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Has anybody changed their prescription patterns yet? I've had quite a few patients express concern about this med over the past year or so.
Another gabapentin study...
Started by 1 Up
Has anybody changed their prescription patterns yet? I've had quite a few patients express concern about this med over the past year or so.
Interesting. Also interesting that it said a recent analysis found no evidence of increased cognitive decline. I don’t know what to make of it but I tell patients to use it for as short a duration as possible
I hate this bc I’ve many times thought of going in gabapentin for RLS. Want to avoid the dopamine agonists
I hate this bc I’ve many times thought of going in gabapentin for RLS. Want to avoid the dopamine agonists
Interesting. I wonder if the risks remain the same with pregabalin.
Are low dose opiates and/or Tylenol the safest option for oral medication therapy for chronic pain patients?
They controlled for commodities supposedly, but gabapentin is going to correlate with DPNP which will correlate with poor glucose control, which I’m sure is a dementia risk factor.
I never prescribe gabapentin or Lyrica for neck or back pain with or without radicular symptoms. There is just no evidence for it. You’re basically using a membrane channel stabilizer to try to address a focal compressive injury. It makes as much sense to use it for carpal tunnel syndrome as it does for radicular pain. I routinely stop these medications without any worsening of symptoms.
Every time I have a new resident in clinic recommend one of these medications for radicular pain, I always ask them to find me a few systematic reviews demonstrating efficacy. No one ever can. I then have them check up-to-date and they find out that neither medication is recommended. So then they realize that they have never seen any real evidence that either of these medications is effective. Instead, they just saw a few of their attendings prescribe them and assumed that they must work.
On the other hand I will blast patients with these medications in cases of polyneuropathy, and metabolic causes of plexopathy and polyradiculopathy. In these cases they really are lifesavers.
Every time I have a new resident in clinic recommend one of these medications for radicular pain, I always ask them to find me a few systematic reviews demonstrating efficacy. No one ever can. I then have them check up-to-date and they find out that neither medication is recommended. So then they realize that they have never seen any real evidence that either of these medications is effective. Instead, they just saw a few of their attendings prescribe them and assumed that they must work.
On the other hand I will blast patients with these medications in cases of polyneuropathy, and metabolic causes of plexopathy and polyradiculopathy. In these cases they really are lifesavers.
Increased dementia risk has been associated with opioids, other AEDs, antihistamines and anticholinergics so likely all TCAs, most all sleep meds and benzos
Being alive has been shown to have a positive risk correlation to the chance of risky risks.
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Agree. There is a big difference between taking gabapentin at night only 90 minutes before bed, vs taking it all day.
I'm less convinced that it causes dementia, but it does affect cognition while in your system. Did this study test patient on chronic gaba, who then stopped it for 3 days before the test? If not, then its as accurate as testing dementia on a patient who just got IV versed.
retrospective study.
data mining.
please note that this study shows correlation not causation. it is not saying that gabapentin causes increased dementia. it is saying that physicians need to monitor more closely those on gabapentin, especially those who have gotten multiple prescriptions, and interestingly non-elderly.
in terms of safety profile, probably still safer than opioids.
and for that matter "just taking a pill at nighttime" does not obviate the possible long term side effects of said medication.
gabapentin's half life is 5-7 hours. however, time to total elimination is closer to 25-35 hours. meaning that once day dosing will still eventually lead to steady state higher than zero.
data mining.
please note that this study shows correlation not causation. it is not saying that gabapentin causes increased dementia. it is saying that physicians need to monitor more closely those on gabapentin, especially those who have gotten multiple prescriptions, and interestingly non-elderly.
in terms of safety profile, probably still safer than opioids.
see above. not the purpose of the study. your last line is not consistent with the study.
and for that matter "just taking a pill at nighttime" does not obviate the possible long term side effects of said medication.
gabapentin's half life is 5-7 hours. however, time to total elimination is closer to 25-35 hours. meaning that once day dosing will still eventually lead to steady state higher than zero.
What do you take it for? RLS
Sleeptalking/walking
Does not cause, but may increase risk of cognitive decline.
So does everything else, except metformin.
So does everything else, except metformin.
Same difference…one study says it adds to cognitive decline next study says it protects against cognitive decline
these studies are looking specifically at the use of gabapentin for traumatic brain injuries.
it should not be generalized for gabapentin in the non TBI population.
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
remember, these are preliminary. just like high dose steroids for spinal cord injury, or gabapentin pre surgery.
it should not be generalized for gabapentin in the non TBI population.
Gabapentin Alleviates Brain Injury in Intracerebral Hemorrhage Through Suppressing Neuroinflammation and Apoptosis - PubMed
Neuroinflammation plays an important role in brain tissue injury during intracerebral hemorrhage. Gabapentin can reduce inflammation and oxidative stress through inhibiting nuclear factor κB (NFκB) signals. Here, we showed that gabapentin reduced brain tissue injury in ICH through suppressing...
pubmed.ncbi.nlm.nih.gov
Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study - PubMed
Singh R, Ambasta S, Bais PS, Azim A, Kumar S, Upreti B, <i>et al</i>. Role of Gabapentin in Traumatic Brain Injury: A Prospective Comparative Study. Indian J Crit Care Med 2024;28(2):120-125.
pubmed.ncbi.nlm.nih.gov
remember, these are preliminary. just like high dose steroids for spinal cord injury, or gabapentin pre surgery.
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Very difficult to account for all the contributing factors in these populations.. diabetes, small vessel disease, chronic depression, anxiety, all the meds that go along with these and on and on. Chronic illness, aging, and medications cause cognitive deficits.. therefore we now don’t prescribe anything because everything is bad. We can all go fishing now.
Someone needs to do this exact study on the charts of old people who have been previously randomized in gabapentin trials.
We could all get published just demonstrating associations between uncontrolled variables and outcomes.
We could all get published just demonstrating associations between uncontrolled variables and outcomes.
