Gabapentin, benzo tapering, and Neuropathic Pain

[[Md...]]

So, i unfortunately suffer from something called Post Traumatic Trigeminal Neuropathy, which occurred after dental work. 

I have been taking benzos for the last 7 months to treat the pain. They work great and bring the pain from about a 10 to a 1 or even zero. 
 

With that being said, I don’t want to be on benzos for the rest of my life due to the known ramifications, and I need to find another anti-convulsant for neuropathy. Gabapentin seems to be the lesser of the two evils, and was specifically designed to treat neuropathy. 

I was also reading this article where a study was conducted showing that Gabapentin was a great way to help people taper off benzos.

https://www.healio.com/news/psychiatry/20210502/gabapentin-plus-benzodiazepine-safe-for-benzodiazepine-withdrawal-treatment

If this is true, I might be able to kill two birds with one stone: find a long term solution for my neuropathy, and possibly not having to endure though any serious withdrawal side effects from tapering benzos.

I could be over simplifying thing here, but it also might be worth a shot, since I may have to deal with this neuropathy indefinitely. My aunt has actually been taking Gabapentin for her neuropathy for 20 years and has had zero issues with it. 

Has anyone tried tapering off benzos using Gabapentin before? If so, what was your experience? 
 

Thanks.

[[Ri...]]

I'm sorry you're experiencing the neuropathy, but gabapentin is definitely not a great way to taper off benzos. The study you mentioned isn't a great one, it was not a randomized controlled trial, which is essentially the gold standard. If that was the case, we would all be doing it. You may want to look more into gabapentin, as it can come with its own set of withdrawal symptoms on cessation. Also, I think everyone gets mixed results as to effectiveness. Hopefully, your neuropathy will resolve on its own.

[[Md...]]

18 hours ago, [[R...] said:

I'm sorry you're experiencing the neuropathy, but gabapentin is definitely not a great way to taper off benzos. The study you mentioned isn't a great one, it was not a randomized controlled trial, which is essentially the gold standard. If that was the case, we would all be doing it. You may want to look more into gabapentin, as it can come with its own set of withdrawal symptoms on cessation. Also, I think everyone gets mixed results as to effectiveness. Hopefully, your neuropathy will resolve on its own.

While I appreciate your concern, I do need to find something for my neuropathy, regardless. Otherwise, I may as well just stay on these benzos, because not only do they treat the pain, but all anti-convulsants are pretty much poison at the end of the day. 

Btw, this is not some basic type of neuropathy. This is a very rare type of neuropathy that doesn’t just go away. It’s usually a lifelong condition that causes something called central sensitization, basically CRPS, but in your face. It’s a debilitating, suicide type of pain. 

Neuropathy is usually treated with anti-convulsants, and Gabapentin is generally the lesser of all the evils when it comes to anti-convulsants. 

There’s also been anecdotal reports on these very boards of Gabapentin masking benzo withdrawal symptoms, so I think it’s still worth exploring. 

Not to mention that many detox centers are giving their patients Gabapentin to help mask the symptoms of benzo withdrawal. 

I also have zero intentions of tapering from whichever anti-convulsant I end up going with, because again, this is usually a type of neuropathy that just doesn’t disappear, especially once it’s become centralized.

“Additionally, PTNP has been reported to be associated with a substantial psychosocial burden [6], increased level of depression, pain catastrophizing, as well as reduced quality of life (QoL) and coping efficacy levels [5]. Pain intensity level was shown to be a significant predictor of all mentioned above modalities [5]. The prognosis of PTNP is poor, significant improvement is reported only by 10–20% of the patients and in long-term follow up appointments 30% of the patients report some level of improvement while 50% of the patients report worsening or no change in their pain levels”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9775491/

And in case you don’t want to read that entire article, this video sums it up quite well. 
 

So I’m basically stuck between a rock and a hard place.

Thanks for chiming in though.

 

Edited October 4, 2023 by [Md...]