Taking Gabapentin For Hand Pain. Why Am I Feeling Pain And Depression?

Posted on Sat, 16 Feb 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 16 Feb 2013 Answered on

Sat, 16 Mar 2013 Last reviewed on

Question : I have started 400mg gabapentin for 6 days. My first 2 days I felt better than I had in months. now after 3rd day I started feeling pains again/ depression . what has happened? this was prescribed by my VA doctor. I had pains in my arms

Answered by Dr. Polash Sannigrahi (1 hour later)

Hello dear,
Gabapentin is an anti epileptic medication, also used to relieve pain of neurological cause.
Dose titration is required to find out the exact dosage required to control the pain, as different individuals respond to different dosages.
So...if the pain is not relieved at present dose, it has to be increased.

Also an analgesic preparation is added for the initial few days to control the pain & to allow Gabapentin to exert its beneficial effects.
You can also ask your Physician to add a Nerve stabilizing medication like carbamazepine or phenytoin.

Side effects of Gabapentin include sedation, tiredness, giddiness, etc. but they are mild & well tolerated.
Please let me know the exact reason for which Gabapentin was started.
And also the cause of your pain in arms- whether it is induced by trauma or fatigue or any damage to the nerve due to infections?
It will be helpful for me to make a better diagnosis.

Wishing you a Good Health. Let me know if I need to clarify further.
Thanks & take care.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Polash Sannigrahi (25 hours later)

went to VA doctor for regular checkup in May of 2012.complained of pain in left arm and ocasional numbness. my left hand Dupretrens contracture. He prescribed Gabapentin for the pain and numbness.I did not take it because of all the side effects. In Oct I had hand surgery to correct the problem with the left hand and in Oct had surgery to fuse a wornout joint in my right hand thumb. Was taking Hydroco/apap5-325m every 6 hours for the pain from surgery. It took the edge off but I still felt it. so I looked at the Gabapentin studied its side effect and decided to try it after I stopped taking Hydroco. I took it for 2 day felt better than I had in months. The 3rd day I felt about the same pain and depression because of the pain. Question: could it be because I still had the hydroco in my system after 3 or 4 days? Hope this helps XXXXXXX

Answered by Dr. Polash Sannigrahi (6 hours later)

Hello,

There are two reasons for your increase in pain:
1. As you correctly mentioned the effect of hydrocortisone remains for few days.
2. Gabapentine takes few days to start its action.

I would suggest you to discuss with your treating doctor regarding increasing the dose of gabapentine. Once symptoms subside dose can be reduced.

Hope I answered your query. Let me know if you have other enquiries.

Regards

Above answer was peer-reviewed by : Dr. Prasad