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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4050
Experience:  MD Psychiatry
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Hello. I have been taking Gabapentin 300mg 3 times daily for

Resolved Question:

Hello. I have been taking Gabapentin 300mg 3 times daily for generalized anxiety disorder and major depressive disorder for 2 months. It has been a miracle for me and I've been able to leave my house and feel like getting out of bed for the first time in years. Unfortunately the past couple weeks it hasn't been working nearly as well. I feel like I need my dose increased but I don't know how to ask my Psychiatrist about it. Thanks. I'd like to add because of my GAD I'm terrified to ask my psychiatrist about most things. Also should I talk to my therapist about how significantly the gabapentin has changed my life and that I'm scared of it not helping anymore? I'm also prescribed alprazolam 1mg 3 times daily for 2 years now and remeron 30mg at bedtime for depression. Before taking gababentin I felt like a hopeless case and the smallest task or encounter with another person made me extremely anxious but now I feel I can handle it. I have had extreme (choking) panic attacks for years many times a month but have only had one recently when the new medication gababentin wasn't as effective. Thanks again.
Submitted: 1 year ago.
Category: Mental Health
Expert:  911DOC replied 1 year ago.

The way you ask your psychiatrist about it is the same way you just asked me about it! Good job for asking.

 

Gabapentin in the treatment of panic disorder and GAD is 'off label', meaning, it was not what the medicine was created to do (it was created to treat seizures), but, as often happens, doctors have discovered that it has other uses too. One is the treatment of chronic nerve pain, and another is in a cases such as yours where it is part of the medication regimen used to control your symptoms.

 

Also, there is a maximum dose of 1800mg per day, and right now you are taking half of that, so there is some room to move on the dose, but only your prescribing physician can make that call.

 

I think your question is an excellent one, and it is one I would think your psychiatrist would be pleased to answer for you. Remember, your psychiatrist works for YOU. They are there to help YOU. There is no reason to fear asking your doctor about this, but then I understand that your GAD is a difficult thing to deal with.

 

I would place a call to your psychiatrist's office and ask to speak or meet with him/her as soon as you can about a possible medication modification.

 

Please let me know if you have questions about my answer.

 

Positive feedback is always appreciated.

 

Best

911doc

Customer: replied 1 year ago.
I never received an answer about talking to my therapist about this. Am I charged for a follow up question? If so reply. I've read if you don't rate your answer at least a 3 they will continue to answer until you give a 3 and will be charged for these answers. Is this true?
Expert:  911DOC replied 1 year ago.

sorry, of course you should talk to your therapist about this. it's what they are there for. ultimately, the cure for your problem will come from your therapist and not from a pill. as you have already discovered, medicine can have less effect over time, so it's very important to see the medicine as a bridge to your cure, rather than the cure itself. with your therapist you should be working to change the way your brain responds to stressors. you can do this, but it does take time.

 

you are only charged one time for this question when you leave positive feedback. for instance, this response is included with your original question.

 

best

Expert:  Dr. Kaushik replied 1 year ago.

Greetings !

 

Welcome to the site.

 

I am Dr. Kaushik and I am a psychiatrist and I believe I can help with your query.

 

You see you are taking too much stress about something which is not that serious a scenario as you believe it is since presently you have been taking a low dose of 900 mg/day in 3 divided doses of 300 mg each. This is actually a starting dose for gabapentin and it can be used at dose as much as 1800 mg /day in 3 divided doses, so basically speaking your psychiatrist will understand your point of view if you tell him that you got a miraculous improvement in your symptoms after he added gabapentin and you felt encouraged about your chances of recovering from this long standing condition completely but now since past few days your condition has slipped back a bit and the affects of gabapentin seems to be waning therefore request him to revise the dose of gabapentin by increasing the dose to 400 mg three times a day making total dose of 1200 mg/ day which is still within the normal therapeutic dose range.

I feel your psychiatrist shall takE your humble request sportingly and make the necessary changes as per the request and anyways you are not asking him anything which is unjustified since the next plausible step that any seasoned and wise psychiatrist would take after finding that the drug regime is loosing it' s edge and that would be to optimize the efficacy of the drug by increasing it' s dose, this is a common practice and you should not take too much tension about this since what you are seeking is a natural course that any psychiatrist would usually adhere to, so politely present your point of view in as many words mentioned above and hopefully your psychiatrist will respond to your request by increasing the dose as per the expectation. There does not seem to be any reason for not doing this as your request is well within your rights as a patient and it is plausible.

As far as your therapist is concerned you shall tell him/ her about the drug use and the benefits you have reaped along with the recent developments since this will enable the therapist to help you to cope with your present predicament by practicing with you some coping exercises which will not only help current scenario but also it will help you to combat against anxiety in the long run.

I hope this helps.

Wish you all the best.

Please kindly leave a Positive rating if you are satisfied with the answer.

Regards.

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4050
Experience: MD Psychiatry
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