Gabapentin is as an anti-epileptic drug and as an analgesic, particularly for pain of the neuropathic or neurogenic type. When used for controlling epilepsy, it is usually used in conjunction with another anti-epileptic drug. But Gabapentin is widely used to treat nerve pain or neuropathic pain than it is to treat epilepsy.
Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (”change of life”, the end of monthly menstrual periods). Talk to your doctor about the risks of using this medication for your condition.
It is also widely used to treat Anxiety and Migraine prevention.
One of Gabapentin “off-label” usage is for migraine prevention and treatment, including migraines with or without aura, vestibular migraines. It can reduce the frequency of headaches, pain intensity, and the use of symptomatic medications. Gabapentin is a good preventive therapy for migraines refractory to standard medications.
The chemical structure of gabapentin is related that of gamma-aminobutyric acid (GABA) which is a neurotransmitter in the brain. The exact mechanism as to how gabapentin controls epilepsy and relieves pain is unknown, but it probably acts like the neurotransmitter GABA.
The effective dose of gabapentin varies greatly. Some persons need only 200-300 mg a day whereas others may need 3000 mg or more a day. It may take several weeks to become effective, so it is important to stay on it for an adequate length of time.
The Efficacy of gabapentin in migraine prophylaxis experiment shows gabapentin is an effective prophylactic agent for patients with migraine.
In the Clinical trials, 143 patients evaluated gabapentin for migraine prophylaxis. After 3 months the patients taking gabapentin had a reduction of the migraine frequency by 1.5 migraines per month (or by 35.7%) compared with a reduction of 0.6 migraines per month for the placebo group. Also, gabapentin reduced the headache frequency by 50% or greater in 45% patients compared with only 16% patients on placebo. The most frequently reported adverse events were asthenia, dizziness, somnolence, and infection.
In Famous medical websites, migraine patients also review the gabapentin as the migraine prevention medicine. They rate Gabapentin 8.1 stars out of ten stars. It is a high mark and means Gabapentin is a very effective medicine for migraine prevention.
I haven’t been taking this medication for long but it’s helped so much. Neuro started me off on 300mg at night and now I’m at 600mg at night. It doesn’t make me sleepy or drowsy. Before starting gabapentin, I was having migraines just about every day. I started having aphasia and vision changes with my migraines, so I decided to take action. I’ve only been on it for almost 2 weeks but I’ve been migraine free and my triggers are no longer triggers at this point, which is fantastic. I should note it has reduced my appetite but this is not a negative thing.” – Crystaldreams July 25, 2017
This medication is..interesting. I am 20 with what a few doctors think is Fibro and a chronic pain condition but was Rx’d this med by a psych doctor for tension migraines. While it does NOT really help with migraines, it has been making me awfully sleepy and drowsy, and helping with weird aches and pains throughout my body. It can be used as a mood stabilizer and I can see why- because it makes you so drowsy you can’t do or say anything, especially after taking the evening dose! I’ve been afraid to drive any car since starting this. It makes me more drowsy than my anxiety meds which don’t make me drowsy at all! Doctor is raising the dose because since writing that first part- I have become quite used to the med, where my dose does NOT work – Chelseabergstresser (taken for 1 to 6 months)May 11, 2017
“I have chronic Migraine called Glutamate Storm. First dose of 100mgs made me sleep 36 hours. Before I got the prescription I never slept more than 5 hours per night and often only got 2 hours of sleep per night. But I did not want to take a prescription every day, so I only took it when my ears were ringing really loud and I was sleep deprived. But then I noticed that my chronic cough was always gone the day after taking Gabapentin. So I started taking it every day for that. When I did, my headache and ear ringing got a lot better. I am now taking 400 mgs per day. I had bad breath at first, but it’s gone. Dr. says it might have detoxed something. I am all for that. Better out than in. This drug has helped me a lot. And I am not pro-pharma.” – Gylm April 26, 2017
It is rare to experience withdrawal symptoms from gabapentin, but it does happen. A review of medical journals published between 1993, when gabapentin was approved, and 2015, found 18 case reports of gabapentin addiction, dependence, or withdrawal.
Doctors publish case reports when they encounter a patient with a rare disorder or with a condition that they want to make their colleagues aware of. Case reports are significant because they help further knowledge and identify subjects worthy of future research.
It’s worth noting that just because there are so few reports of gabapentin withdrawal, doesn’t necessarily mean it’s as rare as people once thought. It’s possible that many people simply don’t seek treatment for gabapentin withdrawal.
According to the Drug Enforcement Administration (DEA), gabapentin use is on the rise. Doctors wrote more than double the amount of gabapentin prescriptions in 2017 as they did in 2011.
The illicit use of gabapentin also appears to be increasing.
In a small survey of prescription drug abusers in Appalachian Kentucky, 15 percent reported using gabapentin to get high. That number is a 165 percent increase from the year prior and a 2,950 percent increase from 2008.
It appears as though gabapentin dependence and withdrawal are most common among people who use at least one other substance, such as opioids or alcohol. In the case reports, all patients had past drug or alcohol addiction issues.
Opioid users have reported using gabapentin to intensify their high. Cocaine users have reported the same, as well as attempts to use gabapentin to help alleviate cocaine withdrawal.
Signs and Symptoms
Among the documented cases, gabapentin withdrawal began between 12 hours and 7 days after the last dose.
