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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by krybrahaha on May 4, 2004, at 4:00:26
I have noticed you know alot about medications. My question is how does Neurontin work in the brain? I wonder this because this is the only med out of many that have worked for my anxiety.
I have tried every med under the sun for anxiety and have settled on Neurontin. This med has been a godsend for me, when others have not. I have taken all the SSRI's, and alot of the benzo's with mild success.
Posted by jlbl2l on May 4, 2004, at 5:43:54
In reply to To Chemist, how does this med work?, posted by krybrahaha on May 4, 2004, at 4:00:26
neurontin and the upcoming successor pregablin (Lyrica) are the 2 most drugs I am interested in at the moment, so I hope you don't mind me trying to answer this - about both drugs since they are similar.
I believe neurontin works through modulating the voltage-sensitive Ca2+ channels in the brain, same with pregabalin (Lyrica) soon to be released.
It increases gaba , but does not bind to gaba a or b receptors. According to literture, it appears to modulate glutamate synthesis as well. Most literature points to increase gaba by modulation of the Ca2+ channels in the brain , (calcium is what i am referring to). gabapentin is structrually related to gaba, though chemically modified, and can pass through the blood brain barrier. magnesium will INHIBIT its actions, which gives another clue into its mech. of action.
neurontin has been found effective for seizure disorder and neuropathic pain, however, in other unpublished studies or general reports, it has been found effective in numerous disorders including, social phobia, generalized anxiety (pregablin's FDA submission included that), depression, sleep disorders, fibomyligia, bipolar disorder and many other physiatric disorders.
In vitro studies indicate that neurontin has NUMEROUS modes of action including : reduction of the release of several mono-amine neurotransmitters, modulating the action of the GABA synthetic enzyme, increasing non-synaptic GABA responses from neuarl tissue and probably more.
however, it appears that some people have *no* response to neurontin AT any dosage level, while some , it becomes there miracle drug. from what ive heard, pregabalin has solved this problem, though i have no idea how or why it didnt effect certain people at all.
in the latest study, which i can cite, they found pregablin was superior to xanax and effexor for generalized, or social anxiety (which had a co-depression w/it) i believe.. if you would like me to locate that study i will, its very recent, and i was VERY surprised that it was more effective than xanax!!!
AND they dont expect pregablin to be a controlled substance, as it is supposued to be non-addicting, just like neurontin.
in conclusion, both neurontin and the upcoming Lyrica (pregablin) are both highly novel and possibly one a kind treatments for MANY conditions.
hope this helps
jlbl2l
Posted by chemist on May 4, 2004, at 13:53:53
In reply to To Chemist, how does this med work?, posted by krybrahaha on May 4, 2004, at 4:00:26
> I have noticed you know alot about medications. My question is how does Neurontin work in the brain? I wonder this because this is the only med out of many that have worked for my anxiety.
>
> I have tried every med under the sun for anxiety and have settled on Neurontin. This med has been a godsend for me, when others have not. I have taken all the SSRI's, and alot of the benzo's with mild success.hi there....i have read jlb121's post and he/she is on the right track....i would include that upon binding of neurontin to the calcium channels, a decrease in glutamate and aspartate as well as less activity in AMPA receptors results; and that there is evidence that antagonism of glutamic acid dedecarboxylase (which leads to increased production of GABA) is possible with neurontion. the anxiolytic effect is from a build-up of GABA in your brain, and this excess of GABA is what we want for anxiety. the benzodiazepines increase GABA concentrations because these drugs bind directly to the A-type GABA receptors, which leads to a conformational change (and a flux of chloride) and thus prevents reuptake of GABA. in any event, whether you take neurontin or a benzodiazepine or another drug with anxiolytic properties, the mechanism by which GABAnergic transmission (provided the drug is reducing anxiety by producing excess GABA, a qualifier there) is increased may be different, but the end result is what we're after. i will note that to date, only 2 controlled trials for the use of neurontin in bipolar disorder have been published, and both trials indicate that neurontin is not superior to placebo for mood-stabilization. there are at least 2 controlled trials that demonstrate that neurontin is a good drug for treating of social phobia/anxiety disorder as well as panic attacks. finally, neurontin inhibits the firing of voltage-dependent sodium channels and has been shown to increase blood serum concentrations of serotonin.....hope this helps in addition to the other post, all the best, chemist
Posted by djmmm on May 4, 2004, at 17:00:03
In reply to To Chemist, how does this med work?, posted by krybrahaha on May 4, 2004, at 4:00:26
> I have noticed you know alot about medications. My question is how does Neurontin work in the brain? I wonder this because this is the only med out of many that have worked for my anxiety.
>
> I have tried every med under the sun for anxiety and have settled on Neurontin. This med has been a godsend for me, when others have not. I have taken all the SSRI's, and alot of the benzo's with mild success.lots of Neurontin research:
http://home.tampabay.rr.com/lymecfs/list3.htm
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