Long-Term Effects of Gabapentin
The prescription drug gabapentin – widely known by the brand name Neurontin – is a medication used to help manage partial seizures in people who suffer from epilepsy and to treat pain in people with postherpetic neuralgia and some other forms of neuropathic pain. However, like many medications, gabapentin does have some negative side-effects, some of which may be experienced after just one use, and some of which may arise as a result of long-term use. These effects can range from mild discomfort to severe physical symptoms that can pose a threat to the individual’s long-term health and safety.1
When taking gabapentin, it’s important to understand these potential effects and risks. It’s also important to understand that, as is the case with any drug, misusing it may cause you to experience a greater number of symptoms or experience them with greater severity. While gabapentin is not a controlled substance or considered a drug with a high potential for abuse, there have been reports of people abusing it to experience a more intense high from opioids such as methadone.2
Gabapentin has uses beyond its primary indication for the management of certain types of seizures. The U.S. Food and Drug Administration has also approved to manage the pain of postherpetic neuralgia (the pain that occurs after a case of shingles).
Gabapentin is sometimes prescribed for several off-label uses, including the management of:3
- Diabetic neuropathy.
- Neuropathic pain after a spinal cord injury.
- Restless leg syndrome.
Like many medications, people who take gabapentin have reported a variety of side effects from the drug. Some of the more common side effects include:4
- Weakness or lack of energy.
- Impaired coordination.
- General feeling of unease.
- Feeling of unsteadiness.
- Abnormal eye movements (nystagmus).
- Gastrointestinal upset.
Incoordination and unsteadiness may be more of a concern for elderly patients who are more likely to incur serious injuries upon falling.5
This does not encompass the full list of potential side effects, only the more common and relatively less severe ones. More significant side effects are possible and may be more likely to arise in certain populations, including those who misuse the drug in any way.
Severe Side Effects
More serious side effects are possible when taking gabapentin and may include:1,4
- Abdominal pain.
- Blurred vision.
- Weight gain.
- Blood pressure changes.
- Peripheral edema.
- Temporary amnesia
Those with a history of kidney disease may be subject to gabapentin toxicity, since this drug is substantially excreted through the kidneys.
Children between the ages of 3 and 12 may be prone to mood changes, onset of aggressive behavior, impaired concentration, hyperactive behavior, and changes in academic performance when taking gabapentin.7
Suicidal ideation is a rare but extremely serious side effects of gabapentin. You should seek help immediately if:4
- You have new or worsened depression or anxiety.
- You are suffering from panic attacks.
- You are having manic episodes.
- You are having intrusive thoughts about dying or suicide.
- You experience any other unusual changes in your mood or behavior.
The Likelihood of Experiencing Side Effects
There are certainly some ways to predict who will experience certain side effects; however, it is impossible to know with 100% certainty what side effects you’ll experience, especially if you are not using the substance as intended. The list of side effects you’re likely to experience may be much longer if you are taking it in higher doses than prescribed, without a prescription, or in combination with other drugs of abuse. For example, if you’re abusing it in combination with another drug, such as methadone, you risk experiencing the side effects of either drug alone, as well as the effects of the interaction between the two.8
It is impossible to know with 100% certainty what side effects you’ll experience, especially if you are not using the substance as intended.
Certain prescription medications and supplements may also interact with gabapentin with a resultant higher risk of side effects. If you are prescribed gabapentin, always fully disclose to your doctor what medications and other substances you are using on a regular basis.
As indicated above, the presence of preexisting conditions may make your side effects worse. For example, if you suffer from depression, your depression may worsen while you take gabapentin. If you have impaired renal (kidney) function, you may be more likely to experience toxic reactions from the drug.4
If you do begin to experience side effects while using the medication as directed, make sure to keep your doctor apprised of your symptoms. You might need an adjustment in your dose or you might to switch to a new medication.
If you are abusing gabapentin alone or with any other drugs and find yourself unable to quit, seek help to avoid experiencing severe side effects or overdose.
Will I Get Withdrawal Symptoms If I Quit?
Physical dependence develops when a person has taken a substance for a sustained period of time and no longer functions in the same way without it. Gabapentin is associated with a risk of dependence and withdrawal. Abrupt discontinuation of the drug may result in symptoms similar to those of benzodiazepine or alcohol withdrawal9 and may include:
- Hypertension (high blood pressure).