The majority saw withdrawal symptoms within 24 to 48 hours.
Common Symptoms
The most common symptom was agitation, occurring in about half of the recorded cases. Confusion and disorientation were the next most common symptoms, followed by:
Sweating
Gastrointestinal symptoms
Tremors
Fast heart rate
High blood pressure
Insomnia
In many of the cases reported in the medical journals, individuals entered gabapentin withdrawal without the intention to do so.
This was typically a result of running out of gabapentin or leaving it at home during a trip out of town.
This sample of cases is unlikely to be reflective of most people’s experiences with gabapentin withdrawal. The reason for this is that only people with severe or alarming symptoms seek emergency medical treatment.
Among the cases reported, gabapentin withdrawal symptoms typically peaked three days after someone’s last dose. In almost all cases, doctors eventually treated the symptoms by resuming the previous gabapentin dose. Once people resumed their dose, their symptoms disappeared within hours.
Gabapentin oral capsule is used for short-term or long-term treatment.
The length of treatment depends on what condition it’s being used to treat. It comes with serious risks if you don’t take it as prescribed.
If you stop taking it suddenly or don’t take it at all:
For seizures: This can increase your risk of status epilepticus, which is a medical emergency. With this condition, short or long seizures occur for 30 minutes or more. If your doctor decides to reduce your dose or have you stop taking gabapentin, they will do this slowly. Your dose will be reduced or your treatment stopped over the course of at least one week.
For postherpetic neuralgia: Your symptoms won’t improve.
If you miss doses or don’t take it on schedule: Your medication may not work as well or may stop working completely. In order for this drug to work well, a certain amount needs to be in your body at all times.
If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:
double vision
slurred speech
tiredness
loose stools
If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.
What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember. If you remember just a few hours before the time for your next dose, then only take one dose. Never try to catch up by taking two capsules at once. This could result in dangerous side effects.
How to tell if the drug is working: You should have fewer seizures. Or you should have less nerve pain.
Gabapentin is an anticonvulsive medication which first discovered in the 1970s in Japan.
Its original use was as a muscle relaxer and anti-spasmodic medication, but later, it was discovered the potential of the medication as anticonvulsive medication and as an adjunct to stronger anticonvulsants.
Gabapentin
Gabapentin is an anticonvulsant medication that got FDA approval for partial seizure therapy in 1993. Currently, gabapentin has FDA approval for:
Postherpetic neuralgia
Adjunctive therapy in the treatment of partial seizures with or without secondary generalization in patients over the age of 12 years old with epilepsy, and the pediatric population, 3 to 12 year-olds with a partial seizure
Moderate to severe restless leg syndrome (RLS) moderate to severe
It also has off-label use for neuropathic pain, fibromyalgia, bipolar disorder, postmenopausal hot flashes, essential tremors, anxiety, resistant depressant and mood disorders, irritable bowel syndrome (IBS), alcohol withdrawal, postoperative analgesia, nausea and vomiting, migraine prophylaxis, headache, interstitial cystitis, painful diabetic neuropathy, social phobia, generalized tonic-clonic seizures, pruritus (itching), insomnia, post-traumatic stress disorder (PTSD), and refractory chronic cough.
In one placebo-controlled, retrospective study that investigated the effects of gabapentin on about 700 patients with refractory partial seizure disorder, there was an improvement in overall well-being in patients. The effect prompted a controlled investigation of the drug in primary psychiatric conditions.
An important benefit of gabapentin is that there is no interaction with valproate, lithium, and carbamazepine. Also, gabapentin has minor side effects.
Gabapentin in the Treatment of Anxiety and Depression
Gabapentin is rarely prescribed for patients with only anxiety disorder but is commonly prescribed for patients with bipolar disorder to reduce anxiety levels. Clinicians can also use it for patients who have anxiety and depression. Since anxiety is a coping skill, there is no drug to treat anxiety, but the medications used for this purpose make it possible to live at the moment, giving patients a chance to undergo anxiety treatment with non-pharmaceuticals. Even though the studies show that gabapentin is ineffective in the treatment of bipolar disorder, a case-control study with 60 patients in an acute phase of mania had a significant reduction in symptoms of anxiety with lithium and 900 mg of gabapentin. In another study with 21, mixed-state patients refractory to mood stabilizers received gabapentin (up to 2000 mg per day) for eight weeks, and patients with depressive symptoms had significant improvement in their CGI-BP (Clinical Global Impression-Bipolar) scores.
A meta-analysis of 7 trials pointed to gabapentin’s greater efficacy versus placebo in generalized anxiety disorder (GAD), although the effect size was approximately 0.35 for mental anxiety symptoms. A study of 153 patients who responded to the initial treatment of 450 mg per day for maintenance treatment of social anxiety disorder.
There are no clinical studies on the effectiveness of gabapentin as monotherapy or adjunctive therapy in major depressive disorders. However, there are case reviews that show some patients with depression who are refractory to standard antidepressants but showed therapeutic improvement when using gabapentin as adjunctive therapy.
In a randomized, double-blind study, with 130 patients that had under eye surgery, a one-time dose of 600 mg gabapentin significantly reduced the perioperative anxiety compared to a placebo. However, there was no significant difference compared to melatonin.
