Key Points

  • Gabapentin, an anticonvulsant medication approved in 1993, treats seizures, nerve pain, and other conditions by affecting calcium channels in the nervous system.
  • While typically not producing euphoria at prescribed doses, some people experience mild highs when taking higher doses, with misuse potential primarily among those with substance use disorders.
  • Common side effects include dizziness, drowsiness, and coordination problems, while more serious risks of abuse include respiratory depression, physical dependence, and dangerous interactions with other substances.
  • Gabapentin overdose can cause severe drowsiness, confusion, slurred speech, and in serious cases, coma or respiratory depression, with increased dangers when combined with other central nervous system depressants.
  • Some states now classify gabapentin as a controlled substance due to its potential for misuse, though its abuse potential remains lower than many other prescription medications.

Gabapentin, primarily prescribed for seizures, nerve pain, and certain mood disorders, has become a subject of concern regarding its potential for misuse. People who take higher doses than prescribed or who combine gabapentin with other substances may experience euphoric effects. This medication affects neurotransmitters in the brain, explaining its therapeutic benefits and potential for producing pleasurable sensations in some circumstances.

What is Gabapentin?

Gabapentin, originally approved by the FDA in 1993, functions primarily as an anticonvulsant medication with multiple medical applications.[1] Doctors prescribe this medication to manage epileptic seizures, postherpetic neuralgia following shingles outbreaks, and various types of neuropathic pain conditions. The medication affects calcium channels in the nervous system, which influences the release of excitatory neurotransmitters that contribute to seizures and pain signals.

Medical literature classifies gabapentin as a GABA analog, though it does not directly affect GABA receptors as previously thought.[2] Studies show the medication binds to specific sites in brain tissue, which explains its effectiveness against certain types of seizures and nerve pain. Patients typically receive gabapentin in capsule, tablet, or liquid form, with dosages determined by their specific condition, medical history, and response to treatment.

Despite its therapeutic benefits, patients should know that gabapentin carries potential side effects, including dizziness, drowsiness, and coordination difficulties.[3] Healthcare experts carefully monitor patients starting this medication, especially those with kidney issues, as the body eliminates gabapentin primarily through renal pathways. Doctors often start treatment with low doses and gradually increase them to minimize adverse reactions while maximizing therapeutic outcomes.

What is Gabapentin Prescribed For?

Gabapentin serves as a versatile medication in modern medicine, addressing several conditions through its mechanism of affecting nerve signals and neurotransmitters in the brain:[4]

  • Epilepsy and seizure disorders: The medication helps control partial seizures when used alone or combined with other anticonvulsants.
  • Neuropathic pain: This includes postherpetic neuralgia (shingles pain), diabetic neuropathy, and other nerve pain conditions.
  • Restless legs syndrome: Some patients find relief from uncomfortable sensations and urges to move their legs.
  • Anxiety disorders: Doctors sometimes prescribe gabapentin off-label for generalized anxiety, social anxiety, and panic disorder.
  • Fibromyalgia: The medication may help manage widespread pain and improve sleep quality in people with this condition.
  • Hot flashes: Women experiencing menopausal symptoms or those undergoing treatment for breast cancer may receive gabapentin to reduce hot flashes’ frequency and intensity.
  • Alcohol withdrawal: Medical teams use gabapentin in some treatment protocols to manage withdrawal symptoms and reduce cravings during detox.
  • Insomnia: The sedative properties make it helpful for certain sleep disorders when prescribed by sleep specialists.

Does It Have Side Effects?

Gabapentin Side Effects

Gabapentin, while effective for many conditions, can produce side effects that patients and healthcare professionals must monitor carefully:[5]

  • Dizziness: Many patients notice this effect, especially during initial treatment or after dosage increases.
  • Drowsiness: The medication often causes sedation, impacting daily activities and driving ability.
  • Fatigue: General tiredness affects a significant percentage of people taking this medication.
  • Coordination problems: Some patients experience unsteadiness or difficulty with precise movements.
  • Vision changes: Blurred or double vision occurs occasionally, particularly with higher doses.
  • Peripheral edema: Swelling in the extremities sometimes happens due to fluid retention.
  • Weight gain: Gradual increases occur in many patients during long-term treatment.
  • Memory or concentration issues: Cognitive effects manifest in some individuals taking gabapentin.
  • Nausea and digestive problems: Stomach discomfort, diarrhea, or constipation affect some patients.
  • Mood changes: Symptoms like irritability or depression develop in certain cases.

Can Gabapentin Get You High?

Gabapentin, when taken at prescribed doses, typically does not produce a high or euphoric effect for most patients. However, research indicates that some people may experience a mild euphoric sensation when taking higher doses than prescribed.[6] This effect occurs because gabapentin influences neurotransmitters in the brain that affect mood regulation and pain perception, though the exact mechanism differs from more potent substances like opioids or benzodiazepines.

The potential for misuse exists primarily among certain populations. Studies show that those with histories of substance use disorders report using gabapentin to enhance the effects of other drugs, particularly opioids, or to substitute when preferred substances aren’t available.[7] Prescribers increasingly recognize this risk, with some states now classifying gabapentin as a controlled substance.

Can You Take Too Much Gabapentin?

Gabapentin overdose presents real risks, though fatalities from this medication alone remain relatively rare.[8] Taking excessive amounts can lead to severe side effects, including extreme drowsiness, confusion, slurred speech, and in serious cases, coma or respiratory depression. Medical literature documents that combining gabapentin with other central nervous system depressants like alcohol, opioids, or benzodiazepines significantly increases these dangers. Emergency departments treat overdose cases through supportive care since no specific antidote exists for gabapentin toxicity. Patients with kidney problems face heightened risks as their bodies eliminate the medication more slowly, allowing it to accumulate to potentially harmful levels.

What Are the Risks of Gabapentin Abuse?

Gabapentin abuse can create health risks, particularly when people take doses exceeding medical recommendations:[9]

  • Central nervous system depression: Excessive dosing can severely impair breathing, consciousness, and vital functions.
  • Respiratory problems: High doses may suppress breathing, especially when combined with alcohol or opioids.
  • Physical dependence: Regular misuse leads to withdrawal symptoms when stopping, including anxiety, insomnia, and seizures.
  • Dangerous drug interactions: Combining with alcohol, opioids, or benzodiazepines significantly increases overdose risk.
  • Memory impairment: Cognitive function suffers from excessive use, affecting daily functioning.
  • Risk of seizures: Paradoxically, abrupt discontinuation after abuse can trigger seizures, even in people without epilepsy.
  • Mood disturbances: Depression, anxiety, and mood swings occur more frequently with misuse.
  • Increased fall risk: Coordination problems and dizziness worsen with higher doses, particularly affecting older adults.
  • Suicide risk: Some research suggests higher suicidal ideation rates among those misusing gabapentin.
  • Organ damage: Long-term abuse may affect kidney function, especially in people with existing renal issues.