Neurontin and diving

[bluebanded goby]

A neurologist has mentioned the possibility of prescribing neurontin to help with neuropathies (pain, tingling, etc) I experience in one hand and arm. Is there possibly an issue with diving while on this? I'm wondering, for example, if there might be a tendency for it to mask mild DCS symptoms.

I _am_ aware (from posting about my situation in past messages here) that peripheral neuropathies in general are considered a relative contraindication for diving, due to the fact that the symptoms can be confused with DCS. I think my dive doc is thinking we might be able to characterize and isolate the symptoms enough to tell them apart from DCS. But I was curious if introducing this medication could add another complication. (The neurologist and dive doc are two different doctors, and I haven't had the chance to run this idea by the dive doc yet.) Thanks in advance for any comment.

 

[BillP]

Howdy bluebanded goby:

Interesting question, but I'm afraid I don't really have an answer for you. I don't know that anyone has actually looked at Neurontin's use in diving.

Neurontin (gabapentin) is an antiseizure medication. There are some guesses as to its mechanism of action, but how it works on the nervous system isn't really understood. Somewhere along the line it was noticed that Neurontin also helped with abnormal pain such as allodynia (pain caused by a stimulus that wouldn't normally cause pain) and hyperalgesia (excessive sensibility or sensitivity to pain) found with neuropathy (a functional disturbance of the peripheral nervous system). The way neuropathy causes pain and how Neurontin helps isn't fully understood either, but it is thought that Neurontin somehow modulates an abnormal adaptation of the nerves to an injury.

The effectiveness of Neurontin in pain from neuropathy has been looked at fairly extensively, but its effects in "normal" acute pain from an injury in people has not. Seizure medications like Neurontin don't seem to affect "normal" pain like they do the "abnormal" pain of neuropathy, however.

You will want to read more about Neurontin, and particularly about its side effects. There's a good .pdf document on Neurontin at:

http://www.pfizer.com/hml/pi's/neurontinpi.pdf

HTH,

Bill

The above information is intended for discussion purposes only, and is not meant as specific medical advice for any individual.

 

[John Reinertson]

My greatest concern (as a family doc who uses Neurontin for many patients/conditions) would be the sedation that is common with neurontin when first starting. As long as you document (In writing please) The condition requiring neurontin and your physicians are comfortable with a stable dose and no sedation prior to diving, it's probably OK, especially if there are no recent dose changes or new symptoms.

I've had back surgery and have a permanent numbness at L5 on my right side.
That's no big deal as long as it's clear it is pre-existing and any treating doc knows not to sweat one numb toe and a numb side of my calf on my right side . It only becomes a problem when concealed or unclear. I am not necessarily at greatly increased risk of the bends on the right leg because of it, but I could scare the heck out ogf a treating doctor if it he/she weren't aware of my medical history.

Be sure there are no recent medicine changes and be sure any relevant medical history is written down and not concealed.. that can lead to major confusion, more so than the medicine itself sometimes.

John