Gabapentin Withdrawal

and Other Side Effects

Gabapentin Withdrawal

Table of Contents

What is Gabapentin?

Gabapentin is a prescription painkiller most prescribed in the instance of neurological issues, such as epilepsy or nerve pain. It is an anticonvulsant that affects and alters the chemicals and nerves associated with seizures and neuropathic pain to treat the symptoms associated with a variety of conditions.  

Is Gabapentin Addictive?

In many situations, gabapentin is prescribed as an alternative to opioids since it is less addictive. However, as with almost every substance, there is a potential for addiction, especially with misuse.  

When the body is regularly exposed to a substance such as gabapentin, it can become accustomed to it and lead to addiction. When the substance is no longer administered and the body goes without exposure, withdrawal symptoms can develop.  

What Class is Gabapentin?

Gabapentin belongs to its own specific class: gabapentinoids. This pharmaceutical class includes gabapentin as well as another medication, pregabalin. Both substances are often prescribed in the treatment of seizures caused by epilepsy, postherpetic neuralgia, or other nerve-based pain or complications.1

Where is It on the Schedule?

While gabapentin’s classification can vary by region in the United States, many states have not classified it as a controlled substance. For many areas, gabapentin is not a scheduled substance.

However, where it is scheduled, states have classified gabapentin as a Schedule V substance.2 Schedule V substances have a lower potential for misuse and addiction compared to other substances, although the risk still exists.

Dosage

While there is a standardized starting dosage for gabapentin, the dosage can vary based on circumstances, such as the beginning of medically guided detox and withdrawal.

  • 300mg: 300mg is the starting dosage for gabapentin, usually totaling up to 900mg in a day through three different dosages.
  • 100mg: During tapering off in withdrawal, a medical professional may lower the dosage to 100mg per dose to help the body acclimated to lower levels of gabapentin.

What Is Gabapentin Used For?

Gabapentin, as well as other gabapentinoids, are used in the treatment of nerve-based pain when opioids are not the preferred method of pharmaceutical treatment.3 Some of the conditions that gabapentin is used to treat are:

  • Epilepsy
  • Fibromyalgia
  • Restless Leg Syndrome
  • Pain from spinal cord injuries
  • Neuropathic pain as a symptom of other conditions
 The conditions that gabapentin is capable of treating depend on the brand and dosage of the drug. As a result, adhering to a doctor’s prescription ensures the best possible results.

Anxiety

While gabapentin is most commonly used in the treatment of neuropathic pain and epilepsy, some medical professionals have utilized it for the treatment of anxiety alongside depression and bipolar disorder.4 The science behind gabapentin’s usefulness in psychiatry treatments is still be explored.

Sleep

Gabapentin can also be beneficial for improving sleep. It does so in two different ways. 

First, gabapentin treats the discomfort that occurs because of restless leg syndrome by treating the neuropathic pain. Since restless leg syndrome is a common source of sleep issues, many patients find improved sleep patterns with gabapentin.  

Gabapentin can also increase slow-wave sleep, the deepest phase of non-rapid eye movement sleep.  

Side Effects of Gabapentin

As with any substance, regular administration introduces the possibility of gabapentin side effects. This risk can increase with gabapentin abuse or misuse 

Short-Term

Outside of allergic reactions, which should be immediately discussed and examined by a health practitioner, the use of gabapentin can produce short-term effects. While many of these are not life-threatening, it can still be beneficial to speak to the prescribing professional to help prevent greater side effects.

Short-term side effects of gabapentin abuse include:

  • Drowsiness
  • Dizziness
  • Headache
  • Blurred vision
  • Unsteadiness
  • Anxiety
  • Unwanted eye movements
  • Gastrointestinal issues

Long-Term

With prolonged exposure, the body can become at risk for more severe long-term effects. Long-term effects of gabapentin abuse can include:

  • Weight gain
  • Memory problems
  • Unusual thoughts
  • Anxiety
 Long-term use of gabapentin also has the potential to cause more severe, life-threatening symptoms. These symptoms may include significant respiratory issues that can require immediate medical attention as well as thoughts of suicide. In the development of either of these conditions, speaking with the prescribing medical professional is necessary and should be done immediately.

Signs of Gabapentin Addiction

While certain factors cause a body to become predisposed to addiction, gabapentin addiction can develop any time the body becomes accustomed to it. The time frame for gabapentin addiction can vary between individuals, and recognizing the signs of gabapentin addiction can be significant in seeking treatment.