The chemical structure of gabapentin (Neurontin) is derived by addition of a cyclohexyl group to the backbone of gamma-aminobutyric acid (GABA). Gabapentin prevents seizures in a wide variety of models in animals, including generalized tonic-clonic and partial seizures.
The exact mechanism of action with the GABA receptors is unknown; however, researchers know that gabapentin freely passes the blood-brain barrier and acts on neurotransmitters.
Gabapentin has a cyclohexyl group to the structure of neurotransmitter GABA as a chemical structure. Even though it has a similar structure to GABA, it does not bind to GABA receptors and does not influence the synthesis or uptake of GABA.
Gabapentin works by showing a high affinity for binding sites throughout the brain correspondent to the presence of the voltage-gated calcium channels, especially alpha-2-delta-1, which seems to inhibit the release of excitatory neurotransmitters in the presynaptic area which participate in epileptogenesis.
Even though there is no evidence for direct action at the serotonin, dopamine, benzodiazepine, or histamine receptors, research has shown gabapentin to increase total-blood levels of serotonin in healthy control subjects.
The elimination half-life of gabapentin is 5 to 7 hours, and it takes two days for the body to eliminate gabapentin from its system.
One benefit of gabapentin use is its mild side-effect profile. The most common side effects are fatigue, dizziness, and headache.
Gabapentin has no activity at GABAA or GABAB receptors of GABA uptake carriers of brain. Gabapentin interacts with a high-affinity binding site in brain membranes, which has recently been identified as an auxiliary subunit of voltage-sensitive Ca2+ channels. However, the functional correlate of gabapentin binding is unclear and remains under study.
Gabapentin crosses several lipid membrane barriers via system L amino acid transporters. In vitro, gabapentin modulates the action of the GABA synthetic enzyme, glutamic acid decarboxylase (GAD) and the glutamate synthesizing enzyme, branched-chain amino acid transaminase.
Results with human and rat brain NMR spectroscopy indicate that gabapentin increases GABA synthesis. Gabapentin increases non-synaptic GABA responses from neuronal tissues in vitro. In vitro, gabapentin reduces the release of several mono-amine neurotransmitters.
Gabapentin prevents pain responses in several animal models of hyperalgesia and prevents neuronal death in vitro and in vivo with models of the neurodegenerative disease amyotrophic lateral sclerosis (ALS). Gabapentin is also active in models that detect anxiolytic activity.
Although gabapentin may have several different pharmacological actions, it appears that modulation of GABA synthesis and glutamate synthesis may be important.
Is Gabapentin Addictive ?
Asking about the signs someone is addicted to gabapentin first begs the question: What is gabapentin?
To answer that question requires putting gabapentin in perspective as a pharmaceutical drug that, while providing relief to thousands of people for nerve pain, also has the potential for abuse. It isn’t an opioid, but it has found a niche audience among those who take it recreationally, and for doctors who began to seek alternatives to narcotics as the opioid epidemic reached its apex, it seemed like a safer alternative.
In 2016, gabapentin was the 10th most prescribed drug in the United States, with 64 million prescriptions written that year . That was up from 39 million prescriptions written only four years earlier, in large part because “gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary,” according to a 2018 article in the journal Psychology of Addictive Behaviors.
In that particular article, researchers analyzed data from a study of drug users in Kentucky who reported using gabapentin for non-medical purposes. Their findings? “Overall, the sample reported having initiated gabapentin more than 10 years earlier after having it prescribed for a legitimate, though generally off-label, medical indication (e.g., pain, anxiety, opioid detoxification). Participants reported use of gabapentin in combination with buprenorphine, other opioids, cocaine, and caffeine to produce sought-after central nervous system effects (e.g., muscle relaxation, pain reduction, sleep induction, feeling drunk, and feeling ‘high’).”
Gabapentin, such studies reveal, can be problematic. Whether used in conjunction with other drugs or on its own, it can be abused, which makes it a substance of concern. To understand the signs someone is addicted to gabapentin, however, requires some knowledge of what it is, where it comes from, how it works and how it can be addictive.
Comparative Studies
Gabapentin and lamotrigine have been compared in an open, parallel-group, add-on, randomized study in 109 patients with uncontrolled partial epilepsy and learning disabilities. The two drugs were similarly efficacious, with similar incidences of adverse events and serious adverse events. Neither lamotrigine nor gabapentin exacerbated any of the challenging behaviors observed in these patients.
The most common adverse reaction to gabapentin was somnolence, which was mostly reported during the initial titration phase.
In a double-blind comparison of gabapentin and lamotrigine in 309 patients with new-onset partial or generalized seizures, the target doses were gabapentin 1800 mg/day and lamotrigine 150 mg/day.
Severe adverse events were reported in 11% of patients taking gabapentin and 9.3% of patients taking lamotrigine. Two patients had serious adverse events thought to be related to the study drug; one took an overdose of gabapentin and the other had convulsions with lamotrigine. The most frequent treatment-related adverse events in both treatment groups were dizziness, weakness, and headache; 11% of patients taking gabapentin and 15% of those taking lamotrigine withdrew because of adverse events. There was an increase of over 7% in body weight from baseline in 14% of the patients taking gabapentin and 6.6% of those taking lamotrigine. There were benign rashes in 4.4% of those taking gabapentin and 11% of those taking lamotrigine.
