Gabapentin: Definition, Uses, Side Effects, and Addiction

Understanding What Gabapentin Is

What Is Gabapentin?

Gabapentin is primarily a prescription anticonvulsant medication and one of the common nerve pain medicines used to treat specific conditions. 

Gabapentin is known as a gamma-aminobutyric acid (GABA) analogue. GABA is a neurotransmitter in your brain that helps calm or reduce the excitability of nerve activity. A GABA analogue is a substance that’s chemically similar to the natural GABA neurotransmitter. 

Gabapentin acts as a GABA analogue that mimics the effects of natural GABA by reducing nerve activity and calming the brain. Medications like gabapentin can be effective for addressing conditions that cause central nervous system and nerve cell activity to be overactive.

Is Gabapentin a Muscle Relaxer or a Pain Pill?

Gabapentin is classed as an anticonvulsant medication or antiseizure medication, which means it can be categorized with conventional pain medicines since it can treat nerve pain.

What Is Gabapentin Prescribed For?

As Medline Plus notes, the many forms of gabapentin, whether it’s gabapentin tablets, gabapentin capsules, or an oral solution, are primarily used in conjunction with other medications to treat certain types of seizures for those with epilepsy.

In addition, gabapentin can also be prescribed as a first-line and off-label medication for a variety of conditions, like:

• Postherpetic neuralgia (PHN) from shingles
• Restless legs syndrome (RLS)
• Diabetic neuropathy, trigeminal neuralgia, sciatica, and other neck and back nerve pain 
• Hot flashes for individuals being treated for breast cancer or those in menopause
• Anxiety disorders, alcohol addiction, withdrawal symptoms, and addiction cravings

How Does Gabapentin Work?

In the treatment of seizures, gabapentin works by binding to specific calcium channels in your brain to decrease communication between overactive nerve cells, while producing more GABA to calm nerve activity in the brain.

Regarding pain relief, gabapentin works by binding to specific calcium channels in the brain and spinal cord to reduce and block the release of neurotransmitters that send pain signals through the nervous system. Thus, gabapentin changes the way your body senses pain.

Is Gabapentin Available Over-the-Counter?

No, gabapentin is not available over-the-counter.

Gabapentin is a prescription medication that must be prescribed by a healthcare provider because it’s a Food and Drug Administration (FDA) approved anticonvulsant designed to treat specific types of seizures and nerve pain. 

What Is the Brand Name?

Gabapentin is available as a brand-name product under a variety of names, such as Neurontin, Gralise, and Horizant.

The Uses of Gabapentin

What Is the Main Thing Gabapentin Is Used For?

Gabapentin is primarily used for the prevention and control of partial seizures in those with epilepsy, to relieve nerve pain from PHN following a case of shingles, and to treat moderate-to-severe restless legs syndrome.

Is Gabapentin Considered an Opioid?

No, gabapentin is not considered an opioid.

Opioids work differently from gabapentin as opioids bind to opioid receptors to block pain signals. In contrast, gabapentin binds to specific calcium channels to block the neurotransmitters that send pain signals.

Does Gabapentin Help With Muscle Pain?

No, gabapentin can help with nerve pain rather than muscle pain.

Does Gabapentin Treat Mental Health Problems?

According to Innovations in Clinical Neuroscience, gabapentin is often used off-label as a third-line medication for mental health conditions like depression, anxiety disorders, and substance use disorder (SUD).

Are There Different Forms of Gabapentin?

Yes, there are several different forms of gabapentin, including tablets, extended-release tablets, capsules, and oral solution.

Is Gabapentin a Controlled Substance?

Gabapentin’s status as a controlled substance is dependent on what state you live in. 

The federal government doesn’t classify gabapentin as a controlled substance. 

Although gabapentin is not a narcotic and isn’t typically classified as a controlled substance, some states have reclassified it as a Schedule V controlled substance. Gabapentin’s reclassification in some states like Tennessee, Michigan, and North Dakota means it is the least likely to cause addiction or dependence, but it still carries a greater risk than non-controlled substances. 

