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Gabapentin Dosage for sleep enhancement


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9 replies to this topic

#1 PeacedOutHippie

  • Location:India

Posted 14 August 2008 - 10:37 AM


Hi everyone! I've long read the awesome discussions that we have here at the ImmInst but even to my surprise this is my first post!

I fell in love with gabapentin as soon as I got my first strip. It has been INCREDIBLY difficult to find any 'useful' information on this drug as almost everything mentioned on the internet is about nervous pain, etc. So I have been a bit confused about the dosage. 300mg seemed to work wonders for me. But last night I took 600mg and well, it was way too much. I couldn't come to terms with my severe need to take a piss somewhere in the middle of my sleep cycle and when I did decide to make my way to the restroom, I could barely walk! Incredibly vivid dreams and super difficulty getting out of bed even after 12 hours of sleep!

So, my question to other off-label gabapentin users is how much do you take to get good sleep?
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#2 sUper GeNius Re: Gabapentin Dosage for sleep enhancement

  • Location:Phila PA USA Earth

Posted 14 August 2008 - 02:49 PM

Hi everyone! I've long read the awesome discussions that we have here at the ImmInst but even to my surprise this is my first post!

I fell in love with gabapentin as soon as I got my first strip. It has been INCREDIBLY difficult to find any 'useful' information on this drug as almost everything mentioned on the internet is about nervous pain, etc. So I have been a bit confused about the dosage. 300mg seemed to work wonders for me. But last night I took 600mg and well, it was way too much. I couldn't come to terms with my severe need to take a piss somewhere in the middle of my sleep cycle and when I did decide to make my way to the restroom, I could barely walk! Incredibly vivid dreams and super difficulty getting out of bed even after 12 hours of sleep!

So, my question to other off-label gabapentin users is how much do you take to get good sleep?


Gabapentin is considered by many to be very safe drug. It can be used in doses above 2000 mg daily, although one is slowly titrated up.

One becomes tolerant to gabapentin's (side)effects after a short while, so after a while, it will probably have little sleep enhancing effect without one increasing the dosage. I guess you could use it occasionally, but then again, why not simply take benadryl?

I don't think I would use any medication longterm for sleep. It is unknown just how gapapentin works and its longterm effects on the brain.
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#3 edward Re: Gabapentin Dosage for sleep enhancement

  • Location:Southeast USA

Posted 14 August 2008 - 04:00 PM

I posted this in the mega sleep thread, at the time access was free and you could view the whole thing (I should have downloaded it) anyways by all accounts Gabapentin was very good at enhancing sleep unlike most sleep meds.

http://linkinghub.el...389945702002174
http://www.sleep-jou...(02)00217-4/pdf
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#4 PeacedOutHippie Re: Gabapentin Dosage for sleep enhancement

  • Location:India

Posted 14 August 2008 - 05:11 PM

Gabapentin is considered by many to be very safe drug. It can be used in doses above 2000 mg daily, although one is slowly titrated up.

One becomes tolerant to gabapentin's (side)effects after a short while, so after a while, it will probably have little sleep enhancing effect without one increasing the dosage. I guess you could use it occasionally, but then again, why not simply take benadryl?

I don't think I would use any medication longterm for sleep. It is unknown just how gapapentin works and its longterm effects on the brain.


Well, according to the experiments posted in the above links it does look like a very safe drug to use in the long term even at much higher doses than I've dreamed of. And reading about how specific gabapentin is in its pharmacology.. Sounds pretty safe, for howmuchever thats worth.. Thanks a lot for the studies dude!

Any more personal experiences or studies out there that people might want to share?
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#5 sUper GeNius Re: Gabapentin Dosage for sleep enhancement

  • Location:Phila PA USA Earth

Posted 14 August 2008 - 10:25 PM

I posted this in the mega sleep thread, at the time access was free and you could view the whole thing (I should have downloaded it) anyways by all accounts Gabapentin was very good at enhancing sleep unlike most sleep meds.

http://linkinghub.el...389945702002174
http://www.sleep-jou...(02)00217-4/pdf


I'm reporting my personal experiences with the drug. After I became accustomed to the dose, it provided no additional help in sleeping. Interestingly, when I first started at 300mg, it worked very effectively for a few weeks. Later, having on a dose of 1200mg for months, it no longer had ANY effect on sleep. I

I find plain old diphenhydramine to provide a more restful sleep, but I do become acclimated to it after a few days.

Edited by FuLL meMbeR, 14 August 2008 - 10:25 PM.

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#6 Mouser Re: Gabapentin Dosage for sleep enhancement

Posted 12 March 2009 - 03:28 AM

Tried gabapentin for the first time last night, 400mg. Didn't notice any effect. Had restless sleep, but probably due to stress and caffeine too close to bedtime. I'm hesitant to go up to 800 mg because most dosage schedules I've found indicate 300mg 3-4 times per day. On the other hand it seems absorbance of the drug is highly diminished with higher dosages. So, maybe doubling the dose won't really have the results of a double dose, if you get what I mean.

