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Gabapentin is an anticonvulsant medication used for the treatment of nerve pain, migraine, bipolar disorder, and epilepsy.1 Gabapentin produces very few side effects, and it also doesn’t have any severe drug interactions. This means you can generally use gabapentin while taking other medications without having to worry about harmful consequences.1
However, gabapentin can occasionally create a certain degree of physiological dependence, which means that the body has grown accustomed to the presence of this anticonvulsant. If this does occur, you may experience gabapentin withdrawal symptoms when you abruptly discontinue the medication. Although gabapentin withdrawal may be uncomfortable, it’s usually not life-threatening.
In this article:
- Gabapentin and Addiction
- Gabapentin Withdrawal Symptoms
- Who is at Risk for Gabapentin Withdrawal?
- Gabapentin Withdrawal Treatment
Gabapentin and Addiction
Gabapentin does not produce a euphoric high and thus, is generally considered to have a very low potential for misuse and addiction. That said, gabapentin addiction has been reported in individuals with a previous history of a substance use disorder.2 This is why it’s important that treatment professionals who are considering prescribing gabapentin make sure to screen for opioid and other prescription medication misuse to determine if gabapentin is the right line of treatment.3
Although dependence can contribute to the development of an addiction, it’s important to note that addiction and physiological dependence are not synonymous—dependence develops due to long-term use of gabapentin and can occur in people who take this medication exactly as prescribed. Conversely, gabapentin addiction refers to a pattern of compulsive gabapentin use despite negative consequences.4
Signs of Addiction
Some signs of an addiction to gabapentin may be similar to other substance use disorders. These signs can include:4
- Changes in mental status and/or behavior
- Exhibiting dishonest or secretive behaviors
- Doctor-shopping, or meeting with multiple physicians in order to obtain several gabapentin prescriptions
- Neglecting hobbies in favor of gabapentin use
- Experiencing problems at work, school, or home due to gabapentin use
- Spending an excessive amount of time obtaining and using gabapentin
- Failing to cut down on gabapentin use despite attempts to
- Experiencing strong cravings for gabapentin
- Continuing to use gabapentin despite worsening psychological or physical problems
- Experiencing gabapentin withdrawal symptoms when you suddenly discontinue or reduce use
Once you’ve developed a physiological dependence on gabapentin, you will likely experience withdrawal symptoms when you stop taking the medication.5 These withdrawal symptoms can be rather unpleasant or uncomfortable, which may make it hard to quit.
If you or a loved one is struggling with gabapentin use, don’t hesitate to reach out and get help today at
800-681-1058
(
Who Answers?)
to find a detox treatment center that can help manage withdrawal and keep you safe and comfortable.
Anxiety and agitation are common gabapentin withdrawal symptoms.
Gabapentin Withdrawal Symptoms
Gabapentin withdrawal symptoms can occur if you’ve been taking gabapentin for as little as three weeks.6 Gabapentin withdrawal symptoms often resemble alcohol and benzodiazepine withdrawal symptoms since the substances share a similar mechanism of action.7
Withdrawal symptoms from gabapentin can appear anywhere from 12 hours to seven days after discontinuation of this anticonvulsant medication.5 A clear withdrawal timeline for gabapentin hasn’t yet been documented, but reports have indicated that symptoms may gradually worsen over a 10-day period.7
Although everyone’s withdrawal syndrome will manifest differently, gabapentin withdrawal symptoms may include:7,8,9,10
- Headache
- Excessive sweating
- Nausea
- Anxiety
- Insomnia
- Agitation
- Anxiety
- Confusion
- Tremors
- Chest pain
- Changes in mental status
- Hypertension
- Delirium
- Seizures
Tremors are a common withdrawal symptom when coming off of gabapentin. However, these tremors are not typically life-threatening and tend to resolve on their own.10 Additionally, if you were taking gabapentin to treat a seizure disorder, suddenly quitting use may result in rebound seizure activity, including uncontrollable seizures (status epilepticus).11
Delirium can occur even when you take a low dose of gabapentin, although it more commonly manifests if you’ve been taking gabapentin for a longer period of time. When delirium does occur, you may exhibit incoherent speech, a confused mental state, and unusual behavior. It’s also possible that you might develop some paranoia. Delirium is easily managed with proper medical care, and most often treated effectively with the medication, haloperidol.12
Less Common Withdrawal Symptoms
Akathisia is a lesser-known symptom of gabapentin withdrawal, as it has been recently reported in only a small number of patients. With this withdrawal symptom, you may experience a movement disorder best described as a sense of inner restlessness. This can include a decrease in mental status, agitation, and restless limb movements. Lethargy may also occur with akathisia, but is less common than the other symptoms.6
Catatonia is another movement disorder that may occur during gabapentin withdrawal. Again, it is an uncommon withdrawal symptom, but it’s helpful to be aware of nonetheless. When catatonia does occur, you may experience an abnormality in movements and behavior, due to disordered thinking. Symptoms may include rapid, strange movements, staying extremely still, lack of speech, and more.13
Seizures are another relatively rare gabapentin withdrawal symptom. They have been reported in only a handful of patients, but medical professionals are always advised to be alert for the possibility of seizures in their detoxing patients. If they do occur, seizures can be managed with proper medication, emphasizing the importance of medical oversight while detoxing from gabapentin.8
Who is at Risk for Gabapentin Withdrawal?