The hypothesis that both amitriptyline and gabapentin are more effective in relieving neuropathic pain than diphenhydramine has been tested in a randomized, double-blind, triple crossover, 8-week trial in 38 adults with spinal cord injuries [18]. Maximum daily doses were 2600 mg for gabapentin and 150 mg for amitriptyline.
Amitriptyline was more efficacious in relieving neuropathic pain than diphenhydramine. Withdrawal because of possible adverse reactions occurred five times during gabapentin treatment:
(1) shortness of breath;
(2) dizziness, fatigue, and nausea;
(3) increased spasticity and pain;
(4) fatigue, drowsiness, constipation, and dry mouth; and
(5) severe itching.
The four most frequent adverse events were dry mouth, drowsiness, fatigue, and constipation, which were all more common with amitriptyline.
Do not take NEURONTIN if you are allergic to gabapentin or any of the other ingredients in NEURONTIN. See the end of this Medication Guide for a complete list of ingredients in NEURONTIN.
Tell your doctor about all other medicines you use, especially:
hydrocodone (Lortab, Vicodin, Vicoprofen, and others);
morphine (Kadian, MS Contin, Oramorph, and others); or
naproxen (Naprosyn, Aleve, Anaprox, and others).
This list is not complete and other drugs may interact with gabapentin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.
Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Pain drugs
When used with gabapentin, certain pain drugs can increase its side effects, such as tiredness. Examples of these drugs include:
morphine
Stomach acid drugs
When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:
Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.
Gabapentin, also known by the brand name Neurontin, is a prescription painkiller belonging to its own drug class, Gabapentinoids. It is considered an anti-convulsant, and is most commonly used to treat epilepsy, restless leg syndrome, hot flashes, and neuropathic pain. It is often used as a less-addictive alternative to opioids; however, Gabapentin addiction and abuse still occur in many patients.
Gabapentin has a similar chemical structure to Gamma-aminobutyric acid (GABA), the brain chemical which affects the body’s nervous system. It can produce feelings of relaxation and calmness, which can help with nerve pain, anxiety, and even poor sleep.
Gabapentin is prescribed to treat nerve pain, alcohol and cocaine withdrawals, restless leg syndrome, diabetic neuropathy, fibromyalgia, and seizures. It works by altering one’s calcium channels to reduce seizures and ease nerve pain. Some brand names of Gabapentin are Neurontin and Gralise. The drug’s known street names are “gabbies” or “johnnies.”
Dosages of Gabapentin
Adult and pediatric dosages:
Capsule
100 mg
300 mg
400 mg
Tablet
300 mg (Gralise)
600 mg (Gralise, Neurontin)
800 mg (Neurontin)
Dosage Considerations – Should be Given as Follows:
Reducing the dose, discontinuing the drug, or substituting an alternative medication should be done gradually over a minimum of 1 week or longer.
Geritric dosing considerations:
Renal impairment is present, gabapentin dose reduction may be required, depending on renal function.
Partial Seizures
Neurontin
Adjunctive therapy for partial seizures with or without secondary generalization.
Initial: 300 mg orally every 8 hours.
May increase up to 600 mg orally every 8 hours; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated
Post herpetic Neuralgia
Neurontin
Day 1: 300 mg orally once per day.
Day 2: 300 mg orally every 12 hours.
Day 3: 300 mg orally every 8 hours.
Maintenance: Subsequently titrate as needed up to 600 mg orally every 8 hours; doses greater than 1800 mg/day have demonstrated no additional benefit.
Gralise
Dose gradually to 1800 mg/day orally; take once a day with evening meal.
Day 1: 300 mg orally once a day.
Day 2: 600 mg orally once a day.
Days 3-6: 900 mg orally once a day.
Days 7-10: 1200 mg orally once a day.
Days 11-14: 1500 mg orally once a day.
Day 15 and after (maintenance): 1800 mg orally once a day.
Dosing considerations:
Gralise tablets swell in gastric fluid and gradually release gabapentin. Swallow Gralise tablets whole; do not cut, crush, or chew them.
Creatinine clearance 30-60 mL/min: 200-700 mg every 12 hours
Creatinine clearance 15-29 mL/min: 200-700 mg once per day
Creatinine clearance less than 15 mL/min: 100-300 mg once per day
Hemodialysis (Creatinine clearance less than 15 mL/min):
Administer supplemental dose (range 125-350 mg) post hemodialysis, after each 4 hour dialysis interval; further dose reduction should be in proportion to Creatinine clearance (a Creatinine clearance of 7.5 mL/min should receive one-half daily post hemodialysis dose)
Renal impairment (Gralise):
Creatinine clearance is greater than or equal to 60 mL/min: 1800 mg daily with evening meal
Creatinine clearance 30-59 mL/min: 600-1800 mg daily with evening meal
Creatinine clearance greater than 30 mL/min or hemodialysis: Do not administer
In addition its potentially addictive nature, Gabapentin can cause suicidal thoughts, moods swings, and abrupt changes in a user’s behavior. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.
