Neurontin Frequently Asked Questions


What is Neurontin?
Neurontin (gabapentin) was approved by the Food and Drug Administration (FDA) in 1994 for the control of partial seizures due to epilepsy in adults and children. It is also approved for management of postherpetic neuralgia (PHN) caused by shingles (herpes zoster). Neurontin affects chemical and nerves in the body that are involved in the cause of seizures and some types of pain. The exact way it works is unknown. Neurontin was originally sold by Parke-Davis, a subsidiary of Warner-Lambert, which in turn was acquired by Pfizer, Inc., in 2000. The Neurontin drug is typically prescribed with other medication for controlling partial seizures associated with epilepsy, but used alone for the treatment of PHN. Neurontin comes is 100, 300 and 400 mg capsules, 600 and 800 mg tablets, and is available in an oral solution form.

Can Neurontin be taken with other medicines?
Yes, because Neurontin is typically prescribed with other anti-epileptic drugs (anticonvulsants) to help the primary epilepsy treatment control partial seizures. It is also used when the primary treatment is causing problematic side effects. This is called adjunctive therapy. However, when taken with Antacids, the blood levels of Neurontin drug is significantly decreased, which reduces its effects. Neurontin should be taken at least 2 hours after any antacid is taken (e.g., Tums, Rolaids, Maalox). Typically, if Neurontin is prescribed to you for the treatment of PHN, you shouldn't be taking anything else.

Always let your physician know about ALL other medications you are taking (over-the-counter and prescription) because some may cross-react with Nurontin, which may reduce its effectiveness or even make your condition worse. While taking Neurontin, don't start any new medicines without talking to your doctor first. Your doctor or pharmacist will know which medicines are safe for you to take with Neurontin.

What is a partial seizure?
A seizure is how your body reacts to a brief electrical disturbance in the brain, which can include a change in sensation, awareness, or behavior. Electrical disturbances that start in a small part of the brain are called partial seizures. They only involve part of the brain and part of the body.

There are two types of partial seizures: simple and complex. A person who has a simple partial seizure stays alert, can answer questions and follow commands. They may also experience unusual sensations or movements. The seizures end quickly, usually lasting for just a few seconds. However, some can last up to 2 minutes. The person remains conscious and alert through the seizure, so he or she can remember what happened before, during and after the episode.

Complex partial seizures involve a change in or loss of consciousness. They may begin with an odd taste or smell, a rising feeling in the stomach, or a sense of déjà vu. The person may not be able to answer questions or follow commands. The person will also generally repeat an activity like chewing, tapping, or clapping the hands. When the seizure subsides, the person will have no memory of the seizure or the repeated activity that took place during the seizure. Also, the person will usually be tired or disoriented for a short period of time (post-ictal period), usually for about 15 minutes but possibly up to 2 hours.

Both kinds of partial seizures can spread to become stronger generalized seizures, which involve a much larger portion of the brain. These are called "secondary generalized seizures" and generally last less than 2 minutes. Partial seizures can happen to anyone of any age, but more typically occur in people who have had a head injury, brain infection, stroke, or brain tumor. However, the cause is usually unknown.

What are generalized seizures?
There are two types of generalized seizures: convulsive (muscle jerking) and non-convulsive. Non-convulsive seizures fall within several subgroups. The following is a description of some of the non-convulsive and convulsive seizures and their symptoms.

Absence Seizures: Also known by the older term of Petit Mal, absence seizures fall into three groups: simple, complex and atypical. Simple seizures are the blank stare seizures. Complex seizures are ones that involve a change in muscle activity, like repeated eye blinks, slight tasting movements of the mouth, hand movements like rubbing the fingers together and contraction or relaxation of the muscles. Simple and complex absence seizures typically last 10 to 20 seconds, and the person is not aware the seizure is taking place because their level of consciousness is impaired. Once the seizure subsides, the person is immediately conscious and aware. However, he or she will not remember the seizure and may experience memory lapses of the time period just before and just after the seizure. Simple and complex absence seizures are rare in adults, and typically happen to children between the ages of 6 and 14.

Atypical means unusual or not typical, so atypical absence seizures are not like simple or complex absence seizures because the person will stare as they would in any other absence seizure, but is often somewhat responsive. A seizure can also be accompanied by eye blinking or slight jerking movements of the lips. The behavior can also be hard to distinguish from the person's usual behavior, especially in the case of people of lower intelligence. Another factor that distinguishes the atypical absence seizures from the simple and complex ones is that they can last anywhere from 5 to 30 seconds with a gradual beginning and ending. These types of seizures typically begin before the age of 6 and continue into adulthood. They usually affect people of lower intelligence who also have other types of seizures that are difficult to control.

