Table of Contents
What is Gabapentin?
Gabapentin is a central nervous system (CNS) depressant prescribed to reduce seizures and nerve pain from shingles. If someone is suffering from gabapentin addiction and stops using the substance, they may suffer from gabapentin withdrawal symptoms.
Each of the drug’s brand names serves a distinct purpose and should not be swapped without direct instruction from your doctor. Neurontin is the brand name for the version of gabapentin used to treat epilepsy in adults and children over the age of three. The Gralise brand treats neuropathic (nerve) pain and cannot treat seizures. The Horizant brand treats neuropathic pain and is also prescribed off-label to treat restless leg syndrome.
What Does Gabapentin Treat?
The only FDA-approved uses for gabapentin are as anticonvulsant and postherpetic neuralgia (chronic pain where shingles occurred). As such, doctors typically prescribe gabapentin to treat seizures caused by epilepsy and nerve pain from shingles. 1
However, the off-label use of gabapentin to treat other conditions has skyrocketed in past years, even without solid evidence confirming benefits. Physicians regularly prescribe gabapentin for anxiety and to treat restless leg syndrome.
Off-label uses for which physicians have prescribed gabapentin include: 2
- Restless leg syndrome
- Cocaine and alcohol withdrawal
- Hot flashes
- Depressive disorders
- Anxiety disorders
- Bipolar disorder
- Insomnia/sleep disorders
- Diabetic neuropathy
- Attention deficit disorder
Is It Safe to Take Gabapentin?
When taken as prescribed and if you are completely transparent with your doctor about other medications and supplements you are taking, gabapentin is generally safe to take. You must tell your doctor about any other substances you are taking, as gabapentin can be less effective or lead to added side effects when combined with certain drugs.
There are four central population warnings associated with gabapentin, which include:
Gabapentin may not be safe if you have kidney issues, as your body may take longer to remove gabapentin, leading to dangerous build-ups. Seniors may also experience age-related kidney decline and should discuss gabapentin risks with their doctor. 3
If you are taking gabapentin for epilepsy, quitting “cold turkey” can lead to a dangerous condition called status epilepticus, where seizures last longer than five minutes or occur repeatedly in a short period. Epilepticus should be considered a medical emergency as it can lead to permanent brain damage and death if not treated immediately.
Gabapentin’s side effects during pregnancy have yet to be determined, although research has found that gabapentin does pass through breast milk and can lead to serious side effects for children.
Gabapentin comes with a warning label cautioning that gabapentin can lead to increased thoughts of suicide. If you begin experiencing increased negative outlook and suicidal ideation, talk to your doctor right away.
However, when used as prescribed, the relatively low gabapentin addiction potential makes the drug generally safe for healthy individuals.
What are the Effects of Gabapentin?
Although generally safe, studies have shown several common, short-term side effects that can accompany gabapentin use. 4
Common Short-Term Gabapentin Side Effects
- Somnolence (feeling very tired)
- Asthenia (abnormal fatigue and muscle weakness)
- Ataxia (loss of control of body movements)
- Lack of coordination and loss of balance
- Nausea and vomiting
- Flu-like symptoms
- Swelling of extremities like legs or feet
- Headache or double vision
- Problem with eye movements
- Trouble speaking
If these problems become more severe or fail to lessen over time, it’s advisable to discuss your symptoms with your doctor.
Children over the age of three taking the drug for seizures may experience a different set of gabapentin side effects. Should your child exhibit the following symptoms, it is wise to discuss the changes with their physician.
Common Gabapentin Side Effects in Children
- Changes in behavior
- Difficulty focusing
- Issues with memory
- Reacting too quickly, emotionally, or overreacting
- Depression and anxiety
- Suspicion and distrust
- Aggressiveness, hostility, or restlessness
Serious Gabapentin Side Effects
- Respiratory depression and failure
- Difficulty swallowing or breathing
- Suicidal ideation
- Weakened muscles
- Temporary amnesia
- Mood changes, like anxiety or aggression
- Peripheral edema
- Blurry vision
- Blood pressure shifts
- Weight gain
- Abdominal pain
- Tremors or shakiness
- Skin rashes
- Hives appearing on the body
- Difficulty breathing
- Swollen lips and tongue
- Blue-tinged skin
- Severe fatigue
- Frequent infections
- Muscle weakness
- Upper stomach pain
- Unusual bruising on the body
- Whites of eyes or skin become yellow-tinged
Gabapentin Interactions with Other Drugs
It is critical you let your doctor know all supplements and medications you take, as gabapentin can become less effective or interact dangerously with certain drugs.
While taking gabapentin, a general rule of thumb is to avoid other central nervous system depressants or drugs that cause drowsiness. When paired with sleep-inducing drugs, gabapentin can increase the risk of respiratory failure, coma, and even death.
Drugs that could be dangerous to combine with gabapentin and should be discussed with your doctor include:
- Anxiety medications
- Painkillers including opioids (see below) and OTC medications
- Seizure medications (like phenytoin)
Sedatives (Opioids, Alcohol, Benzodiazepines, Barbiturates)
While opioids are commonly prescribed alongside gabapentin to reinforce nerve pain treatment, combining the two drugs can lead to dangerous interactions when not carefully monitored. CNS depressants – alcohol, benzodiazepines, barbiturates, insomnia medications – work by slowing brain activity. This effect can lead to difficulty breathing, depressed respiration, coma, and death.
