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Gabapentin effectiveness help

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Posted 12/29/2014 6:56 PM (GMT 0)
For those of you who are currently taking, or have taken gabapentin in the past and obtained pain relief, approximately how long did it take before you noticed an improvement? I realize we are individuals & respond differently, but I'm trying to gather as much info as possible for my elderly father. He has a trashed back from decades of construction work in addition to post-shingles pain. He is very stubborn and expects an immediate response if he tries a new medication for his pain. I'm hoping that your responses will help me to convince him to give it time before just giving up. He tried it once & since he didn't have immediate relief, he just gave up. His PCP is Rxing his meds & isn't the best of help with PM, so I try to educate myself & propose ideas. His PCP has been fairly accommodating with my ideas, but it's frustrating when I feel as if I'm doing his job when it comes to dealing with my father's pain control. His PCP won't refer my father to PM, although idk if PM would really help at this point in my father's life as he continues to decline.
Thank you all so much!

Post Edited (1 day at a time) : 12/29/2014 12:59:44 PM (GMT-7)

Posted 12/29/2014 7:58 PM (GMT 0)
Hi, 1 day.

Sounds like your dad might be better helped by a pain doc. Do you have a good one near him, or maybe his PCP could recommend one? I'm in the elderly group and love my pain docs! I have had better results with injections and nerve ablation for my back than with medicines.

There are many gabapentin threads, some with good results, some bad or not effective, with effectiveness mostly depending on what causes the nerve pain. My trashed back wasn't helped at all by gabapentin. See the search box at the top of the page!

My pain doc gave me a facet joint injection for my shingles pain. Blocking the pain nerves in the spine works for many people, but your dad's PCP is not qualified to do this. If the pain is high up, the doc needs to be an anesthesiologist. Lumbar injections can be done by a physiatrist. I'd be surprised if the dermatome is lumbar for shingles.
Posted 12/29/2014 10:14 PM (GMT 0)
A good friend of mine takes gabapentin and she said it took about 3 weeks to kick in. She has had great results with it. My husband took it and it messed up his sense of balance after about 1-2 weeks, so he got taken off of it.
Posted 12/30/2014 12:25 AM (GMT 0)
The gabapentin should help with the post-shingles pain. It will take a couple days to see if it is helping with the nerve pain. Also, the dosage of gabapentin can be increased if he is not getting nerve pain relief.

As far as the DDD in his back, I do not know if gabapentin helps with that.
Posted 12/31/2014 2:16 AM (GMT 0)
With back issues there is often nerve involvement, which is where the gabapentin can help with back problems. Have you asked his PCP directly if pain managment might be in order ? Sometimes you have to have a referral and sometimes you don't, it depends on the insurance. You may want to call his insurance company and ask if a referral is required.
Posted 1/1/2015 4:38 PM (GMT 0)
Thank you for your responses. What's really frustrating is my dad's PCP won't refer him to PM. I've asked many times over the past few years, but this particular doc just won't do it. He's convinced he can treat my dad's pain. To his credit, he has listened to my suggestions in the past, but for some reason will not budge when it comes to referring to PM. I guess at this point I'll just ask him why he won't do the referral.
My dad is in his late 80s and very stubborn. He has been with this PCP (concierge medical practice) for over 20 years. He would never consent to a different PCP, so I'm stuck with trying to make this work.
Regarding the gabapentin, since I am stuck with this particular doc, is there anything else I could ask his doc to give it another try? He didn't even tell my dad that it would take time to work, and didn't say a thing when my dad gave up after only one week.
Sorry about the rant, but it's really hard to make this work when so many things are going against it.
Posted 1/2/2015 3:05 AM (GMT 0)
Unfortunately all these meds used to treat nerve pain take time to get the maximum benefit of the drug. Some of the meds like Gabapentin, its finding the correct dosage & getting there. Would it help if the dr told your dad it takes a while with the Gabapentin? A lot of time folks will think the Gabapentin isn't working until they go off of it.
Posted 1/3/2015 3:06 PM (GMT 0)
Thank you for your advice. It really helps to talk about this with others who know what it's like to be in chronic pain. Even though I also have CP, when it comes to taking care of a family member who's in a similar situation, I'm not always sure I'm going in the right direction.
Both of my folks have an appointment with their PCP soon. I've made a list of things to discuss, including gabapentin (I plan to email the doc ahead of time to give him time to maybe think about it & respond). I get the feeling their doc is dismissive of my dad's pain, even though he states things like "your back is really messed up" or "you're riddled with arthritis, no wonder you're in pain". Acknowledging that my dad has "genuine" pain is one thing, but this doc continues to stonewall treatment. It's almost like he's just biding time until the inevitable occurs. So I'm stuck in the middle, trying to be an advocate for my dad, but getting nowhere & watching him suffer. I guess the only alternative is to put blinders on & just take it one day at a time.
I know I've gone completely off topic here, but I really don't know what to do. Thank you to all who have responded.
Posted 1/4/2015 6:00 AM (GMT 0)
It's been a while, but if I recall correctly, it was probably about 8 weeks (plus, I think I had at least one dose increase in there).

One thing that can help when advocating for someone is to be specific about behavioral limitations & behavioral goals (e.g., "my dad wakes up early in the morning & used to always head straight downstairs to put on a pot of coffee, but now he spends half the morning lying in bed, moaning in pain. We'd like for him to be able to see enough pain relief that he could be up making his coffee within an hour of waking up."). So often docs can get bogged down in the "subjectivity" of pain & miss how it actually impacts one's health and well-being. When you bring it back to behavioral indicators, it moves the conversation away from "life is pain" to something a bit more productive. Life is pain & your dad will probably have to live with some pain for the rest of his days, but if the pain itself is keeping him from even participating in a modified/reduced level of his former activities, his doc should be willing to address that.

Good luck with everything!
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