- Incoherent speech.
- Impaired ability to pay attention.
Someone using gabapentin to control seizure activity should not stop using gabapentin suddenly without talking to their physician. Withdrawal may bring on prolonged seizure activity (status epilepticus).4
Withdrawal may begin within as little as 12 hours of discontinuation or as late as 7 days after quitting or significantly reducing your dose.12 To decrease your risk of experiencing severe withdrawal symptoms, you can undergo a gradual taper off of the drug, performed by your doctor.9 If you are abusing gabapentin and want to seek help for addiction (see below), you may also slowly withdraw from the drug (and any other substances of abuse) in a medical detox program.
Gabapentin Abuse and Addiction
As mentioned above, gabapentin is a prescription drug with many uses and a relatively low potential for abuse; however, there is evidence to suggest that some people are misusing it. The most common reasons for misuse of this medication include:
- Achieving a high.
- Preventing or diminishing symptoms of opioid withdrawal.
- Potentiating (heightening) the effects of methadone.
A study that evaluated gabapentin abuse looked at information posted by users online and noted several areas of discussion, including:8
- Gabapentin’s potential to produce both sedative and psychedelic effects.
- The ability to obtain the drug online without a valid prescription.
- It’s potential to help you feel less inhibited and more social.
- Getting a high by combining it with drugs like amphetamine, LSD, marijuana, alcohol, and SSRIs.
- The ability of gabapentin to produce a feeling of dissociation (on the hands and head).
Gabapentin misuse frequently goes hand in hand with opioid abuse. A study of gabapentin abusers found that nearly 88% misused opioids concurrently.8 If you are abusing gabapentin alone or with opioids or other drugs, you face a number of physical and mental health risks. Fortunately, there is help.
Help for Addiction
Gabapentin misuse can give rise to numerous short-term and long-term health issues. Because of this, any abuse of gabapentin is cause for concern and intervention. Treatment centers that provide evidence-based treatment with professionals knowledgeable about gabapentin abuse – as well as its polydrug abuse with opioids or other drugs – can provide help you need to gain control over your substance use and live a life in recovery. This may be achieved through a variety of therapeutic approaches, including:
- Medical detox and withdrawal management.
- Cognitive Behavioral Therapy
- Drug education classes.
- Interpersonal or family therapy
- Life skills training.
When you stop abusing gabapentin or any other substance, you give your body and mind a chance to recover and normalize. Many of the health issues that come with gabapentin abuse will resolve when you clear your body of the substance and stay drug-free. Professional rehabilitation can be an important stepping stone to a healthy and substance-free future.
- U.S. National Library of Medicine. (2018). Gabapentin.
- Roy R. Reeve, D.O., PH.D., Mark E. Ladner, M.D. (2014). Letters to the Editor, Potentiation of the Effect of Buprenorphine/ Naloxone With Gabapentin or Quetiapine. Am J Psychiatry 171(6), 691.
- Wallach JD, Ross JS. (2018). Gabapentin Approvals, Off-Label Use, and Lessons for Postmarketing Evaluation Efforts. JAMA, 319(8), 776–778.
- Parke-Davis. (2011). Neurontin (gabapentin).
- Julius Chen, M.D., M.P.H. (2010). For Elderly, Even Short Falls can be Deadly.
- Zand L1, McKian KP, Qian Q. (2010). Gabapentin toxicity in patients with chronic kidney disease: a preventable cause of morbidity. Am J Med, 123(4), 367-73.
- Pfizer. (2017). Neurontin, Medication Guide.
- Gabriel C. Quintero. (2017). Review about gabapentin misuse, interactions, contraindications and side effects. Journal of experimental pharmacology, 9, 13-21.
- Tran KT1, Hranicky D, Lark T, Jacob Nj. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disord 7(3), 302-4.
- William J. Bonner, M.D. (2013). Gabapentin Withdrawal Syndrome: A Case Report. PM&R, 5(9S), S311.
- Thaddaus R. Hellwig; Rhonda Hammerquist; Jill Termaat. (2010). Withdrawal Symptoms after Gabapentin Discontinuation. Am J Health Syst Pharm, 67(11), 910-912.
- Tracey L. Mersfelder PharmD, William H. Nichols, DO. (2015). Gabapentin.
- Abuse, Dependence, and Withdrawal. Annals of Pharmacology.