Gabapentin vs Diazepam

[barefoot]

I occasionally take Diazepam for acute anxiety on an as and when basis. I get a prescription of 28 tablets (5mg) roughly every six months, so I’m not taking many or taking them often. If I take one, it’s usually because I’m triggered and my other strategies aren’t working to help me regulate, or sometimes I take one before I go to bed if I’m feeling very wired.

They work well for me.

My mother passed away a couple of weeks ago, which has been a massive shock. I’ve taken more Diazepam in the past fortnight than I usually would in that time frame - probably around dozen in total. I’ve taken those to manage stressful family discussions/dynamics and I also took one every night before I went to bed for about a week until I got some sleeping pills from my GP.

The funeral is next week and I plan on taking a couple before the service. Partly because I’ve volunteered to do a reading and I think I’m going to need something to take a little edge off.

I saw my therapist yesterday who suggested I speak to my GP about Gabapentin. She said her oncologist partner prescribes it to his patients over other alternatives and that it is as effective as Diazepam - so it should work for me just the same - but that, unlike Diazepam, it isn’t addictive.

I assume she is thinking that I may be taking more than usual over the next few weeks as the reality of my mum’s passing starts to hit and as I try to regulate my feelings around the loss.
So, I think she thinks my GP may be reluctant to prescribe me more Diazepam (I only got my last prescription in August and am now almost half way through them!) in case I get addicted.

Has anyone taken Gabapentin? What have been your experiences?

Has anyone taking both Gabapentin and Diazepam? Which did you prefer?

And has anyone in the UK found GPs are more willing to prescribe Gabapentin rather than Diazepam? My GP is satisfied that I only use the Diazepam on an ad hoc basis for acute anxiety attacks and that I’m clearly not addicted if 28 tablets last me about six months. But I’m not sure how he will feel about giving me more at the moment when my current lot runs out.

Thanks!

 

[Friday]

My 2 cents is regardless of what the medication is, starting a brand new one right in the middle of a stressful time, is a big risk.

Starting a new drug that has common side effects of anxiety, emotional instability, depression, & suicidal impulse? Seems even riskier. This is a med they usually require people non-psych patients to start therapy whilst taking it for at least the first 6 months, to monitor their mental health, because suicide is a big risk.

Gabapentin Side Effects in Detail - Drugs.com

Psychiatric

Common (1% to 10%): Abnormal thinking, amnesia, depression, hostility, confusion, emotional liability, anxiety, nervousness, insomnia

Uncommon (0.1% to 1%): Mental impairment

Rare (less than 0.1%): Hallucinations

Frequency not reported: Suicidal behavior and ideation, hypomania[Ref]

Meanwhile... On this side of the pond upping meds because of a death wouldn’t make even the most cautious GP blink, and most I’ve known would encourage it to prevent a bad cycle kicking off / to maintain functionality & stability given the history. A sudden death of a loved one is not an underlying or chronic condition being treated, it’s acute & limited. The exact same as someone who is on low dose painkillers for a chronic condition will uptick their use of them following surgery (acute condition), or after breaking an ankle. That’s normal & expected. Because there is clear cause. It only becomes concerning if the use doesn’t decrease again within a “reasonable” timeframe. What’s “reasonable” varies a lot doctor by doctor. Some are going to think in terms of weeks (3/6/12 weeks), other in terms of months (3/6/12 months).

To be very clear, I’m not a doctor & I’m not telling you to stay with the med you know, and not to take the one you don’t. For all I know gabapentin could be your “magic wand” med, with perfect results & zero side effects. I’m simply counseling caution during an already trying time / my own experience says switching meds is a big stressor in and of itself, more often than not.

 

[bumbles]

I've actually had a pretty good experience with gabapentin (after my first dose increase). It seems to chill me out to an extent that it almost feels like my thoughts hit a wall before I can start ruminating hardcore. The added bonus is that I don't black out extended periods of time like I did on benzos.

 

[joeylittle]

I saw my therapist yesterday who suggested I speak to my GP about Gabapentin. She said her oncologist partner prescribes it to his patients over other alternatives and that it is as effective as Diazepam - so it should work for me just the same - but that, unlike Diazepam, it isn’t addictive.

I take gabapentin 300mg PRN (as needed) for sleep. But it can be dosed up to somewhere around 3600mg per day in split doses, for other conditions....that's a very wide range.

If your doc is suggesting a low dose as needed for sleep, which would be an off-label use, the side effects commonly associated with the drug would be near-irrelevant.

But, if you need to be using something for daytime emotional regulation, you'd need to be on a daily dose, not just as as-needed for sleep. It's less to do with just subbing gabapentin for the diazepam, more to to with what you're needing to use it for. You'll want to be very specific with the prescriber, and it may be that you discover it takes two different meds to replace the diazepam.

 

[EveHarrington]

I think gabapentin is a good mood stabilizer, but it can definitely have an adjustment period so I’d hold out on the change for now. Dose one made me feel so awesome. I’m adjusting to it and while I sit here and think I can’t feel any benefit, I know when I’ve gone too long between doses as my mood will crash. I guess that’s what a good drug does though.....just helps you feel more normal again.

 

[barefoot]

My 2 cents is regardless of what the medication is, starting a brand new one right in the middle of a stressful time, is a big risk.

My therapist did say not to make any changes before the funeral so she wasn’t suggesting doing anything sudden/immediate. I think she meant that if I run out of this batch of Valium much quicker than usual because of current circumstances, a doctor may be happier to prescribe M.E. Gabapentin because it isn’t addictive. But I get the stressor of my Mum passing away is going to exist for longer than just getting past the funeral next week! So that’s something perhaps for me to think about in terms of whether it’s the right time to change a med.

