Biomedicine – Anticonvulsants
ACTION: Binds to gabapentin binding sites in brain and may modulate release of excitatory neurotransmitters.
INDICATIONS: Adjunct in treatment of partial seizures, management of postherpetic neuralgia (PHN). Treatment of moderate to severe primary restless legs syndrome, Management of PHN.
OFF-LABEL: Treatment of neuropathic pain, diabetic peripheral neuropathy, vasomotor symptoms, fibromyalgia, postoperative pain adjunct.
SIDE EFFECTS
Frequent (19%–10%): Fatigue, drowsiness, dizziness, ataxia.
Occasional (8%–3%): Nystagmus, tremor, diplopia, rhinitis, weight gain.
Rare (less than 2%): Anxiety, dysarthria, memory loss, dyspepsia, pharyngitis, myalgia.
ADVERSE EFFECTS/TOXIC REACTIONS: Abrupt withdrawal may increase seizure frequency, increased risk of suicidal behavior/thoughts. Over dosage may result in slurred speech, drowsiness, lethargy, diarrhea
INTERACTIONS
DRUG: Antacids decrease absorption. Morphine may increase CNS depression.
HERBAL: Evening primrose may decrease seizure threshold. Gotu kola, kava kava, St. John’s wort, valerian may increase CNS depression.
LAB VALUES: May alter serum glucose; WBC count. May increase serum alkaline phosphatase, ALT, AST, bilirubin.
(Neurontin)
TCM – Chapter 4-2: Wind-Damp Dispelling, Channel & Collateral-Opening
Enters: LV, GB, SJ, SP
Temperature: cool
Taste: slightly bitter, sour, acrid
ACTION: Dispel Wind-Damp-Heat, open channels, move Qi, cool Blood
INDICATIONS: Exterior Wind –Damp-Heat Bi syndrome, or interior Wind disorders d/t Liv Bloodand/or Yin deficiency.
Tongue: red, dusky
Pulse: tight, uneven
RATIONALE: Its enter s Shaoyang channel to dispel trapped wind-dampness pathogen. Its sour properties sooth sinews. Acrid disperses Qi stagnation, should be used with cautiousness in Qi deficient patients – may cause fatigue and dizziness. Bitter taste clears deficient heat. Cool properties cool blood.
CATION: Qi deficiency
NOTE: excessive use may deplete Qi
MODIFICATIONS: if Qi deficient add Dang Shen if upper body is affected or Huang Qi if lower body is affected