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Gabapentin Withdrawal: What Are the Symptoms?

Gabapentin Withdrawal

Gabapentin is a medication prescribed to treat postherpetic neuralgia, a condition that involves pain that persists after shingles, and to help treat some types of seizures.1,2 Gabapentin is also used off-label for various concerns, including for seizures during drug and alcohol detox.3

Gabapentin Withdrawal

Also known by the brand name Neurontin, gabapentin’s specific mechanism of action is unknown. It is similar to GABA, an inhibitory neurotransmitter that impedes activity in the central nervous system, in its structure, but it does not impact the uptake, breakdown, or attachment of GABA.1,4

Potential side effects of gabapentin may include:1

  • Drowsiness.
  • Incoordination.
  • Feeling dizzy.
  • Tremor.
  • Nausea/vomiting.
  • Abnormal movement of the eyes.
  • Double vision.
  • Thoughts of suicide.

Gabapentin misuse does occur.5 It can be especially dangerous if the medication is mixed with opioids, as it can raise the likelihood of fatal opioid overdose.6 Combining gabapentin with any sedating drugs, like benzodiazepines, may increase the risk of depression of the central nervous system.1

Gabapentin use can lead to physical dependence. Gabapentin withdrawal symptoms may occur in an individual who abruptly discontinues the drug.5,7,8 Thus, individuals should be tapered off under medical supervision.8

Gabapentin Withdrawal Symptoms

Dependence is when a person’s body requires a drug to function properly. Regular use of a drug can result in dependence. If the drug is suddenly stopped, in other words if a person stops taking it “cold turkey” rather than tapering off it, withdrawal symptoms can result.9

Stopping Neurontin (gabapentin) suddenly may cause an increase in seizure activity in those who have seizure disorders.1 Other potential symptoms of gabapentin withdrawal may include:1,7

  • Sweating
  • Nausea
  • Increased heart rate
  • Trouble sleeping
  • Pain
  • Anxiousness
  • Being irritable
  • Confusion

If gabapentin needs to be stopped, a person should be tapered off of it by a medical provider.8

Gabapentin Withdrawal Duration and Severity

Among those experiencing withdrawal symptoms, the severity may vary from person to person. The timeline may vary widely as well. Withdrawal may begin as soon as 12 hours or as late as 7 days after stopping the drug.5

The more significantly dependent on gabapentin a person is, the more intense withdrawal may be.10 When withdrawal starts, how severe it is, and how long it lasts are influenced by how long a person has been using the drug and how much the person’s body has adapted to its presence.11

If a person struggles with a co-occurring medical and/or mental health condition, withdrawal symptoms may be more complicated.10

Gabapentin Detox & Tapering

Individuals should not discontinue gabapentin on their own. They should consult their medical provider.1 In general, the medical provider should slowly decrease the amount of gabapentin the person is taking over the course of more than a week.8

An individual struggling with misusing gabapentin may need addiction treatment.

Treatment may involve addressing underlying issues and learning techniques to manage stress and to cope with potential triggers and drug cravings.

 

References: 

  1. Pfizer. (2017). Highlights of Prescribing Information, Neurontin.
  2. Mayo Clinic Staff. (2018). Postherpetic neuralgia.
  3. Mack, A. (2003). Examination of the evidence for off-label use of gabapentinJournal of Managed Care Pharmacy, 9(6), 559-568.
  4. National Center for Biotechnology Information. (2019). gamma-Aminobutyric acid.
  5. Mersfelder, T. L. & Nichols, W. H. (2016) Gabapentin: Abuse, Dependence, and Withdrawal. Annals of Pharmacotherapy, 50(3), 229-33.
  6. Gomes, T., Juurlink, D. N., Antoniou, T., Mamdani, M. M., Paterson, J. M., & van den Brink, W. (2017). Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control studyPLOS medicine14(10), e1002396.
  7. Hellwig, T. R., Hammerquist, R., & Termaat, J. (2010). Withdrawal symptoms after gabapentin discontinuationAmerican Journal of Health-System Pharmacy67(11), 910-912.
  8. Yasaei, R. & Saadabadi, A. (2019). Gabapentin. In StatPearls [Internet].
  9. National Institute on Drug Abuse. (2007). 8: Definition of dependence. In The Neurobiology of Drug Addiction.
  10. World Health Organization: Western Pacific Region. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. Geneva: World Health Organization.
  11. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine. Philadelphia, PA: Wolters Kluwer.