This is a med they usually require people non-psych patients to start therapy whilst taking it for at least the first 6 months, to monitor their mental health, because suicide is a big risk.

Yikes! I think I need to do more reading up on this med!

upping meds because of a death wouldn’t make even the most cautious GP blink, and most I’ve known would encourage it to prevent a bad cycle kicking off / to maintain functionality & stability given the history. A sudden death of a loved one is not an underlying or chronic condition being treated, it’s acute & limited

Yes, that’s true. Perhaps I’m worrying about nothing and that, under the circumstances, he’ll be ok with giving me another Valium prescription if he can see I’m not taking enough for it to become a dependency issue.

It seems to chill me out to an extent that it almost feels like my thoughts hit a wall before I can start ruminating hardcore.

Sounds good!

@joeylittle She wasn’t meaning to take a low dose to help me sleep every night, I don’t think. I think she was meaning to just take it as and when I have a major anxiety spike as I do now with Valium (and hence I generally only take a few per month. I’m not feeling that I need to be taking any med consistently on a daily basis in order to stay regulated. I thought she made it sound like it could just be used in the moment when needed - she said, for example, that some people use it for public speaking anxiety. Maybe those instances are a low dose to take the edge off and perhaps she thinks that will work fine for me on that basis.

Hmm...I think I need to do some more research myself and speak to her again and then see if I want to bring it up with my GP whenever I run out of Valium.

 

[barefoot]

Thanks for sharing your experience @EveHarrington I’ve never been on a daily dose of anything for PTSD related anxiety/mood stabilising so this is all new to me. And, as I said again, I don’t want or think I need to be doing that. The Valium is very much a take as and when back up plan for acute anxiety where I need some extra help because my usual grounding/soothing things aren’t working. It sounds like Gabapentin can’t be taken like that so switching to that would mean taking doses every day no matter how I feel?

 

[Friday]

Yes, that’s true. Perhaps I’m worrying about nothing and that, under the circumstances, he’ll be ok with giving me another Valium prescription if he can see I’m not taking enough for it to become a dependency issue.

Something I’ve found with super addictive meds is that doctors tend to relax a lot about rx’ing them when I keep them in the loop... before it’s an issue (ie I haven’t run out, yet) ...in the form of a question ;)

IE something along the lines of... Hey Dr Smith, I just wanted to touch base with you because my mom just passed suddenly a few weeks ago & I’ve been taking more of my Valium than I usually do. I still have most of my prescription left, I just wanted to ask if taking more whilst dealing with all the funeral arrangements was okay?

And then let them reassure me about what I already know (yes, it’s fine & expected).

It’s mostly a trust building thing. They learn they can count on me to be aware of the risks, be responsible about my use, and to keep them informed. Besides, people like to be relied upon & trusted in their field of expertise. Even though I know the answer, and HE knows I know the answer, that I’m deferring to his professional judgment & including him in a personal matter? Creates a more solid relationship.

A note on this : I have a very firm belief that “no” is always an okay answer to any question. If I’m NOT okay with being told no? I don’t ask. I get myself to a place where I am okay with it, first, and then ask. Weirdly enough, being okay with the occasional no (sure, no problem, I completely understand, that’s why I was asking!) more often than not changes their answer from no to yes. :confused: Which I don’t really understand, unless they were testing me. I don’t “get” that kind of test, if I tell someone no, I actually mean no, but it seems to be pretty common for a lot of people to say no to see what kind of response they get before giving their “final” answer :confused: . So when I DO touch base with my doctor, in the for, of a question? I do prep myself first, in case they say no. IE I have other options, I still have half the bottle, and etc. so forth & so on. So I’m good if they tell me what I expect, or if I get thrown a curve ball. And if they do the weird no-yes thing? I just kind of let it pass on by as human weirdness I don’t particularly grok.

 

[Abstract]

Afraid can't help too much Barefoot but will affirm what you say about how cautious practitioners are here about prescribing Diazepam when they are used regularly for any period of time at all, because of how quickly they become addictive. Sounds wise to look at alternatives. Good luck with the funeral.

 

[EveHarrington]

The thing about gabapentin is that some docs are willing to prescribe it as needed or just as a nighttime sleep aid. My boyfriend takes gabapentin only as needed as his doc is willing to prescribe it in this manner. Other docs (like both of mine, GP & psych) stick to the book as there have been lawsuits against the pharmaceutical company for pushing the drug in non-approved ways, so they are gun-shy about pushing it too far beyond its “proven“ boundaries. My doc says he is willing to prescribe it for anxiety but not for mood stabilization. I have both issues so I don’t care what it’s technically prescribed for as it does indeed work on both issues.

I definitely need it round the clock. My boyfriend finds it works better for him as needed.

It’s definitely something that will depend on the comfort level of your doc, and how he/she is willing to prescribe it.

 

[whiteraven]

In my state, gabapentin is listed as a Schedule 5 drug and some docs will only prescribe it for nerve pain and seizures. I was taking it for both. While it absolutely helped, it also caused short-term memory problems and a significant amount of weight gain.

 

[EveHarrington]

In my state, gabapentin is listed as a Schedule 5 drug and some docs will only prescribe it for nerve pain and seizures. I was taking it for both. While it absolutely helped, it also caused short-term memory problems and a significant amount of weight gain.

What was your dose?