According to IQVIA National Prescription Audit, total prescriptions dispensed for gabapentin were approximately 68.3 million in 2019, 69.0 million in 2020, and 70.9 million in 2021. In 2019, the FDA issued a warning that details the risk of respiratory depression (breathing difficulties), especially when taken with central nervous system (CNS) depressants such as antidepressants, opioids, and benzodiazepines.
As we see an increase in gabapentin prescriptions, there are growing concerns about its potential for abuse and addiction. While it is not classified as a controlled substance by the DEA, many individuals in addiction recovery may wonder if they should be worried about using gabapentin.
What Is Gabapentin?
First approved by the Food and Drug Administration (FDA) in 1993, gabapentin initially served as a treatment for partial seizures. By 2002, it received approval for managing a painful complication of the shingles virus known as post-herpetic neuralgia.
Gabapentin is seen as a relatively safe alternative medication when compared to other controlled substances. For this reason, off-label use has increased over the years. Instead of prescribing opioids for pain or benzodiazepines for sleep and anxiety, doctors began prescribing gabapentin. As a result, a study in 2018 found 1 in 5 chronic pain patients were prescribed gabapentinoids.
How Does Gabapentin Work?
Gabapentin works by binding to specific receptors in the brain and nervous system, which helps to decrease pain. It also interacts with neurotransmitters, such as GABA (gamma-aminobutyric acid), which can calm nerve activity, relieve anxiety, and aid in sleep regulation.
What Does Gabapentin Treat?
Gabapentin has been found effective in treating several conditions, including seizures, nerve pain from shingles or diabetes, and restless leg syndrome.
Commonly known by the brand name Neurontin, gabapentin is a medication primarily prescribed to people who suffer from epilepsy. Other conditions are that gabapentin is approved to treat partial seizures, post-herpetic neuralgia, and restless leg syndrome (in its extended release formula Horizant). Other brand names for gabapentin include Gralise and Horizant.
Due to its calming effects, it has also been prescribed off-label for other conditions such as anxiety, bipolar disorder, and migraines.
Gabapentin is available in a few forms, including: capsule, tablet, solution, or suspension. All forms of gabapentin require a doctor’s prescription.
Common Gabapentin Side Effects
When taking prescription medication like gabapentin, it is important to follow your prescribed dosage and not exceed the recommended amount. Taking more than the recommended dose of gabapentin can increase the risk of side effects and potentially lead to serious health complications or an overdose.
Not everyone will experience side effects of gabapentin. Each person’s body chemistry is different and some individuals may have a higher tolerance for gabapentin than others. However, it is still crucial to monitor your own health and well-being while taking this medication.
Common gabapentin side effects include:
- Sleepiness
- Drowsiness
- Dizziness
- Confusion
- Weakness
- Nausea
- Vomiting
- Diarrhea
- Blurry vision
- Headaches
- Memory issues
- Poor coordination
- Impaired cognition
- Slower reaction time
- Mood changes
- Anxiety
- Depression
- Weight gain
- Swollen arms and legs
- Higher rate of infections
For those currently taking other medications, it’s important to discuss this with your doctor before starting treatment to prevent any negative interactions with gabapentin.
If you or a loved one experiences any of these side effects, you should consult with your doctor immediately. It is also important to check in with your healthcare provider on a regular basis while taking gabapentin and report any changes in mood, behavior, or physical symptoms.
Serious Side Effects of Gabapentin
For those who are currently taking other medications, it’s important to discuss this with your doctor before starting treatment to prevent any negative interactions with gabapentin. Additionally, individuals with a history of substance abuse or mental health disorders may be at higher risk for experiencing serious side effects from gabapentin.
Serious side effects of gabapentin may include:
- Suicidal thoughts
- Aggressive behavior
- Hallucinations
- High body temperature
- Swollen glands
- Unexpected bruises or bleeding
- New rash
- Severe weakness of fatigue
- Muscle pain or weakness
- Respiratory depression
- Seizures
Signs of an inflamed pancreas due to gabapentin include:
- Long-lasting stomach pain
- Feeling sick or being sick
Warning signs of kidney failure due to gabapentin include:
- Yellow skin or eyes
- Muscle pain or weakness
Potential signs of serious skin reactions due to gabapentin include:
- Red or purple rash that turns into blisters or peeling of the skin
- Red rash with swelling of the face, lips or lymph nodes in the neck or armpits
- Fevers or flu-like symptoms
If you experience any of these dangerous side effects while taking gabapentin, it’s important to seek medical attention immediately.
WARNING: Use caution when taking gabapentin, especially when combined with other CNS depressants such as antidepressants, opioids, or benzodiazepines. These combinations can increase the risk of respiratory depression, sedation, and death.