In addition to being a Schedule V controlled substance in some states, gabapentin has mandated gabapentin reporting in several other states. Mandated reporting means that every time a gabapentin prescription is filled, it’s entered into the prescription drug monitoring program (PDMP) system in that state to help a healthcare provider monitor and track individuals who may be at risk for addiction or overdose.

Side Effects of Gabapentin

What Is the Biggest Side Effect of Gabapentin?

The biggest side effect of gabapentin is an allergic reaction. 

Allergic reaction side effects of gabapentin can include:

• Hives and skin rash
• Itchy or swollen skin with or without a fever
• Blistered or peeling skin with or without fever
• Wheezing, breathing problems, and difficulty swallowing
• Swelling of the face, lips, throat, eyes, mouth, or tongue

Does It Cause Drowsiness or Sleepiness?

Yes, drowsiness or sleepiness is one of the common side effects of gabapentin.

What Are the 5 Most Common Side Effects?

Five of the most common side effects of gabapentin include:

• Blurred vision, double vision, or unusual eye movements
• Movement problems: poor coordination, clumsiness, or unsteadiness
• Sleepiness or drowsiness and memory problems or loss
• Stomach issues, including nausea, vomiting, diarrhea, or constipation
• Dry mouth

Are There Serious Side Effects?

Yes, some of the serious side effects include:

• Serious allergic reaction: Slurred speech, swallowing issues, and breathing problems
• Changes in mood or behavior: Suicidal thoughts, restlessness, confusion, and memory problems
• Liver problems: Yellowing skin or whites of the eyes, dark urine, light-colored stool, vomiting, and unusual bleeding or bruising
• Kidney problems: Difficulty urinating, changes in urine volume, bloody urine, weight gain, and swelling of the legs and feet 
• Other abnormalities: Skin, lips, nail beds, fingers, or toes turn bluish, fatigue or weakness, and unexpected muscle pain

Does Gaba Cause Constipation?

Yes, while it’s not one of the most common side effects, gabapentin can cause constipation.

Can You Have an Allergic Reaction to Gaba?

Yes, while it’s rare, you can have an allergic reaction to gabapentin.

Using Gabapentin in Addiction Treatment

Is Gabapentin Used to Treat Addiction?

Yes, gabapentin can be used off-label in conjunction with other treatment modalities to treat addiction to some substances.

Some of the different forms of substance use disorder (SUD) that gabapentin has been used to treat include alcohol use disorder (AUD), cannabis dependence, and opioid use disorder (OUD).

Does It Calm Withdrawal Symptoms?

Gabapentin helps calm withdrawal symptoms for substances like opioids and alcohol during detox and recovery by:

• Reducing anxiety and mental distress
• Improving and stabilizing mood
• Managing the pain and discomfort from physical withdrawal symptoms
• Protecting against seizures
• Improving sleep hygiene and sleep quality
• Reducing cravings and supporting relapse prevention

Why Do Healthcare Providers Prescribe It Off-Label?

A healthcare provider may prescribe gabapentin off-label because it’s been shown to be an effective medication for your condition based on their clinical experience and existing research.

Some of the other reasons why your healthcare provider may prescribe gabapentin off-label include:

• Limited or no safe or effective treatment options
• FDA-approved treatment options are insufficient or have shown no benefits for your needs
• Different forms of treatment, such as an oral solution instead of the approved capsules
• Given in a different dose, such as prescribed to take two tablets instead of the approved one

How Long Does Gabapentin Stay in Your System?

On average, with an immediate-release formulation, gabapentin for a healthy individual can stay in their system for up to 48 hours and is detectable via a urine or blood test for one to three days and five to seven hours, respectively. 

However, the length of time gabapentin can stay in the system can change depending on other factors. such as:

• Kidney function: Impaired kidney function prolongs the time it takes to clear your system
• Age: Older adults may experience slower clearance due to reduced kidney function
• Extended-release tablets: Gradual release, like with Horizant, can prolong its presence
• Dosage: Taking a higher dose of gabapentin can lead to greater accumulation
• Frequency of use: Taking it more often can lead to accumulation, increasing its duration

How Long Does Gabapentin Take To Work?

