Gabapentin (Neurontin)

Gabapentin has helped me over the past year but I feel as though I've developed a tolerance to it. I take 400 mg twice a day. I don't want to increase any further as I'm scared of the withdrawal once I come off of it.

 

I am already on a low dose of benzo. I am planning to try Gabapentin as well. My tinnitus is very related to my nerves in the cochlea. What dosage would you recommend of the combination?

 

Sorry, I am not a doctor and I am not vaguely qualified to answer this, I only know that I take 600 mg of Gabapentin a day which seems to do something in conjunction with the Klonopin, but I would not say I am on a "low" dose of benzo.

 

Just curious; how do you know that?

I've also been looking into Gabapentin. Thanks for sharing these studies!

Wish you well,
Stacken

 

Hi Stacken,

I just perceive it very much in my ears. Also it has got worse with bad sound exposure. It might have a somatic connection as well but I have not really figured it out yet.

Hope you get something good out of your ENT visit today.

David

 

I'm thinking about Gabapentin since my doctor says no to benzos. Can Gabapentin spike or worsen or affect hyperacusis?

 

The Cochrane Database System - including that of PubMed has recently shown more bias towards Gabapentin use with tinnitus.

Cochrane mentions that one study showed a significant negative effect of Gabapentin compared to placebo with an increase in Tinnitus Questionnaire (TQ) score of 18.4 points (standardized mean difference (SMD) 0.82, 95% confidence interval (CI) 0.07 to 1.58).

 

What does that mean? Gabapentin made their tinnitus worse?

 

Can anyone clarify this? It's very confusing. The study shows more bias toward GABA use with tinnitus. Does this mean they are leaning toward using it?

By significant negative effect, do they mean the same as a test result being negative, in other words, it reduced the symptoms of tinnitus? Or do they mean negative as in bad, as in it made the symptoms worse?

 

I’d like to know as well. My doctor prescribed it to me but I’m afraid to try it.

 

Gabapentin caused my tinnitus. I took it for 1 month. Currently I have had tinnitus for 3 months.

 

I've read some reports that Gabapentin can cause tinnitus but most studies show that it either has little effect or has a statistically significant positive effect in reducing tinnitus.

Here's a study posted on the NIH website showing that it can reduce the symptoms:

Short-Term Effect of Gabapentin on Subjective Tinnitus in Acoustic Trauma Patients

 

Has anyone who has visual snow syndrome induced tinnitus tried Gabapentin here?

I would consider Gabapentin together with a higher dose of Clonazepam but I'm not quite sure, at least yet.

 

FYI: I tried Gabapentin (prescribed by my psychiatrist), 2 pills of 100 mg in the evening for 3 months (July, August and September). No effect on tinnitus, no side effects either.

 

When you say Gabapentin helped, in what way did it help? How did it affect your tinnitus?

 

Hi @just1morething, I have read most of your posts on the Abraham Shulman protocol and seeing as you have experience with it, I wanted to ask a couple of questions if I may:

1) Was your tinnitus noise induced? Do you have hearing loss?
2) Did you experience negative side effects from Gabapentin, like mood changes?
3) How long was this substantially effective before you had to re-evaluate?

Better to ask the old hands like yourself with real experience.

Best wishes,
Nick

 

I do have high frequency hearing loss but I think my left ear tinnitus was caused by an airplane barotrauma in 2008 from Chicago to Minneapolis/St. Paul. We were coming back from Puerto Rico. I knew something was wrong when we landed. My doctor said I had 2/3rds fluid level in my left ear.

I don’t think I had too much mood changes from the Klonopin/Gabapentin combination. I did get some dry mouth from Gabapentin. I think Gabapentin is a mood stabilizer as well as a nerve medication. I did talk to Dr. Shulman a couple times by phone. I was very desperate at the time. I’m still desperate today as I have static in my left ear right now. I found out I had TMJ in my left jaw (bone on bone) in 2020 and I had read that can be linked to tinnitus. I recently had a fat graft from my stomach to my jaw. So far it hasn’t helped my tinnitus but it’s only been 2 weeks.