For this reason, you must discuss all medications with your physician to ensure you do not mix dangerous levels of gabapentin with opioids like tramadol, hydrocodone, oxycodone, or codeine. However – when taken as prescribed, opioids and gabapentin can provide a successful approach to pain relief.
Using gabapentin with the antipsychotic olanzapine can increase side effects of dizziness, difficulty concentrating, confusion, and drowsiness. If you are currently taking antipsychotic medications, it is best to talk with your doctor before beginning gabapentin. 5
The above does not represent a complete list of drug interactions. If you are worried about potential drug interactions between gabapentin and other medications, reach out to your doctor – they’ll be able to help.
Signs of Gabapentin Addiction
While gabapentin addiction potential is low, that doesn’t mean gabapentin abuse never happens. Most gabapentin abuse occurs in combination with other drugs, which can lead to dangerous interactions. Alone, it takes very high levels (> 800mg) of gabapentin for users to experience a high.
Many individuals begin abusing gabapentin during recovery, as high doses of gabapentin can lead to a euphoric high that does not always show on drug tests.
Common Signs of Gabapentin Addiction
- Symptoms of long-term or excessive gabapentin use (refer above)
- Needing higher doses to achieve previous effects
- Hiding gabapentin use
- A growing preoccupation with acquiring more gabapentin
- Becoming more isolated from family and friends
- Making mistakes at work or in relationships due to an obsession with gabapentin
- Being unable to quit or decrease the dose, even when you want to
- Experiencing gabapentin withdrawal
- Doctor shopping or seeking out new doctors for more prescriptions
Causes of Addiction to Gabapentin
Addiction typically follows gabapentin abuse, which research suggests occurs for three main reasons. 6
- Excess amounts can provide a calming and euphoric high: Gabapentin abuse mainly occurs in individuals who have a pre-existing addiction to opioids and whose brains may be more sensitive to the relatively small high that gabapentin produces. Many who have abused gabapentin have noted the high feels like the calming and euphoric side effects of smoking marijuana.
- Gabapentin abuse can heighten methadone treatment potency: Using gabapentin before a methadone treatment can increase the relaxing, sedative, and psychedelic effects of the gabapentin high. Using gabapentin in combination with opioids like methadone can increase gabapentin addiction potential and the likelihood of abuse.
- People are self-medicating to prevent or reduce opioid withdrawal symptoms: Many begin abusing gabapentin to decrease the intensity of opioid withdrawal, leading to gabapentin addiction.
Signs of Gabapentin Overdose
Luckily, reports of fatal overdoses from gabapentin alone – even at high concentration levels – usually generate mild to moderate symptoms, rarely leading to fatalities. Most fatal gabapentin overdoses occur when used with other drugs, but it is possible to overdose on gabapentin alone. 7
There is currently no single medication available to reverse gabapentin overdose. If you or someone you know is experiencing a gabapentin overdose, call emergency services.
Gabapentin Overdose Symptoms Include:
- Muscle fatigue
- Drooping eyelids
- Depressed respiration
- Low blood pressure
Gabapentin Withdrawal Symptoms
Gabapentin withdrawal usually sets in within one to two days of abruptly stopping gabapentin doses, although they can take up to seven days to present. 8
Common gabapentin withdrawal symptoms include:
- Digestive issues
- Incoherent speech
More rare gabapentin withdrawal symptoms include:
- Increased in blood pressure
- Tachycardia (rapid heart rate)
If you’re taking gabapentin for seizures and stop taking your meds abruptly, you may face an increased risk of potentially life-threatening seizures. If you’re thinking about going through gabapentin withdrawal, be sure to talk to your doctor, who will likely suggest decreasing your doses slowly.
Gabapentin Withdrawal Treatments
While gabapentin addiction is rare, gabapentin withdrawal can be challenging and lead to side effects when not carefully monitored.
Tapering Off and Replacement Drugs
Most doctors help patients safely detox from gabapentin by using a tapering schedule. Tapering is when doctors slowly reduce your medication dosages so your body can acclimate without intense withdrawal symptoms.
Gabapentin tapering takes about a week, although timelines vary. Your doctor may also prescribe replacement drugs to reduce gabapentin withdrawal and help your body adjust more quickly.
There are many therapeutic approaches for gabapentin addiction and withdrawal.
- Cognitive-behavioral therapy (CBT) is one of the most widely used therapies. It involves exploring thought patterns to identify triggers, develop emotional coping behaviors, and create more healthy and helpful habits.
- Dialectical behavior therapy (DBT) is a subtype of CBT developed for patients with emotional disturbances and may prove helpful in working through self-harm or suicidal thoughts.
- Mindfulness therapy is another powerful therapeutic avenue, giving patients a more calm, accepting, and patient outlook as they learn to observe their thoughts without judgment or reactivity.
- Motivational Interviewing helps patients explore and resolve ambiguity that prevents them from solidifying and increasing motivation.
- Group Therapy helps patients explore the foundation of their addiction and reinforce new habits in a safe environment filled with others who understand the distinct challenges of your experience.
Inpatient Treatment or Outpatient Treatment
The choice between inpatient and outpatient treatment depends on you and your lifestyle. Inpatient treatment provides more hands-on care paired with a structured and supportive environment that removes triggers to help you give your full energy to recovery.
Outpatient treatment often presents a better option for individuals who can’t leave work or home due to family responsibilities. Outpatient treatment still provides high-quality treatment but also requires you to have a safe and strong support system and home environment to help you recover.