 

Tonic Seizures: Muscle "tone" is the muscle's normal tension at rest. In a tonic seizure, the muscle tone is greatly increased and the muscles contract (suddenly stiffen) and become rigid. These seizures most often occur when the person is sleeping. Tonic seizures usually involve most or all of the brain and affect both sides of the body. Tonic seizures are common in people who have the Lennox-Gastaut epilepsy syndrome. The person experiencing them typically remains conscious through the course of the seizure. If the person has the seizure while standing, he/she will usually lose his/her balance and fall. Tonic seizures usually last around 20 seconds. If a person has a few of these seizures close together, they may feel tired for about 15 minutes after the seizures subside.

 

Atonic Seizures: These are opposite of tonic seizures because atonic means "without tone." Instead of muscles contracting, they relax and suddenly lose strength. One of several things can happen to the person experiencing this type of seizure: drooping eyelids, nodding head, dropping things and even falling. This is why this seizure is also known as a "drop attack" or "drop seizure." Another name for this seizure is "akinetic," meaning "without movement." The person remains conscious through the course of the atonic seizure, and it usually lasts less than 15 seconds. Atonic seizures usually begin in childhood and go through adulthood. Since these seizures typically cause injuries, people who suffer from them may wear a helmet or choose another form of protection.

 

Clonic Seizures: Clonus is a condition involving the involuntary contraction and relaxation of a muscle -- repeated, rhythmic muscle twitches or jerks. Restraining or repositioning the affected arm or leg does not help. Clonic seizures involve involuntary muscle jerking. However, these types of seizures are very rare. A person is more likely have a tonic-clonic seizure that starts with the tonic symptoms of muscles stiffening. However, tonic-clonic seizures can sometimes start with the clonic phase of involuntary muscle jerking. This is called a "clonic-tonic-clonic seizure." Clonic seizures happen to people of all ages, including newborns and last for varying amounts of time.

 

Tonic-clonic Seizures : Tonic-clonic seizures are convulsive seizures that are a combination of tonic and clonic seizures. These are also known by the older term of Grand Mal. Tonic-clonic seizures usually begin with the tonic phase of:

•  Stiffening of muscles;

•  Often a cry or groan;

•  Loss of consciousness and a fall to the ground.

 

Subsequently, the clonic phase sets in where the arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. This phase typically lasts less than 5 minutes. The jerking tends to slows down bit by bit before it stops. During the course of the seizure the person may:

•  Drool or foam at the mouth;

•  Bite a tongue, cheek or lip causing the drool or foam to be a little bloody;

•  Turn a little blue in the face;

•  Experience incontinence (loss of urine or stool) when the seizure subsides and the body starts to relax.

 

After the seizure, consciousness returns slowly. A person may feel drowsy, confused, agitated, or depressed for minutes to hours (post-ictal period). Some people have headaches. After this, a person may then feel restless. Tonic-clonic seizures affect children and adults of all ages. If the seizure lasts more than 30 minutes or if three seizures occur with no normal period in between, it could be an indication of a highly dangerous condition called convulsive status epilepticus, which requires emergency treatment.

 

Myoclonic Seizures: Myoclonic seizures are just brief shock-like muscle jerks that last a second or two. The word myoclonic is broken down like this: "myo" means muscle and "clonus" means rapid alternating contraction and relaxation of a muscle (jerking or twitching). Children and adults of all ages, including people without epilepsy can experience occasional myoclonus like a quick muscle jerk. However, epileptic myclonic seizures usually result in abnormal involuntary muscle jerks on both sides of the body.

 

What triggers the seizures?
Seizures may appear to be brought on by a trigger such as lack of sleep or a high level of stress. However, the triggers alone do not explain why a seizure has occurred. All that is known so far is that certain people seem to be more prone to having seizures than others, sometimes referred to as having a "low seizure threshold" which could be due to their genetic makeup. However, the actual cause of seizures is still unknown, and tests are still being conducted to see if a cause can be found.

How can I help someone going through a seizure?
If you are with someone who has a convulsive seizure, you should try to:

  • Stay calm;
  • Time the seizure;
  • Protect the person from injury;
  • Place something soft under the head;
  • Loosen tight clothing at the neck;
  • Roll the person onto his/her side when the jerking stops and;
  • If breathing seems difficult, check the person's mouth to ensure that their tongue, food or dentures are not blocking the airflow;
  • Provide reassurance and minimize embarrassment during recovery.