Signs of gabapentin addiction can include:

  • Taking higher doses
  • Using gabapentin with other substances
  • Attempting to receive gabapentin through fraud
  • Visiting multiple doctors to receive gabapentin prescriptions
  • Being preoccupied with obtaining gabapentin
  • Displaying sudden changes in appearance or social habits.
  • Refusing to stop using gabapentin, despite issues

Signs of Gabapentin Overdose

Gabapentin overdoses are medical emergencies that require immediate attention. The signs to be aware of are:

  • Lethargy
  • Drooping eyelids
  • Diarrhea
  • Sedation

If an individual displays the signs of a gabapentin overdose, immediate medical attention is required to prevent more severe gabapentin side effects, including mortality. The risk for an overdose is increased with gabapentin addiction.

Gabapentin Withdrawal Symptoms

After the body forms a dependency on a substance, creasing administration can result in withdrawal. The timeline for gabapentin withdrawal can vary, but most commonly, symptoms will occur once gabapentin abuse or usage ends and the substance is eliminated from the body.

Gabapentin withdrawal symptoms include:

  • Anxiety
  • Headache
  • Agitation
  • Fatigue
  • Restlessness
  • Insomnia
  • Irritability
  • Dizziness

It is important to note that the immediate withdrawal of gabapentin can increase the likelihood of seizures. Consequently, many treatments involve tapering off to lessen the impact of gabapentin withdrawal side effects.

Treatment for Gabapentin Withdrawal

To promote recovery, gabapentin withdrawal treatment is an important step. Gabapentin withdrawal treatment is focused on eliminating the substance while aiding in the relief of withdrawal symptoms and triggers. The treatment methods can vary to best fit individual needs and circumstances.   

Tapering Off

Immediately stopping the administration of gabapentin, also known as “quitting cold turkey” can increase the intensity of withdrawal symptoms, including cravings. This factor, paired with the tolerance that builds to substances with prolonged use, can make recovery more difficult.   

Tapering off gabapentin doses allows the body to slowly return to its natural state before dependency. Tapering can help reduce the severity of gabapentin withdrawal symptoms and the dangerous side effects of withdrawal such as the increased chance of seizures.    

Replacement Drugs

Withdrawal can result in discomfort as well as increased cravings, which can make recovery difficult. When gabapentin has been used for the treatment of epilepsy, there is also an increased risk for seizures.  

As a result, during treatment, a medical professional may prescribe replacement drugs to alleviate discomfort and treat medical conditions. 

Therapies

Therapy is another beneficial form of treatment for gabapentin withdrawal by targeting the mind and behaviors. 

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy focuses on identifying and correcting trigger behaviors. The objective of this form of therapy is to draw a connection between mindset and behavior while correcting potentially negative relationships and associations.   

Dialectical Behavior Therapy

Dialectical behavior therapy is psychotherapy dedicated to a change in behavioral patterns through discussion with a psychotherapist in which new perspectives and strategies are introduced.  

Mindfulness Therapy

Mindfulness therapy, also known as mindfulness-based cognitive therapy, is psychotherapy that combines cognitive therapy with more holistic practices like meditation to produce a mindful behavior. This therapy is dedicated to understanding the self while also producing a pensive, present-oriented mindset and attitude. 

For gabapentin withdrawal treatment, mindfulness therapy can be beneficial for many patients by allowing for the cultivation of a new perspective and mindset.   

Motivational Interviewing

Motivational interviewing is a counseling approach focused on positive behavioral changes through patient-guided discussion and introspection. This form of treatment allows the patient to dictate the speed of progression under professional guidance.  

Group Therapy

While talking with a medical professional or psychotherapist can be beneficial in gabapentin withdrawal treatment, many people respond well to a community setting. In group therapy, small or large groups will come together to discuss their personal experiences as well as to share coping mechanisms. 

Inpatient Treatment

For many people with a substance use disorder, inpatient treatment offers the best results for treating gabapentin withdrawal.  

Inpatient treatments are often conducted within a rehabilitation space dedicating to treating substance withdrawal. Here, medical professionals specializing in the symptoms and effects of withdrawal are available for care. This care allows for more thorough treatment through several methods, usually, those centered on combining therapy and counseling with medication dedicated to treating withdrawal symptoms.  

Inpatient treatment can also be a preferred option of treatment for dual diagnosis. 

Outpatient Treatment

Outpatient treatment can be either a primary or secondary treatment option.

For individuals utilizing outpatient treatment succeeding inpatient treatment, it can often involve completing similar treatments as a rehabilitation program. This treatment includes continuing therapy and medication – though it can also involve transitioning into a new treatment plan – in a more self-guided method.

As a primary option, outpatient treatment involves determining, establishing, and beginning a mostly self-guided treatment plan.


Resources

  1. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2666788
  2. https://pubmed.ncbi.nlm.nih.gov/33674205/
  3. https://www.nejm.org/doi/10.1056/NEJMp1704633
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745655/

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