Changing from Gabapentin to Topiramate

My new neuro is changing me from the gaba to topiramate and I am getting pins and needles on my legs and arms and more nerve activity waking me every morning. He cut me from 7oo mg daily to 400 mg daily for a week then to 200 mg daily for a week then no more gaba but I have had to take 100 mg in the middle of the day a couple of days now because I am getting tingling on my lip and under my eye. Hoping the topiramate helps and not sure I am excited about the switch. I think it was because I gained so much weight on the gaba but I am nervous about the side effects of the topiramate. I tend to get anxious easily so I hope that doesn't happen with this new drug.

Did you start taking the Topiramate/Topamax at the same time you started decreasing your Gabapentin/Neurontin? If not, then you can easily determine if decreasing the Neurontin caused it, or if adding/increasing the Topamax caused it. When you've taken 100mg of the Neurontin in the afternoon does it help?

If so, it's possible that decreasing the Neurontin is affecting you. Why are you decreasing/stopping it? Is it possible it was helping you more than you realized? Or, does the tingling happen closer to the Tegretol? You need to find a way to determine which one is causing it.

If it continues to be worse for more than a week or two, you should definitely call your doctor. Of course there are always going to be side effects when starting a new med and/or stopping an old one, but if it gets really intense you should call him earlier and let him know.

He'll likely respond with something about you adjusting to the med change and giving it time, so you need to have that ruled out before you call. (and obviously if you're having a severe reaction then you should go to the ER and call him, both)

Also, I know many people who take both meds and find the combination very effective. And with a combo you might find you need a lower dose than before. Just food for thought...

The neuro has me decreasing my Neurontin by 300 mg (1/2 my normal dose) daily as I started the Topiramate. I think he wanted me off the Neurontin right away due to the weight gain. It definitely was helping me. The only major side effect I had from it was the weight and only particularly bad with my last increase in dosage. I am HATING the side effects from Topiramate. The cotton mouth is awful. I am downing water and cannot get enough.

Waiting for a call back from the neuro office. I think I know the answer. Problem is I am not getting any sleep because it is waking me up after just a few hours and my gp's office did not want to help me since the neuro prescribed this.

Just talked to the neuro's PA and he recommended eating a banana before bed. I feel like I am on such a roller coaster. I am always exhausted because I can never get a good night's sleep and then drag through the day. But if I try to take a nap I can't settle down because my nerves won't let me relax. I really hate being fed drugs and try to fight off whatever the doctors try to give me.

Crystal, I wish I knew if it was the decreasing Gabapentin or the Topomax that caused the activity. The pain kept increasing until I decided to stop Topomax on the 20th. It was that or go to ER...my entire body was firing and unfortunately it made my back injury hurt worse. I suspect it was because the dr. had me decrease too rapidly. Honestly, I lost trust in him for the pain he put me through. I wonder if there is undiagnosed diabetes? because I was beyond dehydrated and it felt like my blood was burning? My back injury felt like it was on fire which fuels my suspicion that there is some bleeding there. What is really weird is that although I am now back to my old dose of Gabapentin, my tn pain is

back. It was pretty much under control before the switch and wasn't even presenting much with the exception of some stingers on my cheek under my eye during the firing pain but seems to be coming on about a week after quitting Topomax. Curious what Red's take is on this.

crystalv said:

Did you start taking the Topiramate/Topamax at the same time you started decreasing your Gabapentin/Neurontin? If not, then you can easily determine if decreasing the Neurontin caused it, or if adding/increasing the Topamax caused it. When you've taken 100mg of the Neurontin in the afternoon does it help?

If so, it's possible that decreasing the Neurontin is affecting you. Why are you decreasing/stopping it? Is it possible it was helping you more than you realized? Or, does the tingling happen closer to the Tegretol? You need to find a way to determine which one is causing it.

If it continues to be worse for more than a week or two, you should definitely call your doctor. Of course there are always going to be side effects when starting a new med and/or stopping an old one, but if it gets really intense you should call him earlier and let him know.

He'll likely respond with something about you adjusting to the med change and giving it time, so you need to have that ruled out before you call. (and obviously if you're having a severe reaction then you should go to the ER and call him, both)

Also, I know many people who take both meds and find the combination very effective. And with a combo you might find you need a lower dose than before. Just food for thought...

An update to this thread. Since the fiasco with the new neuro messing with my meds I have had to go up to 2400mg gabapentin daily vs. the 700 mg daily when I first saw him 7 months ago. I'm not sure if rapidly decreasing it caused it to stop being as effective or the topomax caused continuing problems. Now I have numbness/tingling in my lips for about 3 months which is different than before when there was just tingling on the upper left lip (tn side). Now it is my entire mouth. At onset it was painful for the first few weeks. The dunce neuro didn't want to comment or address it when I mentioned it 2 months ago, he said he wanted to take care of one thing at a time. In talking to my therapist about it she commented that I was likely in withdrawals.