GABAPENTIN ADDICTION AND TREATMENT
Introduction
Gabapentin is not an opioid but is, at times, prescribed by doctors as a safer alternative. The misuse of gabapentin is on the rise due to its low cost, classification as a non-controlled substance, and off-label prescribing. Here is a detailed overview of gabapentin addiction, withdrawal symptoms, and recommended treatment.
What is Gabapentin?
Gabapentin is an anti-seizure drug that has been used medically in the treatment of epilepsy and neuropathic pain. The drug can also produce some effects such as anxiety reduction, sedation, and euphoria. Due to these effects, gabapentin is sometimes prescribed for insomnia, anxiety, bipolar disorder, and panic disorder.
It is a prescription drug that comes in several forms, including an oral capsule, an immediate-release oral tablet, an extended-release oral tablet, and an oral solution.
Is Gabapentin Addictive?
Gabapentin is considered a less addictive alternative to opioids. However, addiction can still occur in some people. As the drug produces a range of positive effects such as relaxation and calm, it is possible to become addicted.
The risk for gabapentin addiction is higher in people with other current or past substance use disorders, primarily opioid and multi-drug use.1 Gabapentinoids should not be prescribed if you have a history of substance use or should be administered with caution.
What Class Is It?
Gabapentin belongs to the class of drugs known as anticonvulsants. Anticonvulsants work by calming hyperactivity in the brain in different ways.
It is still not fully understood how gabapentin works. It seems to prevent the increased sensitivity to pain, helping with neuropathic pain. For seizures, it may alter the effect of calcium.
Where Is It on the Schedule?
Gabapentin is not a federally controlled substance in the United States. However, some states have been passing laws in an attempt to prevent its misuse. Kentucky and Michigan were the first two states to pass laws about the regulation of gabapentin.
What Is Gabapentin Used For?
Anxiety
Gabapentin is sometimes used off-label in the treatment of common mental health disorders, including anxiety. It is believed that it works by calming over-activity in the brain and producing calming effects that ease anxiety symptoms. Some studies have shown that gabapentin is more effective in treating social anxiety and better than a placebo to treat generalized anxiety disorder (GAD).2
Sleep
Gabapentin can be a safe and effective treatment for insomnia. It is reported that it can improve slow-wave sleep ("deep sleep") and total sleep time.
Two small studies have found that gabapentin can help people struggling with primary insomnia and occasional sleep disturbance. Other studies have found that gabapentin may improve sleep in people dealing with other medical conditions that can disrupt sleep, such as alcohol dependence, hot flashes, and bipolar disorder.3
Dosage
The recommended gabapentin dosage depends on several factors, including:
- The person's age
- The type and severity of the condition gabapentin should treat
- The form of gabapentin
- Other medical conditions present
300mg
Gabapentin is available in different sizes, including 100, 300, 400, 600, and 800 mg.
The typical starting gabapentin dosage for the treatment of postherpetic neuralgia in adults is 300 mg. The dosage is doubled on day 2 (300 mg twice a day) and tripled on day 3 (300 mg three times a day).
The adult dose for epilepsy with partial-onset seizures is 300 mg three times a day.
100mg
Gabapentin is also available as 100 mg capsules. Generally, doctors will start with a low gabapentin dosage and adjust the dosage over time.
Gabapentin Side-Effects
Long-Term
Some of the more common gabapentin side-effects that can occur with regular use include:
- Memory loss
- Weakened muscles
- Respiratory failure
- Tolerance
- Addiction
Short-Term
The most common gabapentin short-term effects include:
- Dizziness
- Blurred vision
- Fatigue
- Drowsiness
- Delusions
- Swelling of the hands, feet, or lower legs
- Trembling or shaking
- Difficulty speaking
- Dry mouth
- Vomiting
Does Gabapentin Cause Weight Gain?
Weight gain is a rare side effect of gabapentin. Studies show that only a small percentage of people experienced weight gain. In people with epilepsy, weight gain was detected in 3% of people. Only 2% of people with postherpetic neuralgia experienced weight gain due to gabapentin use.4
Overdose and Withdrawal
Overdose
Compared to other drugs like opioids, gabapentin is considered to be relatively non-lethal in overdose cases. However, the risk of a fatal overdose increases when gabapentin is combined with other substances, such as opioids.5
Combining gabapentin with other drugs that have depressant effects increases the risk of respiratory depression. Depending on the severity of the overdose and other factors, consequences may include:
- Seizures
- Permanent brain damage
- Coma
- Death
Withdrawal
Gabapentin withdrawal can happen if, after long term use, it suddenly stops being taken. Withdrawing from gabapentin can produce a range of symptoms, including:
- Anxiety
- Confusion
- Rapid heart rate
- Sweating
These gabapentin withdrawal symptoms occur only in people who use large doses of the drug for an extended period to treat an illness for which the drug is not approved. Many of the people who go through withdrawal have a history of substance misuse or used gabapentin in an attempt to withdraw from other substances.
Although withdrawing from gabapentin is considered less dangerous than withdrawing from opiates, quitting any opioid cold-turkey can be life-threatening.
People living with seizures who abruptly stop taking the drug may be at a higher risk of having a seizure. Withdrawing from gabapentin should be done at a medical facility under the supervision of a professional.
Treatment for Gabapentin Addiction
People who have developed a gabapentin dependence will need to detox under a medical professional's supervision.
Gabapentin is often abused with other substances such as alcohol or opioids. For this reason, polysubstance addiction treatment is recommended. A gabapentin addiction may also present alongside a co-occurring mental health disorder. A good rehab center will provide treatment programs for polydrug use and mental health disorders.
The most important decision you have to make is choosing between an inpatient and outpatient treatment program. During an inpatient program, you live on-site and receive 24/7 medical care. You would stop going to school or work during this time, and life would be focused solely on recovery. This type of treatment is also more expensive in some cases but comes with many benefits.
Outpatient care is more suitable for treating a mild addiction. Outpatient is also useful if you want to continue going to school or work while focusing on recovery.
Gabapentin for Pets
Gabapentin for Dogs
Veterinarians commonly prescribe gabapentin to treat seizures, pain, and anxiety in dogs. The use of gabapentin in veterinary medicine is "off-label," meaning it is not FDA-approved for pets.
Gabapentin for Cats
Veterinarians can also prescribe gabapentin for the treatment of chronic pain in cats.
Also, feline veterinarians have discovered that gabapentin can be an effective short-term anxiety medication for cats. The drug calms the animal without having to use an oral tranquilizer medication or anesthesia during an examination.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you or a loved one might be suffering from gabapentin addiction, ask for professional help today.
Resources
- https://www.sciencedirect.com/science/article/abs/pii/S0924977X17308970
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745655/#:~:text=The%20potential%20anxiolytic%20effect%20of,of%20panic%20and%20agoraphobia%20symptoms
- https://www.drugs.com/medical-answers/gabapentin-you-sleep-3553166/
- https://www.drugs.com/medical-answers/gabapentin-weight-gain-3553163/#:~:text=Gabapentin%20may%20cause%20weight%20gain,after%206%20weeks%20of%20use
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103607/
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