Other Precautions and Warnings
In addition to the potential side effects mentioned above, there are other precautions and warnings associated with taking gabapentin. These include:
- Allergies: If you have a known allergy to gabapentin or any other medications, let your doctor know before starting treatment.
- Pregnancy and breastfeeding: Gabapentin may cause harm to an unborn baby, so it’s important to discuss the risks and benefits with your doctor if you are pregnant or planning to become pregnant. It is also not recommended to breastfeed while taking gabapentin.
- Kidney problems: Gabapentin is primarily excreted through the kidneys, so those with kidney problems may need a lower dose or closer monitoring while taking this medication.
- Mood changes: Some individuals may experience mood changes such as depression, anxiety, agitation, or irritability while taking gabapentin. If these symptoms occur, speak with your doctor right away.
- Driving and operating machinery: Gabapentin can cause drowsiness and dizziness, which can impair your ability to drive or operate machinery safely. Avoid these activities until you know how gabapentin affects you.
- Alcohol and other medications: It is important to discuss any current medications or alcohol use with your doctor before starting gabapentin. Mixing these substances can increase the risk of side effects or adverse reactions.
- Withdrawal: Suddenly stopping gabapentin can cause withdrawal symptoms such as anxiety, insomnia, nausea, and sweating. If you need to stop taking this medication, your doctor will gradually reduce your dose to avoid these symptoms.
In addition to discussing potential side effects and precautions while taking gabapentin, it is also important to understand the benefits of this medication.
Can You Drink Alcohol While Taking Gabapentin?
Drinking alcohol while taking gabapentin is generally not advised. This is because alcohol can exacerbate the central nervous system side effects of gabapentin, such as dizziness, drowsiness, and difficulty concentrating. Some individuals may also experience impairment in thinking and judgment.
Therefore, combining gabapentin with alcohol can increase the risk of these side effects and potentially lead to dangerous situations. For this reason, it’s important to discuss your alcohol consumption habits with your doctor when being prescribed gabapentin to ensure your safety and the effectiveness of the medication.
Is Gabapentin Bad For You?
The belief that gabapentin is a safe and non-addictive medication has led to a lack of caution when prescribing it. However, gabapentin use can cause life-threatening side effects. To make matters worse, the manufacturer of Neurontin, Pfizer, pleaded guilty and agreed to pay over $400 million dollars in fines to resolve criminal and civil charges for illegally paying doctors to prescribe their drug for off-label use.
On top of this, the drug also poses a potential risk for misuse and abuse. As a result, several states have taken it upon themselves to list gabapentin as a Schedule V controlled substance, including:
- Kentucky
- Tennessee
- West Virginia
Some states have also included gabapentin in their prescription drug monitoring programs (PDMPs) including:
- Kansas
- Massachusetts
- Minnesota
- Nebraska
- New Jersey
- North Dakota
- Ohio
- Virginia
- Wyoming
These actions highlight the potential dangers associated with off-label use of gabapentin. For this reason, it is important for healthcare professionals to carefully consider the risks and benefits before prescribing this medication and to follow all laws and regulations in doing so.
What If I Am Prescribed Gabapentin for a Legitimate Condition?
If you have been prescribed gabapentin by a doctor that you trust, and the medication is helping a legitimate condition, it is crucial that patients follow the right dosage guidelines and always keep their doctor updated.
The choice to take a medication should be made by you and your doctor, we encourage you to gather all of the information you can about the medication prior to accepting a prescription for that medication.
Is Gabapentin Addictive?
If you’re wondering “can you get addicted to gabapentin,” the answer may surprise you. While gabapentin can be an effective treatment for certain medical conditions, the medication does have the potential to be addictive. This is because gabapentin affects the brain’s reward center, similar to other substances that can lead to dependence and addiction. In fact, some individuals may experience a sense of euphoria when taking higher doses of gabapentin, which can contribute to its potential for abuse.
Additionally, individuals who have a history of substance abuse or addiction may be more vulnerable to developing an addiction to gabapentin. They may turn to the medication as a way to cope with cravings or withdrawal symptoms from other substances. This is why it is crucial for healthcare providers to carefully assess each patient’s medical history before prescribing gabapentin.
Withdrawal symptoms from gabapentin can also occur if the medication is stopped abruptly without
Why Do People Abuse Gabapentin?
Due to the increase in off-label prescriptions, there has been an increase in the number of people using gabapentin recreationally, often mixing it with other substances such as opioids. In fact, studies have shown that combining gabapentin with opioids can enhance their effects, leading to increased feelings of euphoria.
Additionally, individuals who have a history of substance abuse or addiction may be more vulnerable to developing an addiction to gabapentin. They may turn to the medication as a way to cope with cravings or withdrawal symptoms from other substances. This is because gabapentin can produce similar sensations as some drugs, such as calming nerves and reducing anxiety. For this reason, it is crucial for healthcare providers to carefully assess each patient’s medical history before prescribing gabapentin.