I only have Diazepam and Gabapentin on hand at present, plus I have Lyrica. The Klonopin plus Gabapentin used to knock out my tinnitus until I fell asleep and awakened from overnight sleep or a nap. I’m thinking the airplane barotrauma damaged my left middle ear. How I wish I could go back in time and not take that flight. I was fine in Chicago. The short flights I always had more trouble with. I had taken some decongestants but I guess not enough. Or maybe chewed gum, did the valsalva maneuver or had an EarPopper. But it’s all history now and I’m still not better. I have 3 sets of hearing aids including the Widex Moment. Sometimes they help, sometimes not.

Best wishes to you Nick. I truly hope you find relief from this debilitating condition. I don’t have any good answers. I’m going to evaluate my TMJ later. ENT years ago said my left Eustachian tube was somewhat abnormal so maybe a balloon dilation procedure up my Eustachian tube could help but I have low confidence in that. Truly a brutal condition for me at times although sometimes it goes away until my sleep cycle resets it. Frustrating is an understatement.

 

@just1morething, thank you!

I think it's time we ALL stopped looking back. Is it helping us?

I get some reduction in the reactivity and volume with Clonazepam for sure. I guess trialling Gabapentin on its own for a week would be best before deciding on a combination.

Hearing aids just make mine louder but I have a pair of Phonak Nova M on the NHS. I wear them on the rationale they give some sound therapy, although I can't go above 30% on them.

In terms of years, how long did this combo of medications remain useful for you? I read that eventually you reached homeostasis so to speak.

I was offered balloon dilation last year when I complained of balance problems. They have never looked at my Eustachian tubes in 7 years.

All the best,
Nick

 

@Nick47 , a couple of questions if I may to hijack quickly:

How good/quick was your treatment on the NHS out of interest, i.e. appointment to testing & diagnosis, then getting hearing aids?

You were offered this just from telling an ENT about balance problem? Did they not test? And they thought balloon dilation can help vestibular issues?

 

Setback end of January and hearing aids May. I was pushed forward as the setback saw me in the hands of the crisis team. I had to see a private ENT as it would have been 4-6 months. Waste of time.

I had balance problems since 2015. I was diagnosed with labyrinthitis. After numerous episodes lasting months, I saw a GP in April/May last year who said it wasn't labyrinthitis as it wouldn't keep coming back. He suggested balloon treatment. I never had the treatment as 12 hospitals had zero appointment slots in Leicestershire.

 

I also posted this in the Clonazepam (Klonopin, Rivotril) thread:

I've reduced from 900 mg Gabapentin to 300 mg, split now to 100 mg pills, looking at cutting to 200 mg, then 100 mg. I will probably stay on the last 100 mg for a while because I have heard there's often significant insomnia with losing the last bit of it.

I'm still on 2 mg/day of Klonopin.

No plans on Klonopin reduction at this time, but if I end up feeling okay some months post Gabapentin, I might very slowly and cautiously see what happens when I start to work down. I've done slow tapers off benzos twice so I sort of know what to expect, and what warning signs would be that actually the benefit of the drug is still much outweighing the downsides.

I have to admit that the more screechy, oscillatory parts of my tinnitus do seem to maybe be more pronounced again, which may be a result of Gabapentin reduction, but so far I am not actually thinking about it or actively experiencing it much more often than I was 3 months ago, so, if the upshot is that the subjective audiological severity is worse off the drug but my brain has plasticized around living with this well enough that I still don't think about it much -- I'd prefer to not take the damn pills, of course.

The reason is, I was starting to have anger issues which I had read can occur with extended Gabapentin use, and also I think it's kind of a weird drug and I'd prefer to not be on it indefinitely.

If I can withdraw from one thing, then attempting the same with Klonopin, or at least attempting a reduction, makes sense.

At this point I don't trust global supply lines to not leave me completely screwed at some point. My insurance policy is a 750 mg bag of Norflurazepam (legal analog) but that would be super dangerous to screw with, it's my doomsday plan for tapering if I somehow lose access to my pharma supply, because I am not willing to be dependent on benzos in 2022 without having enough on hand to taper, yet, my doctor didn't want to give me an extra 6 months of Klonopin

(My doctor does know about my doomsday box, he doesn't love it but he thinks I am weirdly informed and make weirdly informed decisions on this stuff...)

