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Does Gabapentin Interact With Seroquel?

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Posted on Wed, 7 Jun 2017
Question: I am weening off parnate but still not sleeping. Gabapentin 600 mgs was not helpful either. I'm reading that some people suggest taking seroquel or asenapine (saphris) for sleep. I have both at home. Is this worth trying?

Interestingly, the day after I decide to stop Parnate and go down to 20 mgs, I get out of bed and feel my motivation and mood lifted. I was doing laundry and dishes until I got sucked into the internet
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (36 minutes later)
Brief Answer:
Seroquel is better and potential option

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

Considering the ongoing sleep issues I feel seroquel will make a better option than saphris. The dose required for sleep is just 25-50 mg per day and it will provide safe sleep.

Asenapine is another option as recommended by someone but it is not potent one and taking it is difficult as it causes some metallic taste in mouth.

Regarding feeling elevated I think it is natural to feel better when you decide something positive after the burden of side effects. This is clear indication that our expectations play a significant role in side effect as well as effect of medications.

I hope this helps you.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (2 days later)
I am still hanging out at 20mgs Parnate and stuck with indecision. Saturday went really well I thought maybe I had come over a "hump" and had hit some therapeutic effects. I think that may have been from the small dose 2-3 mgs of vyvanse and/or the 600mg gabapentin from the night before. It felt like when Celexa kicks in, but less racy.

On Sunday the sedation and blunting returned (still 20mgs parnate). I am dosing in the afternoons so that the energizing stage is over by bedtime and the following sedated/weak period is hopefully gone by morning. I have accepted that I will need a sleep aid every night so now I am taking doxylamine at night AND 300 mg gabapentin. I was told that it improves slow-wave sleep and can keep you asleep, even if it doesn't put you to sleep.

Monday kinda nervous and physically weak again. I began getting frantically worried in the late afternoon over whether I would take my 20mg dose, stop altogether, or consider jumping back to 40mgs after another day or two. Many people think I am giving up too early but I don't know how much time I should give in this zombie state. Questions:

-As I get past 3,4 weeks at 20mgs will any negative effects go away, leaving me with some idea of what to expect from the therapeutic effects? Or is 20mgs nothing but side effects? I always felt at least a brief taste of benefits on other drugs (SSRIs typically) before having to go up in dose.

-Is it a sound idea to take gabapentin at night, with a sleep aid, to improve the quality of sleep?

-Several internet "friends" have promised that a wider range of emotions, motivation, social openness, waits for me if I just wait another week or so at 40 mgs or more, which is the exact OPPOSITE of what I get NOW at 30-40 mgs. I need some help gauging if this is true for me based open how I have felt so far. What would you do?

-I also wonder if the 100mg lamotragine and .5mgs of clonazepam I take daily could be affecting the parnate experience.

Right now the only other option I see is going back onto a mix of trileptal, 5mgs Celexa, and something to help with the sedation and confusion (which will mean finding a different doctor). Celexa seemed to help with the anger during the trileptal, and trileptal was great for making me feel more emotionally open and connected. Celexa also returns me to some degree of motivation/ambition, but I'm not sure if that is hypomania.

sorry for the long question
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (14 hours later)
Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

Although your online friends suggest you to keep on waiting for more time but my experience states otherwise.Most of my patients, who developed intolerable side effects initially failed to response in due course of time. Two of the patient who responded but side effects lead to early discontinuation and ultimately back to square one.

However I must acknowledge that I have limited experience with this molecule and may not be the best person to answer your queries. At the same time I often prefer ECT when there is poor response due to social circumstances prevailing in my country and that again limits my experience with parnate which is often used in resistant cases.

Now regarding your questions
You will see changes in negative thoughts, energy, social interactions, anxiety and other presenting compaints provided there is positive effect of 20 mg of parnate. I must also inform you that 20mg parnate can be effective dose an dit should not be underestimated.

Sleep is important thing to keep side effects as well as illness under control and I do not see any harm with use of sleep aids when there is need for same.

If you are able to tolerate the side effects at 20 mg you can wait for one more week before stopping or increasing the dose.I think this could be rationale approach as we are open to see both declining of side effects and appearance of positive effects.

No they do not affect. Have completely different mode of action.

If we are not able to continue with current molecule definitely we are left with earlier options.

I hope this answers you.
Thanks and regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Does Gabapentin Interact With Seroquel?

Brief Answer: Seroquel is better and potential option Detailed Answer: Dear XXXXXXX Thanks for follow up. Considering the ongoing sleep issues I feel seroquel will make a better option than saphris. The dose required for sleep is just 25-50 mg per day and it will provide safe sleep. Asenapine is another option as recommended by someone but it is not potent one and taking it is difficult as it causes some metallic taste in mouth. Regarding feeling elevated I think it is natural to feel better when you decide something positive after the burden of side effects. This is clear indication that our expectations play a significant role in side effect as well as effect of medications. I hope this helps you. Thanks and regards.