My trigeminal neuralgia began 2 and a half months ago on December 23. I've been on 1500 mg a day of gabapentin since then and at first it completely alleviated my symptoms. About two weeks ago though some pain started returning. At first I thought I missed a couple doses but after a week of no improvement I upped to 1800 mg and the pain has only been getting worse. Has anyone else had a similar experience with gabapentin? I know the max dose is 3600 but some say over 1800 doesn't prove to be any more effective so is anyone finding over 1800 to work better? Has switching or adding meds helped anyone?
You may need to take more, it just depends on the person. As the pain progressed my doctor added 10mg of baclofen with the gabapentin 600 mg five times a day and that has worked for me.
The reason why higher doses of gabapentin may not increase the effectiveness may be due to the saturable absorption. Pregabalin (Lyrica) does not have this problem and therefore may be worth a try.