Withdrawal symptoms from gabapentin seem to affect certain people more than others. People at higher risk of experiencing severe withdrawal symptoms include:14
- Older adults
- Those with a history of substance abuse
- Those with a history of psychiatric illness
The risk of withdrawal symptoms may also be dependent on the dose and length of time you took gabapentin. However, if you or your loved one have taken gabapentin at any point, please speak with a medical professional before discontinuing its use.
Gabapentin Withdrawal Treatment
Through observation and studies of gabapentin withdrawal symptoms, medical professionals are now being advised to taper all patients off of gabapentin when discontinuation of the medication is necessary, rather than abruptly stopping use.
Tapering
In order to quit taking gabapentin, a medical professional will create a tapering schedule for you in which your dose is gradually reduced over a predetermined period of time—typically over a few weeks to a month.7 This will help alleviate or prevent any potential withdrawal symptoms and make it easier to stop taking the medication. A slow taper can also help limit the potential for gabapentin relapse as a means to alleviate uncomfortable withdrawal symptoms.6
If gabapentin was administered to a pregnant woman, extra caution should be taken for the mother and newborn when gabapentin use is discontinued. A taper is especially important for the infant who may have developed a gabapentin dependence in utero. The infant’s taper should begin slowly and continue for weeks to months.15
Even with dose-tapering, withdrawal symptoms can still occur, especially if you have been taking gabapentin in high doses for a long time. Due to the severity of some potential gabapentin withdrawal symptoms, strong medical oversight is always advised before discontinuing the medication.
Detox
Depending on your situation, your medical provider may recommend gabapentin detox at an inpatient detox facility or simply frequent check-ins at an outpatient clinic or doctor’s office. Inpatient detox programs require that you live at the facility for the duration of the detox process, whereas with outpatient detox, you reside at home and attend scheduled meetings at the facility. While outpatient provides more freedom to attend work or school while detoxing from gabapentin, inpatient tends to be safer for those with a severe addiction since you receive around-the-clock care and treatment.
If frequent check-ins at an outpatient clinic are recommended, please be certain to continually follow up with your medical provider and report any withdrawal symptoms that you may be experiencing. Your medical doctor wants to help assist you and make the withdrawal process as safe and easy as possible. They can offer you guidance and support as you work through your gabapentin withdrawal.
While not currently a controlled substance in the United States, gabapentin can be addictive and lead to dependence. If you or someone you know struggles with gabapentin addiction, treatment options are available.
A comprehensive treatment plan typically involves medical detox to safely manage withdrawal symptoms. This can be followed by behavioral therapies and support groups to address the underlying causes of addiction and prevent relapse. Finding a qualified addiction specialist familiar with gabapentin dependence is crucial for successful recovery.
Please speak with your medical provider to find the best method for you or your loved one as gabapentin use is discontinued. As always, you can get help today at
800-681-1058
(Who Answers?)
to receive the assistance that you need and deserve.
Resources
- Norton, J.W. (2001). Gabapentin withdrawal syndrome. Clinical Neuropharmacology, 24(4), 245-6.
- Bonnet, U., Richter, E.L., Isbruch, K., & Scherbaum, N. (2018). On the addictive power of gabapentinoids: a mini-review. Psychiatria Danubina. 30(2), 142-149.
- Modesto-Lowe, V., Barron, G.C., Aronow, B., & Chaplin, M. (2019). Gabapentin for alcohol use disorder: A good option, or cause for concern? Cleveland Clinic Journal of Medicine. 86(12), 815-823.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Mersfelder, T.L., & Nichols, W.H. Gabapentin: abuse, dependence, and withdrawal. (2016). The Annals of Pharmacotherapy, 50(3), 229-233.
- See, S., Hendriks, E., & Hsiung, L. Akathisia induced by gabapentin withdrawal. (2011). The Annals of Pharmacotherapy. 45(6), e31-e31.
- Tran, K.T., Hranicky, D., Lark, T., & Jacob, N.J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders. 7(3), 302-4.
- Barrueto, F., Green, J., Howland, M.A., Hoffman, R.S., & Nelson, L.S. (2002). Gabapentin withdrawal presenting as atatus epilepticus. Journal of Toxicology: Clinical Toxicology, 40:7, 925-928.
- Hellwig, T.R., Hammerquist, R. & Termaat, J. (2010). Withdrawal symptoms after Gabapentin discontinuation. American Journal of Health-System Pharmacy, 67(11), 910-912.
- Pittenger, C., & Desan, P. H. (2007). Gabapentin abuse, and delirium tremens upon gabapentin withdrawal. The Journal of Clinical Psychiatry, 68(3), 483-484.
- Food and Drug Administration. (2011). Neurontin.
- Fabio, R., D’Agostino, C., Baldi, G., & Pierelli, F. (2013). Delirium after gabapentin withdrawal. Case report. Canadian Journal of Neurological Sciences, 40(1), 126-127.
- Rosebush, P.I., MacQueen, G.M., & Mazurek, M.F. (1999). Catatonia following gabapentin withdrawal. Journal of Clinical Psychopharmacology, 19(2), 188-189.
- Mah, L., & Hart, M. (2013). Gabapentin withdrawal: case report in an older adult and review of the literature. Journal of the American Geriatrics Society, 61(9), 1635-1637.
- Carrasco, M., Rao, S.C., Bearer, C.F., & Sundararajan, S. (2015). Neonatal gabapentin withdrawal syndrome. Pediatric Neurology. 53(5), 445-7.