Gabapentin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
drowsiness
tiredness or weakness
dizziness
headache
uncontrollable shaking of a part of your body
double or blurred vision
unsteadiness
anxiety
memory problems
strange or unusual thoughts
unwanted eye movements
nausea
vomiting
heartburn
diarrhea
dry mouth
constipation
increased appetite
weight gain
swelling of the hands, feet, ankles, or lower legs
back or joint pain
fever
runny nose, sneezing, cough, sore throat, or flu-like symptoms
ear pain
red, itchy eyes (sometimes with swelling or discharge)
Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:
rash
itching
swelling of the face, throat, tongue, lips, or eyes
hoarseness
difficulty swallowing or breathing
seizures
difficulty breathing; bluish-tinged skin, lips, or fingernails; confusion; or extreme sleepiness
Gabapentin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Gabapentin Abuse
Gabapentin abuse tends to occur in people who already have an addiction to opioids or other drugs. The effects of Gabapentin intoxication have been described as a sense of calm, euphoria, and a high similar to marijuana.
A 2013 study in Kentucky found that of the 503 participants reporting illegal drug use, 15% reported using Gabapentin in addition to other drugs to get high in the previous six months. Another study, working with a sample of participants meant to represent the national population, found almost a quarter of patients with co-prescriptions of opioids and Gabapentin were getting more than three times their prescribed amount to supply their addiction. People using the drug without a prescription is a growing problem in many areas. Due to the drug’s legal status, this is difficult to address from a policing standpoint. States where Gabapentin abuse is becoming more common are beginning to classify the drug as a more strictly controlled substance.
Signs of a Gabapentin Overdose
Effects of excessive Gabapentin use include:
Drowsiness
Coordination problems
Tremors
Dizziness
Depression
Suicidal thoughts/behaviors
Changes in mood
Dizziness
Poor coordination
Forgetfulness
Anxiety
Difficulty speaking
Inability to feel pleasure
It is important to try to recognize these symptoms and to be wary of other red flags, such as the presence or abundance of pill bottles. These effects can be detrimental to one’s health, livelihood, and overall safety.
Many Gabapentin users in early recovery abuse Gabapentin because at high doses (800mg or more), they may experience a euphoric-like high that does not show up on drug screens. Gabapentin abusers typically take the drug in addition to opioids to produce their desired high, a dangerous and potentially deadly combination. It is possible to fatally overdose on Gabapentin, both on its own or in conjunction with other drugs. However, there is currently no antidote that can be administered to someone in the case of a Gabapentin overdose as there is with opioid overdoses. If you find a loved one showing signs of an overdose–drowsiness, muscle weakness, lethargy and drooping eyelids, diarrhea, and sedation—seek medical attention immediately.
Signs of Gabapentin Addiction
Lying about or exaggerating symptoms to doctors
Seeking out multiple doctors to get extra doses
Switching doctors after the original doctor refuses to continue prescribing the medication
Changes in social habits and/or circles
Changes in personal hygiene and grooming habits
Constant preoccupation with the drug
Unease at the thought of the drug being unavailable
Refusal to quit despite social, financial, or legal consequences
Failed attempts to quit
Treating a Gabapentin Addiction
Frequent and excessive use of Gabapentin can lead to a physical and psychological dependence on the drug. This is when someone becomes so accustomed to taking a drug that they need it to feel and function normally. Quitting a drug like Gabapentin cold turkey can be dangerous and induce several withdrawal symptoms of varying severity.
These include anxiety, insomnia, nausea, pain, and sweating. Quitting also increases one’s likelihood of having a seizure which can lead to personal injury or the development of medical problems and life-threatening emergencies. Trying to quit should be done at a rehab facility or with the guidance and supervision of a professional during a medical detox.
Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.
Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).
Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).
Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.
Talk to your doctor if you have been asked to switch to a different brand and are worried about that.
If your epilepsy has been hard to control in the past and the brand you’re now taking is working well for you, your doctor may recommend you stay on the same one.
Gabapentin is a prescription medication that may help you sleep. That may be why it has been prescribed for people with insomnia, even though it is not approved for that use.
Gabapentin is available on prescription. It comes as tablets, capsules and a liquid that you swallow.
Key facts
You’ll usually take gabapentin 3 times a day. You can take it with or without food.
Most people who take gabapentin do not get any side effects. But some people may feel sleepy, tired and dizzy. Common side effects are usually mild and go away by themselves.
It takes at least a few weeks for gabapentin to work.
Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.
Some people can become addicted to gabapentin after taking it for a long time. When stopping gabapentin you’ll need to reduce your dose gradually to avoid withdrawal symptoms.
If you have epilepsy, you are entitled to free prescriptions for all the medicines you take, not just your epilepsy ones. You can get an application form from your doctor’s surgery.
However, gabapentin enacarbil (Horizant) has been approved by the Food and Drug Administration (FDA) to treat a sleep disorder called restless legs syndrome (RLS).
One of the most common side effects of gabapentin is drowsiness.
In people taking gabapentin for its approved conditions (certain epileptic seizures and postherpetic neuralgia), 19% of patients older than 12 years of age with epilepsy and 21% of patients with postherpetic neuralgia reported drowsiness as a side effect.
Gabapentin and sleep
Most studies show that gabapentin improves slow wave sleep (“deep sleep”) and total sleep time.
Two small studies showed that gabapentin may help people with primary insomnia and occasional sleep disturbance improve total sleep time and wakefulness in the morning.
In other studies, it appears that gabapentin may improve sleep in people with other medical conditions that make it more difficult to sleep, such as alcohol dependence, hot flashes and bipolar disorder.
In a large review of 26 studies on gabapentin and sleep in patients with other medical conditions, the average dose taken daily was about 1,800 mg. Although positive sleep outcomes were reported, the researchers noted that gabapentin was not tolerated as well as placebo and some patients stopped taking it. Misuse and abuse of the drug has also been reported.
