It is a very complete pharmaceutical substance, and its effects are like super amphetamine rush. Gabapentin can induce dissociations such as those found on dextromethorphan only on head and hands.
Gabapentin can be combined with other drugs such as baclofen, cannabis, alcohol, selective serotonin reuptake inhibitors, lysergic acid diethylamide, amphetamine and gamma -hydroxybutyric acid. Some of the limitations in this study were as follows: 40 the omission of other languages for instance, Portuguese, Japanese and others in Asia and Africa for the initial screen of web pages hence, overlooking some studies. Moreover, because it relied more on the information posted on web pages, it is difficult to verify the veracity of the statements posted on the web.
This study can be considered more a descriptive study qualitative rather than a quantitative study, making it impossible to have a statistical index of reference. A study in Scotland Tayside region reported an increase in the number of patients asking for gabapentin and in the number of prescriptions released.
A Finnish study investigated all the cases in which pregabalin or gabapentin was found in postmortem toxicology analysis of medicolegal deaths years and Moreover, drug abuse was associated with Gabapentin poisoning accounted for 4. For those with drug abuse problems, Finally, in the gabapentin abuser group, On the other hand, a descriptive analysis of a database cases EudraVigilance about gabapentin misuse, dependence or abuse years — was performed by Chiappini and Schifano, 42 which reported 4.
A total of 86 gabapentin fatalities were found, and the majority consisted of a combination of gabapentin and opioids. If a clinician is planning to employ gabapentin for treating a drug-related problem, it is necessary to consider its potential side effects.
Another set of studies did not find teratogenic effects of gabapentin; specifically, an investigation evaluated the effects of gabapentin across different species mice, rat and rabbits.
Some limitations of the studies about Gabapentin and teratogenicity have been the small sample size, 61 , 62 and the use of multiple drugs medical polydrug regimen in the studies; these factors limit the generalization of the results. As a reference, a review cited a study about altered cognitive function after early postnatal stage caused by gabapentin.
On the other hand, a recent review by Verrotti et al 61 suggested an important distinction between old and new antiepileptic drugs in terms of teratogenicity: new antiepileptic such as gabapentin drugs have a low risk of major congenital malformations compared to old antiepileptic drugs.
Finally, some authors consider that higher doses of gabapentin can be used and its side effects can be still avoided; 65 the variations in the effects of gabapentin can depend more on the route of administration. Different research studies have stated that gabapentin could either interact or lack interactions with other drugs. In general, some studies have shown that gabapentin is an antiepileptic drug with a low profile of interaction with other drugs. Another review about drug combinations for alleviating epilepsy concluded that gabapentin has a more favorable pharmacokinetic profile, but it is not totally exempt from interactions with other drugs.
On the other hand, a mice study reported that the combinations of gabapentin with antidiuretic drugs such as ethacrynic acid and hydrochlorothiazide do not alter the anticonvulsant activity of gabapentin either single or chronic doses of antidiuretics. Moreover, other experimental studies showed the lack of pharmacokinetic interactions between gabapentin and contraceptive drugs norethindrone acetate and ethinyl estradiol 73 and antiepileptic drugs valproate, carbamazepine 74 and phenobarbitone Another study confirmed that gabapentin lacks pharmacokinetic interaction but shows pharmacodynamic interaction with the antiepileptic drug topiramate.
Finally, a study on the interactions between gabapentin and morphine reported inconsistent results. Specifically, a rodent study reported lack of pharmacokinetic interactions, 77 but other rodent studies showed the presence of pharmacodynamic interactions behavioral synergism. Other investigations probed the interactions between gabapentin and others drugs. For instance, a mice study reported motor impairment because of the interactions between gabapentin and losartan. Moreover, different clinical studies have reported interactions between gabapentin and morphine, and a further induction of side effects.
On the other hand, another mouse study showed that carvedilol a beta-adreno receptor antagonist can also interact with gabapentin, augmenting its anticonvulsive activity; 82 this suggests a potential useful combination for treating epilepsy.
