Neurological Associates
Pain Management Center
Vero Beach, Florida
|
H. Hooshmand, M. D. |
|
DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY BOARD CERTIFIED IN ELECTROMYOGRAPHY BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE INTRACTABLE NEUROLOGY EPILEPSY, PAIN, MS An International Referral Center dedicated to Treatment, Education and Research |
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RSD PUZZLE #95
"NEURONTIN"
(Revised on 5/5/2002)
QUESTION:
"Is there or is there not a limit to the amount of Neurontin that one can take? I am now taking 5200 mg of this stuff daily and the Work Comp doctor is telling me that there is no limit as long as I am not having side effects. To me, this sounds a little off base. Dr. Hooshmand, if you see this, perhaps you could give your opinion also?"
ANSWER: Neurontin is an anticonvulsant that is very similar to valproic acid. Anticonvulsants prevent burning type of neuropathic pain such as seen in diabetes, shingles, and Reflex Sympathetic Dystrophy (RSD). Different types of pain require different anticonvulsants:
1. For stabbing or electric shock types of pain, the treatment of choice is Tegretol or Trileptal.
2. For burning pain, the treatment of choice is Neurontin. The burning pain comprises in only 25-30% of neuropathic pain.
Indiscriminate prescription for any kind of pain is apt to fail, as well as causing
serious side effects of obesity, vertigo, and dysphoria (neurotic and depress attitude).
More serious complications are in the form of intolerance to Neurontin leading to patients
having no other choice but discontinuing the medication (this happens in 7-8% of the cases
being treated with Neurontin (7% is reported in the PDR, and 8.2% in our patients).
3. The third group of pain patients suffer from deep pain in extremities. In this group the treatment of choice is alternating rest and activity. Such patients can be helped with Klonopin®(Brand name Clonazepam).
Neurontin is the most over used medicine in RSD. The dosage of Neurontin in children and the elderly is as low as 300-600 mg per day. In adults it is 1800-2600 mg per day, with a maximum of 3600 mg per day, anything above that dosage causes drowsiness, fatigue, inactivity, irritability, and depression. "The more is not the merrier."
With many thanks,
H. Hooshmand, M.D.
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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.
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This page was last updated on 5/5/2002.