It takes about 2 to 3 hours for immediate-release gabapentin to reach its fullest effect, and it’s typically taken 3 times per day.
RLS treatment
Gabapentin may also be used to treat RLS, a disorder that makes it hard to fall asleep or stay asleep. RLS causes an uncontrollable and uncomfortable urge to move your legs, which is worse at night.
The FDA has approved gabapentin enacarbil (Horizant) — a long-acting gabapentin — as a treatment for RLS.
Side effects of gabapentin
The most common side effects with gabapentin include:
Clumsiness
Viral infection
Drowsiness
Nausea and vomiting
Speaking difficulties
Tremor
Swelling, usually involving the legs and feet
Fatigue
Fever
Movements that are jerky
Coordination difficulties
Double vision
Unusual eye movement
Serious reactions can include:
Difficulty breathing
Allergic reactions with swelling of the throat or face
Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain, but exactly how it does this is not fully understood. Gabapentin is also used to treat certain types of long-lasting pain caused by damage to nerves.
Gabapentin belongs to a group of medicines known as anti-epileptic medicines, although it is prescribed for the treatment of several different conditions. You may have been prescribed it for the treatment of partial seizures, which are a type of epilepsy. A seizure is a short episode of symptoms which is caused by a burst of abnormal electrical activity in the brain. With a partial seizure, the burst of electrical activity stays in one part of the brain. Therefore, you tend to have localised or ‘focal’ symptoms. Gabapentin is used to control the symptoms of seizures and works by reducing the abnormal electrical activity in the brain. Exactly how it does this is not fully understood.
Gabapentin is also prescribed to treat certain types of long-lasting pain caused by damage to nerves. This type of pain, called neuropathic pain, can be caused by a number of different diseases. These include diabetes (where it is called diabetic neuropathy) and shingles (where it is called postherpetic neuralgia).
Although gabapentin is only licensed for use in epilepsy and neuropathic pain, it is also prescribed to help to prevent attacks of migraine. If you have been given it for this reason then you should speak with your doctor if you have any questions about your treatment.
Before taking gabapentin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking gabapentin it is important that your doctor knows:
If you are pregnant, trying for a baby or breast-feeding.
If you have any problems with the way your kidneys work.
If you have diabetes.
If you have ever had a mental health problem known as psychosis.
If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
If you have ever had an allergic reaction to a medicine.
Gabapentin Mechanism of action
The mechanism of the anticonvulsant action of gabapentin has not been fully described. Several possible mechanisms for pain improvement have been discussed. Though similar in structure to the endogenous neurotransmitter GABA, gabapentin has not been shown to bind to GABA receptors at concentrations at or below 1 mM. Gabapentin modulates the action of glutamate decarboxylase (GAD) and branched chain aminotransferase (BCAT), two enzymes involved in GABA biosynthesis. In human and rat studies, gabapentin was found to increase GABA biosynthesis, and to increase non-synaptic GABA neurotransmission in vitro.
Gabapentin has been shown to bind to the α2δ-1 subunit of voltage gated calcium ion channels, which contributes to its pain attenuation effects in diabetic neuropathy and post-herpetic neuralgia. Other neurophysiological findings indicate that gabapentin also interacts with NMDA receptors, protein kinase C, and inflammatory cytokines
What is gabapentin mostly used for?
Gabapentin is an antiepileptic or anticonvulsant treatment originally designed to prevent seizures, but which is now also used to manage certain types of pain and in a variety of other uses.
The medication is also used in veterinary medicine. Note that tablets, capsules or oral solutions designed for human consumption often contain sweeteners which may be poisonous to some species; be sure to buy Gabapentin in veterinary formulations for use in animals.
The medication comes in capsules, which may be opened and mixed into a beverage or soft foods that do not require chewing, though it is difficult to mask its bitter taste.
Preventing Seizures
Gabapentin is most commonly prescribed to prevent certain types of seizures:
Focal seizures
Mixed Seizures
Generalized Seizures
As a preventive treatment, Gabapentin may be used in children as young as 3, but is most often prescribed to people 12 years old and up.
The medication is typically taken 3 times per day, and treatment is usually long-term. Patients are usually started on smaller doses which are then increased if needed. The average dose for adults is 900 to 1800 mg per day.
Daily doses are usually divided into 3 smaller doses, taken morning, afternoon, and at bedtime. Doses should be taken at least 4 hours apart, but not more than 12 hours apart.
It may take several weeks for the medication to become noticeably effective. When working, seizures should occur with significantly less frequency or be eliminated entirely. It does not work on all seizures and is not effective for all patients; if effects are not significant after several weeks of use, speak with doctor about alternative options rather than continuing to buy Gabapentin.
Ending treatment abruptly may cause an increase in seizures; speak with a doctor about tapering off the medication.
Pain Relief
Patients planning to buy Gabapentin for pain relief should understand that it only works on very specific types of pain; namely neuropathic pain, or pain caused by damage to the somatosensory system, including:
Postherpetic neuralgia
Central neuropathic pain
Diabetic neuropathy
Fibromyalgia
Spinal injuries
Cancer
When given for pain, treatment may last just a few days for flare-ups or weeks or months in cases of chronic pain. Dosage rarely exceeds 1800 mg a day; greater amounts may be taken, but rarely produce additional relief.
