Neurontin: Cure or Con?

The drug Neurontin was placed on the market 8 years ago. According to the information approved by the USFDA, it is to be used for only two uses: as an adjunct drug for the control of epilepsy and for the control of Postherpetic Neuralgia. That means it should only be promoted for use for the control of epilepsy if another drug is also being used to control epilepsy or to help control pain due to the herpes zoster skin rash. But that is far from what is happening.

But first, we should look at how good this drug is at doing what the FDA says it can be prescribed to do.  And first let me explain one thing about statistics.  There is a nice phrase that is often used in the world of statistics.  it is "statistically significant." If I throw a penny 10 times and get six heads and four tails, my results would be considered "statistically significant." I would expect to get 50 percent heads and 50 percent tails. But I got 60 percent heads and 40 percent tails. Not astounding in the long run, but "statistically significant." Now lets say that I throw that penny 100 times. I get 57 heads and 43 tails. I would expect another 50 percent heads and 50 percent tails, but I have gotten 57 percent heads and 43 percent tails. This would also be "statistically significant." What the term means is that the results are probably not random. After 100 throws of this coin, I would probably wonder what was going on with this penny. I would check it for flaws or uneven weighting throughout the coin. But, it would not be enough to put my money down on a bet based on the toss of this coin. The result is just not as random as one would expect.

Neurontin is prescribed for pain that remains after the healing of herpes zoster rashes. They call their results statistically significant. But the reality is that Neurontin only improves the level of pain for about 20 percent of patients over a placebo, and pain was being improved at best by an improvement of 50 percent. That means that if a person, from a scoring system from 0 to 10, said that their pain was at a 4 before treatment, about 20 percent would say that they had a pain level of 2 after treatment, the rest having no improvement at all.

Neurontin as a treatment for epilepsy can only be combined with another epilepsy drug, and then, only to control seizures that are not completely controlled by the other medication. According to the statistics, Neurontin reduced the number of seizures experienced by approximately 50 percent in about 15 percent more patients than did a placebo. That means, if we have 100 people taking Neurontin and 100 people taking a placebo, and each person has an average of six seizures a week, about eight of the people taking placebos will have three seizures and 18 people taking Neurontin will have only three seizures.

So, even the most simple of us can see from this explanation that regardless of the reason for the use of Neurontin, a rather small number of people are actually helped by taking the drug. And yet, it is being promoted by the manufacturer as a cure-all for everything from headaches and migraines to chronic pain of any kind. Occasionally, a person does find relief using Neurontin, and far be it from me to decry their success. But it is given out like candy at the urging of the manufacturer, who has advertised the drug extensively, paying prominent physicians to carry the message to their profession. So why should this be a big deal? Why should we care? If it doesnt work, just quit taking it, right? If it were only that easy.

Here is a list of the frequent side effects experienced by those taking Neurontin: asthenia, malaise, face edema, hypertension, anorexia, flatulence, gingivitis, bruises resulting from physical trauma, arthralgia, vertigo, hyperkinesia, parethesia, decreased or absent reflexes, increased reflexes, anxiety, hostility, pneumonia, abnormal vision, confusion, and depression. I know from personal experience that this drug can seriously compromise ones thought processes and cause serious problems, not only with physical side effects but also psychological effects. Another patient I know who took Neurontin became so hostile that he stopped using the drug and he was hospitalized to keep him safe until the drug wore off.

The doses being prescribed of this drug are huge - doses of up to 3200 mg are not uncommon. There is ongoing research to expand the use of this drug, and although most of the results are as unimpressive as what has previously been recorded, they are still touted as "statistically significant" Since most physicians have little understanding of either statistics or research, they are continuing to prescribe this very potent drug as a cure-all rather than trying to use different drugs with fewer, less dangerous side effects.

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