanisms of action provides high therapeutic efficacy of Neurontin at various forms of neuropathic pain syndrome.
The drug is well tolerated, rarely have side effects, sometimes mild dizziness or drowsiness. The drug has no serious interactions with other drugs. however, It is not recommended to drink alcohol with Neurontin or antihistamines. The combination of Neurontin with other anti-pain medications (lidocaine, antidepressants) enhances the therapeutic effect.