Neurontin vs. Propranolol for Epilepsy and Atrial Fibrillation: Important Differences and Potential Risks.

Key takeaways

Gabapentin (Neurontin) and Propranolol (Inderal LA, Inderal XL, Innopran XL) are both prescription medications, but they belong to different classes and treat different conditions. Gabapentin is an antiepileptic used to treat certain seizures and nerve pain, while Propranolol is a non-selective beta blocker used for high blood pressure, chest pain, and migraine prevention, among other conditions. Gabapentin is typically taken three times daily, whereas Propranolol can be taken 1 to 4 times daily depending on whether you use the immediate-release or extended-release form. Both medications are available as a lower-cost generic. Common side effects of Gabapentin include dizziness and sleepiness, while Propranolol often causes dizziness, tiredness, and weakness. Gabapentin can raise the risk of suicidal thoughts, whereas Propranolol can hide symptoms of low blood sugar and is not safe for people with asthma. Both medications require careful monitoring and should not be stopped suddenly without consulting your healthcare provider.

Gabapentin

(Neurontin)

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Propranolol

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Summary for Neurontin

Prescription only

Gabapentin, also known by its brand name Neurontin, is used to treat nerve pain from shingles in adults. This medication can also help treat partial (focal) seizures in adults and children. Gabapentin (Neurontin) comes as pills and a liquid that you take by mouth. The dosage depends on things like what you're treating, how old you are, and how well the medication is working. In general, you take it 3 times a day. Common side effects include making you feel dizzy and sleepy.

Indications for Neurontin

Nerve pain from shingles (postherpetic neuralgia) in adults
Partial (focal) seizures in people age 3 years and older

Pros and Cons for Neurontin

Pros

An option for relieving nerve pain caused by shingles
Can take with other anti-seizure medications for partial-onset seizures in people 3 years and older
Available as a tablet, capsule, and liquid for those who have trouble swallowing pills

Cons

Usually need to taken three times per day
Can cause dizziness and sleepiness
Can cause withdrawal symptoms if you stop taking the medication too suddenly or too fast

Common Side Effects for Neurontin

Sleepiness (19%)
Dizziness (17%)
Poor muscle control or clumsiness (13%)
Fatigue (11%)

Warnings for Neurontin

Severe allergic reactions
Sleepiness, dizziness, and trouble concentrating
Risk of suicidal thoughts and behavior
Higher risk of seizures and other side effects if you stop the medication too suddenly or too fast
Dangerously slowed breathing
Changes in behavior in children

Summary for Propranolol

Prescription only

Propranolol is a non-selective beta blocker. It helps with a range of medical conditions, including high blood pressure, tremors, and migraine prevention. Sometimes, providers prescribe propranolol off-label to ease performance anxiety. You take this medication by mouth, typically 1 to 4 times daily, depending on if you're taking the immediate-release (IR) or extended-release (ER) medication. Keep in mind the IR and ER versions don't treat the same medical conditions. Some of the more common side effects of propranolol include dizziness, tiredness, or weakness.

Indications for Propranolol

High blood pressure
Chronic chest pain
Migraine
Hypertrophic subaortic stenosis
Atrial fibrillation (A.Fib)
Heart protection after a heart attack
Tremors
Pheochromocytoma (a rare tumor of the adrenal gland)

Pros and Cons for Propranolol

Pros

Taken by mouth
Long-acting version only needs to be taken once a day
Oral solution might be a good option for people who can't swallow pills
Available as lower-cost generics

Cons

Not safe for people with asthma or certain serious heart conditions
Can hide many recognizable symptoms of low blood sugar, such as fast heart beat or tremors, which might prevent timely treatment
Missing doses or suddenly stopping propranolol can raise your risk of heart attacks