Risks of Gabapentin Abuse
While gabapentin can be an effective treatment for certain medical conditions, its risk for recreational use and misuse pose serious dangers. For this reason, it is important for individuals to understand the potential risks of gabapentin abuse, as well as the importance of using it only as prescribed by a medical professional.
The misuse and abuse of gabapentin can lead to various negative consequences, including:
- Dependence
- Addiction
- Withdrawal symptoms upon cessation
- Overdose
These risks highlight the need for healthcare providers to carefully monitor patients who are prescribed gabapentin, especially those with a history of substance abuse. This can help prevent misuse and abuse of the medication, and ensure that any potential interactions with other substances are identified and addressed.
Can You Just Stop Taking Gabapentin?
If you are taking gabapentin for epilepsy or any other condition, you should never stop taking it suddenly. Discontinuing your use of gabapentin, especially if you take the medication for seizures, can result in rebound seizures or more frequent seizures.
If you stop taking gabapentin suddenly for your epilepsy, it could cause a condition called status epilepticus. Status epilepticus is a condition in which you experience continuous and uncontrollable seizures. Suddenly stopping the use of gabapentin can also lead to withdrawal symptoms. To avoid these negative effects, it is important to consult with your doctor before discontinuing gabapentin.
Gabapentin Withdrawal Symptoms
Stopping gabapentin suddenly can cause withdrawal symptoms. If you wish to stop taking gabapentin, it is important to do so under the supervision of a healthcare professional.
In general, gabapentin withdrawal symptoms begin 12 hours after your last dose, and can last up to ten days after the last dose. Gabapentin withdrawal side effects can be more severe if a person abuses other substances alongside the medication.
Common withdrawal symptoms for gabapentin include:
- Anxiety
- Insomnia
- Nausea
- Vomiting
- Sweating
- Restlessness
- Fatigue
- Dizziness
- Headaches
- Agitation
- Irritability
- Sensitivity to light
- Irregular heartbeat
- Pain
- Seizures
Factors that affect the withdrawal process from gabapentin include: age, dosage, frequency of use, length of time substance was taken, medical history (including mental health problems), and other substances abused concurrently.
Drug withdrawal symptoms are not only reserved for those who abuse gabapentin, they also apply to anyone who has been taking the medication as prescribed for a long period of time, or has been taking a large dose for about three weeks or longer.
How to Stop Taking Gabapentin
If you are trying to come off of gabapentin, you will need to work with a medical professional to safely and effectively stop the medication. To stop taking gabapentin, you will receive an individualized treatment plan where you slowly taper down your dosage until you reach a level where you can safely stop taking the drug.
Royal Life Centers has medical detox facilities specifically to help you rid your body of substances safely, effectively, and comfortably. An experienced gabapentin detox program like ours will focus on treating your withdrawal symptoms, stabilization, and beginning the therapeutic work of recovery.
Is Gabapentin Prescribed in Addiction Treatment?
Addiction treatment centers may prescribe gabapentin to guests during their stay at a medical detox facility. To reduce the risk of life-threatening withdrawal symptoms such as seizures, medically-assisted detoxification plans often offer gabapentin to guests detoxing off of benzodiazepines or alcohol.
Gabapentin can also prove useful for opioid dependency in medical detox settings, as the medication can treat nerve pain and restless legs— two main physical symptoms of opioid withdrawal.
Can I Take Gabapentin if I’m in Addiction Recovery?
If gabapentin is a necessary medication for you, and is being used to treat a condition properly and effectively, that decision is between you and your doctor. No one except yourself and medical professionals can decide whether or not you should take gabapentin.
If you are taking gabapentin in a medical detox program to prevent withdrawal-induced seizures, rest assured that you are in good hands. The doctors and nurses overseeing your treatment will monitor your dosage carefully to prevent any potential for abuse or dependence. They may also provide alternative medications or therapies to help manage your symptoms without the need for gabapentin.
Get Help For Gabapentin Addiction
Royal Life Centers at Chapter 5 offers comprehensive substance abuse treatment at our Prescott, Arizona rehab facility. Whether you are in need of detox, residential treatment, or ongoing care in outpatient rehab, Royal Life Centers can set you up for success in recovery.
If you or someone you know is struggling with an addiction or substance abuse, please reach out to us at 888-568-5760. Our team of addiction specialists make themselves available to take your call 24 hours a day, 7 days a week. Because We Care.
References:
- Before You Prescribe Gabapentin, Consider These Risks | Psychiatric News
- Gabapentin: Common, Long-Term, and Rare Side Effects | Medical News Today
- Pfizer to Pay $430 Million Over Promoting Drug to Doctors | The New York Times
- Association of State-Imposed Restrictions on Gabapentin with Changes in Prescribing in Medicare – PMC