Never under any circumstance:

  • P ut anything in the person's mouth or between the teeth;
  • Restrain the person unless they are in immediate danger;
  • Give food or drink until recovery is complete.

If the seizure occurs while the person is in a wheelchair, car seat or stroller, leave him or her seated if secure and safely strapped into the device. Just support the head. If the person is unconscious when the jerking stops, remove him or her from the seat and roll the person onto his or her side.

 

Call a doctor or ambulance immediately if:

  • The seizure lasts more that five minutes or a second seizure quickly follows the first;
  • The person has trouble breathing after the seizure;
  • The person is not starting to recover consciousness within five minutes of the seizure stopping;
  • The seizure occurs in water;
  • The person is injured;
  • The person is pregnant;
  • The person has diabetes;
  • You believe it is the person's first seizure or you do not know (regardless of how long the seizure lasts);
  • The person does not fully recover.

A person having a non-convulsive seizure may simply appear dazed or otherwise disoriented. All you need to do in this case is reassure the person and gently guide him or her away from harm until the seizure subsides. You should call a doctor or ambulance if:

  • The person is not starting to recover from the seizure after 15 minutes;
  • The person has diabetes;
  • The person is injured;
  • You believe it is the person's first seizure or you do not know (regardless of how long the seizure lasts).

 

What is epilepsy?

Epilepsy is a chronic disorder of the nervous system in which clusters of nerve cells (neurons) in the brain sometimes signal abnormally (electrochemical disturbances). This disturbance of the normal pattern of neuronal activity can cause seizures.

There are four basic types of epileptic seizures:

Petit mal - a mild generalized seizure involving dizziness, disorientation or staring into space. Petit mal seizures are also known by the more contemporary term "absence seizures" because the person experiencing the seizures looks pretty much like they are daydreaming until the seizure has ended. The person is not aware of the seizures or what takes place during the course of the seizure. They may also have memory lapses of periods of time just before and just after the seizure, as well.

Grand mal - a seizure in which there are severe convulsions and loss of consciousness or coma. The contemporary term for Grand mal seizures is "tonic-clonic seizures".

Jacksonian - spasms mainly limited to one side of the body and often to one group of muscles. These are simple partial seizures. People experiencing these will remain awake and alert through the course of the seizure.

Psychomotor - person engages in motor acts which he or she cannot remember having done.

Epilepsy affects about 100 million people worldwide. Approximately 30% of them have a severe form of the disease that results in more than 100 seizures per day.

 

What is PHN?
Herpes zoster (commonly referred to as "shingles") and postherpetic neuralgia (PHN) is nerve damage that result from reactivation of the varicella-zoster virus acquired during the chickenpox (primary varicella infection). PHN is a form of neuropathic pain, which is chronic pain due to nerve damage. A variety of different diseases and conditions can cause neuropathic pain, including diabetes, shingles, trauma (injury or wound to the body) and diseases of the nervous system including Reflex Sympathetic Distrophy (RSD), also known as Reflex Sympathetic Distrophy Sydrome (RSDS). PHN and other neuropathic pain may be hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, or a pins and needles sensation. It is not the same for everyone, either. It may be mild or it may be severe. Some people feel pain all the time and it comes and goes in others.

What are the possible side effects of Neurontin?

According to the official Neurontin site
(www.neurontin.com ), the common side effects are as follows:

•  For adults taking Neurontin: dizziness, sleepiness, vision problems, swelling of hands or feet, clumsiness, diarrhea, and weakness.

•  For children taking NEURONTIN to control partial seizures: viral infection, fever, nausea, vomiting, restlessness and behavior problems. Side effects were usually mild to moderate.

Other sources list side effects including several that are common to a number of drugs: sleepiness, dizziness, headache, alcohol intolerance and nausea. Other Neurontin side effects listed by these sources are more serious, such as viral infections, convulsions, memory loss, and vomiting/diarrhea. The most severe of the potential Neurontin side effects is a suicidal tendency. It has also been indicated that children are more susceptible to Neurontin side effects than adults, and that children taking are far more likely to experience the behavioral Neurontin side effects such as mood swings, hyperactivity, aggression and lack of concentration.

If any of these symptoms develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Neurontin. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. If you are diagnosed with any serious conditions that may be linked to your long-term use of Neurontin, or if you have been prescribed Neurontin for off-label uses, contact one of the panel attorneys for immediate legal assistance. You could potentially have a claim for a lawsuit. Only a qualified and experienced Neurontin attorney can tell. Click any of the panels from the left or right side of this page to contact a Neurontin lawyer now.