Best wishes to @Carlos1, @just1morething and everyone else.

 

Regarding the incidence of tinnitus as a side effect, the PDR makes no mention of it at all. Drugs.com lists it as Rare (0.01% to 0.1%). I'm not saying that there aren't incidents of tinnitus from Gabapentin but it seems that the risk that it could happen to any particular person seems quite remote.

EDIT:

Following up, the Neurontin FDA label lists tinnitus as infrequent <1% side effect and it is listed in descending order, relative to other infrequent side effects, indicating its prevalence is much lower, perhaps approaching .1%. (1 in 1,000).

I think Neurontin is one of the safer drugs as regards to tinnitus being a side effect.

 

For a while I was getting a lot of contradictory information on Gabapentin, but the Mayo Clinic thought the positives far outweighed the negatives, and no issues regarding long term use. Depending on an individual's health issues and the other meds they may be taking w/ it, of course. I've been on a 400 MG dose of Gabapentin for years. It's taken late at night as a sleep aid due to my tinnitus, along w/ 100 mg of Benadryl. The two seem to work well together and I don't wake up w/ brain fog. One cup of coffee and I'm as sharp as it gets that day.

Since I just came back from my doctor, where my cholesterol meds were changed to a statin (which I may decline if there is a potential issue w/ my tinnitus, as some statins are known to cause/increase tinnitus), I thought it would be good to revisit Gabapentin. There doesn't really seem to be any issues w/ long term use. It doesn't affect kidneys, blood pressure, heart or cholesterol, and I couldn't find any evidence it causes tinnitus. Time to let go of that and research my particular statin w/ tinnitus.

 

Gabapentin made my tinnitus worse. Sleep was the only thing that helped me, as well as dripping some bitter melon oil.

 

I was on large doses of Gabapentin for a few years and noticed the onset of my tinnitus and hyperacusis during that time, especially my hyperacusis. When I went off of it I was left with both and 3 years later it’s lower but still there, so likely permanent.

I’ve also read countless stories of people getting tinnitus and hyperacusis from Gabapentin (Neurontin), both after only one dose and after months or years being on it. If you do some research you’ll see Gabapentin + tinnitus & hyperacusis are very common. It helped me in so many other ways for a time, but I’m so scared of the stuff I’ll never take it again. Especially after I tried it again one day and they both came back so loudly it freaked me out. Never again.

 

It took me 6 years to get to the point where it was very low. Not 3. Unfortunately, it got worse once again due to noise exposure. I never took any drug.

 

It's helpful seeing the negative results people have had from Gabapentin. Since I already had tinnitus for many years before taking this drug, I don't know if it would give tinnitus to anyone because I already had it. It hasn't seemed to make it worse, but my tinnitus is like a lot of others' here. It seems to go up or fade on its own accord, even if I keep exactly the same diet, exercise level, etc.

One thing I'm sure of is that we're all different, and one person's medicine might be someone else's poison. And I am concerned about being on Gabapentin for as long as I have been. Most drugs have some downsides if taken over long periods of time because we are not the same person we were years ago. If I could find a substitute for the Gabapentin I would be inclined to ck it out.

So thanks for the real life results people have posted here concerning this drug. I've grown complacent, and really should reassess my medications and tinnitus protocols, such as they are, which are mostly workarounds and avoidance of certain things that make it worse.

 

This is only an animal study conducted by a undergraduate. Gabapentin worsened noise-induced tinnitus slightly, but a significant positive effect was seen with two other calcium channel modulators of the "L Type" - Nimodipine and Tetrandrine.

→ Identifying Molecular Pathways Underlying Noise-Induced Tinnitus

So if you are considering Gabapentin, consider the other two. Remember, it's only a small animal study and often they don't translate to humans, but sometimes they do.

 

Is Tetrandrine a common drug that a GP could prescribe?

 

It appears as though Nimodipine was studied almost 30 years ago as a candidate for tinnitus relief:

The usefulness of nimodipine, an L-calcium channel antagonist, in the treatment of tinnitus

A handful of patients reported an improvement.

/G