Haven't been able to find any dosage recommendations when it is used only at night for sleep. The one study I found on gabapentin and sleep had the participants take the usual 1,200mg spread through the day. Which gets me thinking... maybe taking it only before bed is the wrong idea - maybe one needs to get to a steady state for the SWS enhancing effects to kick in.
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#7 tlm884 Re: Gabapentin Dosage for sleep enhancement

  • Location:Saskatoon, Sk

Posted 10 February 2010 - 08:21 PM

I just seen my psychiatrist because my Wellbutrin is causing insomnia and most sleeping agents don't agree with me. I asked about gabapentin and she said 900mg is needed to reach a decent blood level for its antiseziure properties. But depdning on the person anywhere between 300mg and 600mg will be sufficient for sleep and anything about this will cause day time groginess and cognitive slowing.
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#8 Canetti Re: Gabapentin Dosage for sleep enhancement

  • Location:Toronto

Posted 11 March 2010 - 12:17 AM

After reading the whole thread, I'd like to weigh in with a couple of points:

One of the troubles with diphenhydramine (Benadryl) as a sleep aid is that it also has anticholinergic properties. Growth hormone release is under cholinergic control, in that, IIRC, somatostatin release is moderated by the cholinergic system (much information on this on pubmed if anyone wants to look it up). I think it was on lef.org a few years ago where I first read that, because of the anticholinergic qualities of diphenhydramine, at the same time that it promoted sleep, it actually interfered with sleep-related growth hormone release. That's not an side-effect that I consider acceptable on a constant basis. Acetylcholine is also the principle neurotransmitter involved with REM sleep, so I suspect that that diphenhydramine must also interfere with proper REM to some extent, though I've never personally tried it for sleep, so I have no personal experience to base this on.

As for gabapentin, which I'm trialling at the moment, I suspect that it's not necessary to take it spread throughout the day to benefit from its effect on sleep. It has a short half-life (5-7 hours) so one has to take it three times a day for around-the-clock control of epilepsy or other chronic ailments, but I see no reason why constant dosing will improve its acute efficacy for promoting sleep. On the other hand, I can imagine how constant dosing would only hasten tolerance to its acute effects. As well, there is at least one study with pregabalin (Lyrica), a related drug with the same putative mechanism of action, showing a significant increase in slow-wave sleep with only a (mostly) night-time dosing:

AAN 2009: Pregabalin Shows Promise in Restless Legs Syndrome (http://www.medscape....warticle/702092) - free registration may be required, so I'll quote the key passages below:

"For this study, researchers randomized 58 patients with RLS to receive treatment with either pregabalin (28 patients) or placebo (30 patients) for 12 weeks. They used flexible dosing: doses that started at 150 mg per day could be decreased or increased every 2 weeks to a maximum of 600 mg/day. The medication was administered once a day at 9 PM, but doses over 450 mg a day were administered twice daily, at 2 PM and 9 PM."

and

"As for sleep quality, the study found that those taking the active treatment spent more time in stages 3 and 4 (deep or slow-wave sleep) and less time in lighter sleep stages than those taking placebo. "They had a mean of 30 more minutes of slow-wave sleep," said Dr. Garcia-Borreguero."
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#9 russianBEAR Re: Gabapentin Dosage for sleep enhancement

Posted 11 March 2010 - 01:34 AM

 I'd be careful with Gabapentin. It's stronger sibling Pregabalin produces massive physical dependence simliar to benzo withdrawal but lighter. I can imagine this does too.

I've heard this from a few people "around my way", and apparently they also did some studies on it.

http://www3.intersci...l...=1&SRETRY=0

Gabapentin withdrawal syndrome in the presence of a taper
Kien T Tran, Diane Hranicky, Tracey Lark and NJ Jacob
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
Correspondence to NJ Jacob, MD, Assistant Professor of Psychiatry and Pharmacy and Therapeutics, Department of Psychiatry, Thomas Detre Hall of the Western Psychiatric Institute and Clinic, University of Pittsburgh, PO Box 19392, Pittsburgh, PA 15213, USA. Fax: 707-516-1265;
e-mail: kientran1975@yahoo.com

The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
KEYWORDS
benzodiazepine • gabapentin • withdrawal
ABSTRACT

Objective: To report a case report of a geriatric patient with a 5-year history of gabapentin use for enhanced bipolar control, who was tapered off of gabapentin over 1 week. The patient displayed unique withdrawal symptoms after the taper of gabapentin.

Methods: The patient is an 81-year-old white female with a life-long history of schizoaffective disorder with bipolar type I tendencies who had been prescribed gabapentin for 5 years.

Results: The patient displayed moderate upper respiratory tract infection symptoms and somatic complaints 1 day after termination of gabapentin. These symptoms gradually worsened until 10 days after, at which time she acutely developed severe mental status changes, severe somatic chest pain, and hypertension. Physical examination, electrolytes, electrocardiogram, computerized tomography, magnetic resonance imaging, and magnetic resonance angiography were all normal. Upon reintroduction of gabapentin, the patient returned to baseline within 1–2 days.

Conclusions: Gabapentin is widely utilized currently for the chronic treatment of recalcitrant migraines, bipolar illness, pain, and epilepsy. It has a wide therapeutic index with few side effects and drug interactions, is not hepatically metabolized, and is excreted by the kidneys. Past reports have suggested that some withdrawal symptoms can present after 1–2 days upon abrupt discontinuation of gabapentin after chronic use within young to middle-aged patients. These symptoms mimic that of alcohol and benzodiazepine withdrawal purportedly due to a similar mechanism of action. Unique to this case is that this geriatric patient developed debilitating withdrawal symptoms after a gradual, week-long taper of gabapentin along with flu-like symptoms. It is proposed herein that a gabapentin taper should follow a course similar to that of a benzodiazepine taper – slowly and over a period of weeks to months.


^
So watch it on those "benzo-lights" :)

Edited by russianBEAR, 11 March 2010 - 01:35 AM.

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#10 TheJuice Re: Gabapentin Dosage for sleep enhancement

  • Location:Sarasota

Posted 24 July 2012 - 10:05 PM

The problem with gabapentin is that you need to scale up your dosage to a certain level for it to work properly. Unfortunately, most people get pretty sick when they take such a high dosage of gabapentin for the first time. It is essential to build up over the course of your 1st month. Then in weeks 4-8 when your dosage is at a high enough level, you will begin to feel better.
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