The length of time it takes gabapentin to start working depends on different factors like the specific condition being treated.

For instance, on average, it can take one to four weeks to feel the full effects of the medication when treating nerve pain. Similarly, taking gabapentin for an anxiety disorder can take several weeks to experience the full effects of the medication. 

Regardless of the condition being treated, it can take some time for gabapentin to be effective as you work in collaboration with your healthcare provider to find the right dose for your needs.

Dangers of Gabapentin Use

Is Gabapentin Safer Than Other Pain Medicines?

Gabapentin is typically considered safer than other pain medicines because it has a significantly lower risk of addiction and overdose compared to pain medications, such as opioids. 

Can You Overdose on Gabapentin?

Although it’s rare, you can overdose on gabapentin, especially when it’s mixed with other central nervous system depressants like alcohol, opioids, or benzodiazepines.

Misusing gabapentin at higher doses can lead to overdose and, in some cases, overdose death. 

However, combining gabapentin with other depressants carries a greater risk of overdose and overdose death because gabapentin can enhance the depressant effect of other substances like opioids. Enhancing those depressant effects can cause slowed breathing and respiratory failure. 

How Does Gabapentin Make You Feel?

Each individual experiences gabapentin differently, but on average, when you first start taking gabapentin, you may feel some sleepiness or drowsiness, dizziness or clumsiness, and you may even feel like you’re thinking more slowly.

Those side effects typically go away as your body adjusts to the medication. Beyond the mild side effects for many when gabapentin is working as intended, it can feel relaxing, pleasant, or even euphoric. 

Gabapentin can reduce symptoms like anxiety to help improve mood and emotional regulation. However, for some, gabapentin can initially increase anxiety, depression, irritation, anger, aggression, agitation, excitement, recklessness, and even suicidal thoughts in rare cases.

Does Gabapentin Feel Like Opioids?

No, when taken appropriately, gabapentin doesn’t feel like opioids because they target different pain pathways.

Opioids are pain medicines that attach themselves to opioid receptors to block pain signals and produce strong feelings of calm, relaxation, pleasure, or euphoria. In contrast, gabapentin calms overactive nerve activity by reducing the chemicals that send pain signals. 

While it can cause sleepiness or drowsiness, it doesn’t have the same euphoric effects as opioids. The calming and sedative effect of gabapentin is mild in comparison to the effects of opioids. 

However, some individuals may experience some feelings of euphoria with gabapentin if it’s taken at higher doses than prescribed or combined with other substances.

Is It Bad to Take Gabapentin Every Day?

No, if it’s been prescribed by a healthcare provider to take daily, it’s not bad to take gabapentin every day.

Is Gabapentin Addictive?

Although gabapentin isn’t a controlled substance or addictive in the traditional sense of understanding of SUD like opioids, it does carry the risk of addiction for some individuals. 

Individuals who mix gabapentin with other substances like alcohol and opioids, or those with a history of polysubstance use, are at a greater risk for developing dependence and addiction to gabapentin. 

Is It Hard to Get Off Gabapentin?

Stopping gabapentin use can be challenging, especially if you’ve misused or abused it, but withdrawal and recovery are possible with support.

Whether you’re taking gabapentin as prescribed or recreationally, withdrawal symptoms can appear 12 hours to 7 days after a missed dose. During withdrawal, you can experience a variety of symptoms like anxiety, restlessness, dizziness, nausea, pain, fatigue, and insomnia. 

On average, withdrawal symptoms typically last up to 10 days. However, that withdrawal timeline can be extended based on your age, dosage, length of use, polysubstance use, and other co-occurring issues like medical or mental health challenges. 

Despite the challenges of addiction and gabapentin withdrawal, working with a healthcare provider in a treatment program can provide the necessary support for detox and recovery. At Legacy Outdoor Adventures, we’re dedicated to helping clients experience transformative healing through integrated, evidence-based, and holistic treatment planning. 

During treatment, our Legacy Outdoor Adventures team will regularly monitor your progress with weekly check-ins to make sure you’re moving toward your goals, your medication is working, we’re addressing side effects, supporting your physical and mental health, and making adjustments to your treatment plan if needed.