The other mice studies reported a reduction in gabapentin anticonvulsant efficacy after the combination with the antidepressant drug, sertraline. Other studies have shown that the interactions between gabapentin and other drugs can be useful for alleviating pain problems. For instance, the combination of lower doses of gabapentin and tramadol can synergistically decrease the experience of pain; moreover, this analgesic effect is dose dependent when administered locally, spinally or orally.
Other clinical studies showed interactions between gabapentin and other antiepileptic drugs such as phenytoin, 86 and mefloquine. Finally, other medical drugs that interact with gabapentin are naproxen 92 nonselective nonsteroidal anti-inflammatory 93 and sevelamer 94 a reducer of serum uric acid concentrations in hemodialysis patients 95 ; as a reference, the interaction between sevelamer and gabapentin is moderate, and the main consequence is a decrease in gabapentin effects.
Some reports have warned about the use of gabapentin in patients with myasthenia gravis 96 or myoclonus problems. This suggests that gabapentin could worsen the symptoms of patients with myasthenia gravis. After gabapentin treatment, the rats of the experimental group showed a decrease in electrophysiological responses amplitude ratio after repetitive nerve stimulation compared to control rats.
Another human study reported worsening or onset of myoclonus after gabapentin treatment 1. The doses related to these problems ranged from to mg. After the discontinuation of gabapentin or clonazepam regimen, the myoclonus ceased without major consequences. Individual clinical studies and large sample studies reported that gabapentin can be misused or abused and can generate general health problems. A strong relationship between opioid use disorder and gabapentin abuse has been reported a study in former inmates.
The prevalences of problems related to gabapentin use described in different studies are in the range of 1. Some of the side effects related to gabapentin are teratogenicity, hypoventilation, respiratory failure, deficits in visual field, myopathy, self-harm behavior, suicidal behavior, mitochondrial toxicity, somnolence, dizziness and asthenia. The gabapentin route of administration is a relevant factor influencing side effects.
Nevertheless, another set of studies has reported the absence of teratogenic effects of gabapentin; 59 , 60 additional investigations with larger sample sizes and screening teratogenic effects in posterior developmental stages are necessary e. It is also necessary to conduct further studies with larger sample sizes on the effects of gabapentin on visual field defect, risks of misuse, myopathy, self-harm and suicidal behavior; the related studies so far have been mainly with small sample sizes.
The studies about gabapentin interactions showed varied results. Different reports suggest that gabapentin has a low profile of interaction with other drugs, 68 , 69 hepatic enzymes 68 and plasma proteins. On the other hand, different investigations have reported that gabapentin could show interactions with other drugs such as losartan 80 and ethacrynic acid 72 and induce motor impairment mice studies.
In addition, gabapentin can interact with caffeine and diminish its anticonvulsant effects mice studies. In addition, gabapentin can interact with antiepileptic drugs phenytoin, mefloquine , 86 , 87 antacids magnesium oxide, cimetidine , 89 , 90 nonselective nonsteroidal anti-inflammatory drugs naproxen , 92 reducer of serum uric acid concentrations sevelamer and morphine.
Some clinical studies have warned about the use of gabapentin in conditions such as myasthenia gravis 96 and myoclonus problems; 97 even, gabapentin can induce symptoms similar to myasthenia gravis ocular—facial—masticatory weaknesses, fatigue, and others. The prevalence of problems related to gabapentin use ranges from 1. Gabapentin inadequate use can lead to toxicity and mortality. Gabapentin can induce diverse side effects such as teratogenicity, hypoventilation, respiratory failure, deficits in visual field, myopathy, self-harm behavior, suicidal behavior, mitochondrial toxicity, somnolence, dizziness and asthenia; these can be related to the route of administration.
However, it seems necessary to conduct more studies with larger sample sizes for confirming these effects. Gabapentin can interact with losartan, ethacrynic acid, caffeine, phenytoin, mefloquine, magnesium oxide, cimetidine, naproxen, sevelamer and morphine.
Gabapentin use is contraindicated in patients with myasthenia gravis or myoclonus. National Center for Biotechnology Information , U. Journal List J Exp Pharmacol v. J Exp Pharmacol. Published online Feb 9. Gabriel C Quintero. Author information Copyright and License information Disclaimer.
