Neurontin no better than placebo

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Neurontin no better than placebo

Post  charmed quark on Tue Mar 05, 2013 6:02 pm

I had no reductions at all from Neurontin (gabapentin) and a lot of side effects. I decided to discontinue this drug. My neurologist scolded me for not "sticking with it" and guaranteed me it worked. He wrote in my charts that I was non-cooperating with my medical treatment. Needless to say, he is no longer my doctor. So while I'm sad that another drug apparently doesn't work for migraine, I do have a bit of schadenfreude

Medline story (Feb. 26, 2013):
Ladies and gentlemen, my name is Christoph Diener. I am a neurologist from the Department of Neurology at the University of Essen in Germany. Today's topic is migraine prevention.

Patients who have frequent migraine attacks might need medical or nonmedical preventive measures. Established drugs to prevent migraine attacks are beta-blockers like propranolol and 2 antiepileptic drugs, topiramate and valproic acid. These drugs are approved for the prevention of migraine. The information that we have on gabapentin, which is widely used for the treatment of neuropathic pain, is conflicting. Some open trials suggested that gabapentin works in migraine prevention, and other randomized trials had major methodological problems.

In the second issue of Cephalalgia this year, a study was published by Silberstein and colleagues.[1] This study was performed in the United States. It was a placebo-controlled, dose-finding study that had 5 treatment arms: placebo, 1200 mg of gabapentin daily, 1800 mg, 2400 mg, and 3000 mg. The ratio of randomization was 2:1:2:2:1. The study included 523 patients and the treatment was performed for 20 weeks. The average age of this population was about 40 years, and 80% of patients were women who had an average of 9 migraine days per month. The primary endpoint was the number of migraine days per month. Compared with placebo, no difference was found between the different concentrations of gabapentin. For the endpoint responders, who were people who had at least a reduction in migraine frequency of 50%-60%, the response rate was about 50%-60% across all treatment groups. Not unexpectedly, there were more side effects with gabapentin, such as dizziness and fatigue.

In conclusion, this very well-performed study indicates that gabapentin is not superior to placebo in migraine prevention. Therefore, it is very unlikely that this drug will be investigated in a large phase 3 trial.

Ladies and gentlemen, I'm Christoph Diener, a neurologist from the Department of Neurology at the University of Essen in Germany. Thank you for listening.


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Re: Neurontin no better than placebo

Post  Seaine on Tue Mar 05, 2013 6:29 pm

I'm not surprised by this at all. Doctors are desperant to give us more drugs because they want to be the ones who solve our medical problem. They can be blind to the fact that they don't work.
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Re: Neurontin no better than placebo

Post  Mini on Wed Mar 06, 2013 2:48 pm

Over several years now, taking Neurontin substantially helped me to reduce the level of head pain.
I have also tried on few occasions to reduce the dose, with view to stopping it, but every time below a certain point, the previous high levels of M pain returned. This made me realise what a blessing Neurontin was.

I realise that like many other medicines, Neurontin does not work for everyone, but it does not mean that for other people Neurontin remains very helfpful.

For example I had disastrous s/e from Topomax, so I had to give it up on the doctors orders, but I know that Topomax can work well for many people. We just need to keep on trying.


Last edited by Mini on Tue Apr 09, 2013 5:43 am; edited 1 time in total
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Re: Neurontin no better than placebo

Post  Platypus on Sun Apr 07, 2013 5:39 pm

Very interesting. Thanks charmed quark for the post.
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Re: Neurontin no better than placebo

Post  Mini on Tue Apr 09, 2013 5:57 am

In my previous post I have also forgotten to add, that previous to gabapentin (Neurontin) I have been tried on several preventatives, such as antidepressants, BP lowering medication and other antiepileptics (and persevered with them, as prescribed at the time) I have no relief whatsoever in reduction, or lowe levels of pain, by taking any of them. I also had some nasty s/e, but I do nto even mention that ascpets.

Yes, Neurontin has some s/e, for me it is mainly sleepiness an yriedness and strangely enough, my hair has began to curl, but I have adjusted and am prepared to put up with it, in view of the fact that my pain levels are so considerably reduced.

Frankly I would not even care of even if to some it is a palcebo effect or not, but if that was the case why did I not get the placbo effect from all other perventatives, that I have diligently tried before?
I think, that as far as M is concerned, even if any half measure is likely to help, I consider it better then none.

Having said all that, I am so sorry SM that it has not worked for you. I hope that some day you find something that works.
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