Occipital Neuralgia

Gabapentin is used for neuropathic pain by suppressing nerve hyperexcitation and is primarily excreted through the kidneys. Most herbal ingredients are metabolized via the hepatic CYP450 pathway, so the likelihood of direct competition with gabapentin is low. However, there is a possibility of liver enzyme induction or inhibition when used in combination with certain highly hepatically metabolized ingredients (such as high doses of Scutellaria root and Rheum palmatum). In addition, caution is required with herbal medicines containing sedative ingredients (such as Ziziphus jujuba and Polygala tenuifolia), as they may interact with the sedative effects of gabapentin. From a Korean medicine perspective, long-term use of anticonvulsants can lead to a decline in spleen and stomach function and accumulated fatigue; therefore, herbal medicines are formulated to complement these effects. At Dongjedang, we verify all Western medications currently being taken during the initial consultation and prioritize gentle prescriptions that aid meridian circulation while reducing the burden on the liver and kidneys. We advise patients to separate their medication intake by at least two hours and to consult with their attending physician regarding the reduction of Western medication dosage based on the progress of treatment.