Some individuals notice effects within the first day or two of treatment, but it may take several weeks to provide consistent pain relief in chronic conditions.
While some patients find Gabapentin tremendously helpful, others find it has little effect, even when treating the same condition. Speak with a doctor about other options if it is not providing significant relief.
Other Uses
Gabapentin is used in a wide range of other conditions, though it is not always the most effective option for certain ailments:
Menopausal symptoms
Uremic pruritus in liver failure
Restless leg syndrome
Insomnia
Anxiety disorders
Migraines
Many of this product’s off-label uses are somewhat controversial, as some claim there is no evidence the medication provides any benefit in some of the above conditions, while others claim it produces good results for some individuals.
In other cases the medication is recognized as being effective, but is not typically the preferred treatment; in these situations Gabapentin may be given when first-line treatments are ill-advised for some reason.
Patients are not advised to buy Gabapentin for off-label use without doctor collaboration, particularly if there are any preexisting major medical conditions.
Gabapentin Can be used for a lot of Nerve Pain related health conditions including Cough, Hot Flashes, Alcohol Withdrawal, Anxiety 161 reviews, Bipolar Disorder, Trigeminal Neuralgia, Postherpetic Neuralgia, Migraine, Insomnia， Occipital Neuralgia， Peripheral Neuropathy，Vulvodynia, Benign Essential Tremor, Epilepsy, Fibromyalgia, Pain Relief, Diabetic Peripheral Neuropathy , Neuropathic Pain，Reflex Sympathetic Dystrophy Syndrome，Periodic Limb Movement Disorder， Spondylolisthesis， Burning Mouth Syndrome，Pudendal Neuralgia， Small Fiber Neuropathy.
What is Gabapentin Off label Usage
Use only the brand and form of gabapentin that your doctor has prescribed. Check your medicine each time you get a refill at the pharmacy, to make sure you have received the correct form of this medication. Do not stop taking Gabapentin unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week. If you stop taking gabapentin suddenly or before your doctor tells you, there is an increased risk of seizures.
How to take gabapentin
Before starting this treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about gabapentin and will provide you with a full list of the side-effects which you may experience from taking it.
Take gabapentin exactly as your doctor tells you to. There are several different strengths of gabapentin tablets and capsules available, and you could be prescribed more than one strength.
You will be advised to take a low dose when you first start taking gabapentin, and then to increase the dose over a few days. This is to allow your body to get used to it. Most people take three doses a day once they are on a regular maintenance dose. Your doctor will explain all this to you, and the dosing directions will be printed on the label of the pack. If you are still unsure about how to take your doses, ask your pharmacist to advise you.
You can take gabapentin before or after food. Swallow the tablets/capsules with a drink of water. If you have been supplied with oral liquid medicine, see the instructions below for using the oral dosing syringe.
Once you are taking a regular amount of gabapentin, try to take your doses at the same times each day. This will help you avoid missing doses.
If you do forget to take a dose, take one as soon as you remember. Try to take the correct number of doses each day, but do not take two doses at the same time.
If you need to take an antacid or indigestion remedy, do not take it during the two hours before or the two hours after you take gabapentin. This is because antacids reduce the amount of gabapentin that your body absorbs.
Instructions for using the dosing syringe with Gabapentin Rosemont Oral Solution
Remove the bottle cap, and push the syringe adaptor into the top of the open bottle.
Insert the syringe into the adapter.
Turn the bottle (with the syringe connected to it) upside down.
Gently pull out the plunger of the syringe so that the solution fills the syringe to the mark which corresponds to your dose.
Turn the bottle the correct way up again, and remove the syringe from the bottle.
Put the tip of the syringe into your mouth, and gently push the plunger so that the liquid is released into your mouth.
Replace the bottle cap. Wash the syringe with water after each use.
Getting the most from your treatment
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this. If you are a woman and want to have a family, make sure that you discuss this with your doctor before you become pregnant. This is so that you can be given advice about your treatment from a specialist.
People with epilepsy must stop driving. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
A small number of people have developed mood changes or thoughts about suicide whilst being treated with anti-epileptics. If this happens to you, you must tell your doctor about it straightaway.
If you buy any medicines, always check with a pharmacist that they are suitable to take with your other medicines.
You must take gabapentin regularly every day. Stopping treatment suddenly can cause problems. If it becomes necessary for the treatment to stop, your doctor will want you to reduce your dose over a few days.
Can gabapentin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with gabapentin. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common gabapentin side-effects
What can I do if I experience this?
Feeling sleepy, tired, unsteady or dizzy; blurred vision and other eyesight problems
Do not drive or use tools or machines
Headache
Ask your pharmacist to recommend a suitable painkiller
Feeling or being sick, indigestion, stomach ache
Stick to simple foods – avoid rich or spicy meals
Diarrhoea
Drink plenty of water to replace the lost fluids
Constipation
Try to eat a well-balanced diet and drink several glasses of water each day
Dry mouth
Try chewing sugar-free gum or sucking sugar-free sweets
Infections, flu-like symptoms, increased appetite, flushing,
increased blood pressure, changes in weight, changes in emotions or mood, fits, movement difficulties, feeling shaky, difficulties sleeping, breathing difficulties, cough, gum changes, bruises, muscle or joint pains, impotence, and swollen feet or ankles
If any of these become troublesome, speak with your doctor for advice
Important: gabapentin has been associated with a number of unwanted effects which affect the blood, pancreas and liver. Although these occur less commonly than the side-effects listed above, you must let your doctor know straightaway if you notice any of the following as they could be serious:
Persistent stomach pain with sickness (these could be symptoms of an inflamed pancreas).