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This article has been cited by other articles in PMC. Abstract The current work is targeted to review the risks of gabapentin misuse, its potential interactions with other drugs, side effects and use contraindications. Keywords: gabapentin, misuse, interactions, contraindications, side effects. Introduction Methodological procedure of the review The current review consists of a total of 99 biographical references from the year to Basic information of gabapentin Gabapentin is a pharmaceutical drug that has a white solid small crystals physical appearance.
Gabapentin use in experimentation Gabapentin has been used in basic and clinical investigation for the past few decades. Problems related to misuse, abuse or dependence on gabapentin Case clinical and large group studies suggest that gabapentin can be abused and induce health problems.
Regarding the information posted about gabapentin in the web sites, these were some of the descriptions: 40 Gabapentin has powerful sedative and psychedelic effects. Gabapentin was sold on the web without the need of a medical prescription. Gabapentin helps in becoming very active, friendly, talkative and disinhibited. Side effects caused by gabapentin If a clinician is planning to employ gabapentin for treating a drug-related problem, it is necessary to consider its potential side effects.
The interactions between gabapentin and other drugs Lack of interactions between gabapentin and other drugs Different research studies have stated that gabapentin could either interact or lack interactions with other drugs. Remarkable interactions between gabapentin and other drugs Other investigations probed the interactions between gabapentin and others drugs.
Some contraindications for gabapentin use in patients with muscular problems Some reports have warned about the use of gabapentin in patients with myasthenia gravis 96 or myoclonus problems. General conclusions Conclusions about problems related to misuse, abuse or dependence to gabapentin Individual clinical studies and large sample studies reported that gabapentin can be misused or abused and can generate general health problems.
Conclusions about the side effects caused by gabapentin Some of the side effects related to gabapentin are teratogenicity, hypoventilation, respiratory failure, deficits in visual field, myopathy, self-harm behavior, suicidal behavior, mitochondrial toxicity, somnolence, dizziness and asthenia. Conclusions about the interactions between gabapentin and other drugs The studies about gabapentin interactions showed varied results.
Conclusions about some contraindications for gabapentin use Some clinical studies have warned about the use of gabapentin in conditions such as myasthenia gravis 96 and myoclonus problems; 97 even, gabapentin can induce symptoms similar to myasthenia gravis ocular—facial—masticatory weaknesses, fatigue, and others.
Footnotes Disclosure The author reports no conflicts of interest in this work. References 1. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. Dickenson AH, Ghandehari J. Anticonvulsants and anti-depressants.
Handb Exp Pharmacol. Landmark CJ. Targets for antiepileptic drugs in the synapse. Med Sci Monit. Rogawski MA, Loscher W. The neurobiology of antiepileptic drugs. Nat Rev Neurosci. Methods : Either gabapentin, hydrocodone or a fixed-dose ratio of gabapentin and hydrocodone was administered min G and min H orally after carrageenan. Nociceptive threshold was determined by the radiant heat paw-flick test for min; paw inflammation was measured by plethysometry.
Results: Gabapentin and hydrocodone reversed thermal hyperalgesia with ED 50 values of Mixtures of gabapentin and hydrocodone in a ratio G:H produced synergistic actions. However, and ratios G:H produced only additive effects. Conclusions: These data suggest that combinations of gabapentin and hydrocodone can produce synergistic antinociception. The use of low-dose combinations may afford therapeutic advantages for clinical treatment of chronic pain adn limit untoward side effects associated with prolonged opioid intake.
Follow-up took place over an average duration of about 30 months. Mean morphine milligram equivalent MME units was All patients experienced significant pain improvement Among patients taking a combination of gabapentin mean dose 1, mg and opioids, the average NRS reduction was Patients taking the combination treatment moved from 7. One reason for this finding might be the high prevalence of low back pain in this study, noted Knezevic: a systematic review led by Enke last year found moderate- to high-quality evidence that anticonvulsants like gabapentin and pregabalin were ineffective for treating low back pain or lumbar radicular pain.
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