A skin rash, or any swelling of your mouth or face (these could be symptoms of an allergic reaction).
Any yellowing of your skin or of the whites of your eyes (these could be symptoms of jaundice).
Any unusual bruising or bleeding (these could be symptoms of a blood disorder).
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to Store gabapentin
Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Once a bottle of Gabapentin Rosemont Oral Solution has been opened it will keep for one month. Do not use it after this time, and make sure you have a fresh supply.
Gabapentin Side Effects
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
increased seizures;
severe weakness or tiredness;
upper stomach pain;
chest pain, new or worsening cough with fever, trouble breathing;
severe tingling or numbness;
rapid back and forth movement of your eyes;
kidney problems–little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or
severe skin reaction–fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Gabapentin is an Addiction Treatment Medication
Gabapentin is used to treat cases of addiction in an off-label manner. Different companies, including Parke-Davis, Greenstone, and Teva, manufacture several varieties of the generic drug. Other drugs that have been used to treat the symptoms of addiction withdrawal, for specific substances, include:
Clondine
Other anticonvulsants, such as Tegretol and Depakote
Methadone and buprenorphine
Naltrexone
Typical Application
Available in capsules, tablets, and as an oral liquid, dosages range from 100 mg to 800 mg. The frequency with which a dose is repeated depends on the specific dose, which is usually based on the severity of withdrawal and the client’s weight. The drug’s half-life is around 5-7 hours.
Generally, it is used during medical detox and throughout subsequent treatment modalities to support relapse prevention while clients adjust to their new sober lifestyles.
Treating Substance Abuse
According to Medscape, gabapentin can inflict users with suicidal thoughts and abrupt changes in behavior. For this reason, it should only be used under medical supervision. It can also cause elevated blood pressure, fever, sleep problems, appetite changes, and chest pain.
While it has been used to treat addictions to other substances, gabapentin is most often used to treat alcoholism — an addiction some 16.6 million adults suffered from in 2013, per the National Institute on Alcohol Abuse and Alcoholism.
During withdrawal from alcohol abuse or dependency, clients may experience anxiety, tremors, agitation, and irritability. In order to understand how gabapentin works, there must be a basic understanding of how the brain works first. Nervous system activity is partially controlled by GABA neurotransmitters. Gabapentin works by reducing activity among GABA. As a result, signals for pain, agitation, and anxiety are reduced, too.
An American Journal of Psychiatry study showed impressive results during the 16-week treatment of 150 people who were dependent on alcohol, noting better results among those who were treated with both gabapentin and naltrexone than the latter alone. TheJournal of Clinical Psychiatry reported on another study in which individuals treated for alcoholism with gabapentin showed a significant reduction in how much they drank and a greater rate of abstinence than those in the placebo group.
Gabapentin has the same calming effect on individuals who are detoxing from marijuana and benzodiazepines. Despite claims from fans of the plant-based drug, marijuana is indeed addictive. In 2012, 305,560 people checked into rehab citing cannabis as their primary drug of abuse, per the Substance Abuse and Mental Health Services Administration. One Neuropsychopharmacology study that analyzed the use of gabapentin in the treatment of marijuana addiction and withdrawal noted individuals in the gabapentin treatment group used less marijuana, had fewer withdrawal symptoms, and experienced improvements in cognitive functioning, compared to the placebo group.
Gabapentin is also used to treat Alcohol Withdrawal
I am still on gabapentin. Dose is 600mg three times a day – total 1800mg in a 24 hour period. I had not had a drink “craving” since August 11, 2014 when I quit. (I did this within one week of starting gabapentin). I did have a glass of wine at Christmas, one beer on my birthday, and one glass of wine at Easter. That’s it. I use to have 10 beers a day, and three glasses of wine or gin for bad panic attacks and generalized anxiety. So for me (not everyone) I can have that occasional drink with friends, at party or any social event – then come home and not touch the stuff and WITHOUT ANY CRAVINGS AT ALL – as I had during my 40-year binge. Still, this drug is amazing. AA never worked for me.
“I went on gabapentin for alcoholism that troubled me for 10 years when nothing including Alcoholics Anonymous barely worked. I read anecdotal information that it helped with alcoholism, went on 600mg twice daily and it was the first thing that helped me. Now I take 1200mg twice daily and find it works great! Afterwards I read a study in the Journal of American Medicine, Gabapentin in Alcohol Dependance, 2014 that confirmed it works well in many people for cravings and binge drinking. This medicine should be further studied to confirm it works well. On this site it is obvious it helps a lot of people struggling with alcoholism which I have, along with Bipolar Disorder. I call Gabapentin my” happy pills” that also takes away my anxiety
I’ve detoxed several times. The last one was really bad. This time My Dr. put me gabapentin 300 mg. 3 times a day and Lithium. I usually suffer withdrawals for 5-7 days. I did have anxiety for two days, but I’m on day 3, no anxiety and no cravings
Important information about all medicines
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty, so the doctor knows what has been taken.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
