Gabapentin may not be as powerful or as popularly abused as some opioid painkillers, but stopping this medication abruptly can still trigger unexpected and potentially dangerous withdrawal symptoms.
Some sources argue that the abuse potential of gabapentin has been understated to the detriment of public health and safety.[1] As a result, many people are unaware that this medication can cause physical dependence. With or without dependence, withdrawal can occur.
Gabapentin withdrawal symptoms vary by a number of individual factors, including your dosage level, how long you used the medication, and more.
Understanding how gabapentin works, when it is prescribed, and what to look for regarding possible withdrawal symptoms is critical to safely taking and/or discontinuing this medication.
Key Points
- Gabapentin is an anticonvulsive medication that decreases neural activity in the brain
- Abruptly stopping your use of gabapentin may result in a broad range of withdrawal symptoms
- Medically supervised tapering and professional rehabilitation services are essential to preventing and treating withdrawal symptoms
What Is Gabapentin?
Gabapentin is a prescription anticonvulsant medication originally developed for the treatment of various seizure disorders. Specifically, the FDA approved gabapentin to treat partial seizures in epilepsy patients.[2]
Researchers are still investigating how exactly gabapentin interacts with GABA (gamma-aminobutyric acid) receptors. The current understanding is that this medication binds with various receptors throughout the brain in a way that inhibits excitatory neurotransmitters.[3]
In other words, gabapentin has the ability to reduce the frequency and intensity with which the brain sends certain signals, which bears great importance for patients with seizure disorders.
Today, gabapentin is prescribed on an off-label basis (meaning for uses outside of its official approval) for a range of conditions with or without associated seizures.
Primary Uses of Gabapentin
Gabapentin is used to treat several medical conditions, including the following:[4]
- Epilepsy: Controls partial seizures in adults and children
- Neuropathic pain: Manages nerve pain from diabetes, shingles, and injuries
- Restless leg syndrome: Reduces uncomfortable leg sensations
- Anxiety disorders: Off-label use for generalized anxiety
- Fibromyalgia: Helps manage widespread muscle pain
Potential Side Effects and Risks of Gabapentin
Most medications are associated with common and rare side effects, and gabapentin is no exception.
More commonly reported gabapentin side effects include dizziness, fatigue, fever, nausea, double vision (diplopia), coordination problems, and memory and concentration issues.[5]
Rare and more serious side effects associated with gabapentin use include suicidality, depression, anaphylaxis (life-threatening allergic reaction), withdrawal seizures, and more.
When combined with opioids, gabapentin may produce a broader range of more severe symptoms.
Long-term use can lead to physical dependence. Your body adapts to the presence of the medication over time. Stopping suddenly disrupts the balance of your nervous system.
Gabapentin Withdrawal: What You Need to Know
Gabapentin withdrawal effects can occur when you stop the medication too quickly. Withdrawal symptoms can begin to manifest within a few short hours after your last dose, and will likely persist for several days afterwards.[7]
Common Physical Symptoms of Gabapentin Withdrawal
Given its interactions with various types of neurons in the brain, gabapentin withdrawal symptoms can affect multiple systems throughout the body.
Neurological symptoms of gabapentin withdrawal may vary depending on the underlying condition(s) for which you were initially prescribed the medication. These symptoms include seizures, tremors and muscle twitching, headaches and migraines, dizziness and coordination issues, and numbness or tingling sensations.
Gastrointestinal symptoms of gabapentin withdrawal include nausea and vomiting, stomach pain and cramping, loss of appetite, and diarrhea or constipation.
You may also experience a more generalized set of symptoms that are often associated with withdrawal from other drugs or substances. These include excessive sweating, heart palpitations, fatigue, flu-like symptoms, and difficulty sleeping.
Psychological and Emotional Symptoms of Gabapentin Withdrawal
Patients hospitalized soon after gabapentin discontinuation often feel increasingly confused, agitated, and anxious.[8]
Other psychological and emotional symptoms of gabapentin withdrawal include delusions, euphoric mood (even though gabapentin is not an opioid or stimulant), and aggression.
Mental health symptoms related to gabapentin withdrawal can be significantly complicated by any underlying mental health concerns affecting the patient before (or during) their gabapentin use. Combining this medication with other drugs and taking it at higher doses may also affect how the person’s psychological and emotional states are affected.
Assessing Risk Factors for Severe Withdrawal
Not all patients are subject to the same risks when suddenly discontinuing gabapentin. Both external (e.g., dosage) and internal (e.g., medical conditions) factors can increase or decrease your risk of experiencing certain withdrawal effects.
For example, high daily doses of gabapentin (exceeding 1,800mg) increase one’s risk of experiencing severe withdrawal side effects after discontinuation.[9] The total timeline of use is also a reliable predictor of withdrawal symptom severity. The longer one takes gabapentin, the more likely one may experience more severe withdrawal symptoms.
How abruptly you discontinue gabapentin is a major determinant of withdrawal symptom severity. Even patients who have been on higher doses for long periods of time can avoid withdrawal by tapering down under medical supervision.
If you have any of the following individual risk factors, you may be at a greater risk for severe withdrawal symptoms:
- History of seizure disorders
- Concurrent use of other medications
- Underlying mental health conditions
- Previous substance abuse history
- Age (elderly patients at higher risk)
How long do gabapentin withdrawal symptoms typically last?
Most gabapentin withdrawal effects occur within twelve hours to several days following cessation, resolving within one to two weeks.[10] However, some people experience prolonged symptoms lasting several weeks or months. The duration depends on factors like dosage, treatment length, and individual physiology. Medical tapering (slowing reducing the dosage of a substance under medical supervision) significantly reduces both the severity and duration of withdrawal symptoms.
Symptom Management and Treatment
Tapering off of gabapentin under close medical supervision is the gold standard for limiting withdrawal effects. Patients should never attempt to stop gabapentin cold turkey without any professional oversight. While tapering off is not a guarantee that side effects or withdrawal symptoms won’t occur, it significantly reduces the likelihood and intensity of these symptoms.
Medical Tapering Recommendations
Gradual dose reduction is the safest approach to prevent withdrawal symptoms.[11] Healthcare providers typically reduce doses by 25-50% weekly. Some patients need slower tapers over several months.
Tapering Schedule Example:
- Week 1-2: Reduce by 25% of the original dose
- Week 3-4: Reduce by another 25%
- Continue until completely discontinued
Medication-Assisted Withdrawal Support
Healthcare providers may prescribe medications to manage specific gabapentin withdrawal symptoms.
Anti-seizure medications prevent withdrawal seizures for patients who are at a higher risk of encountering this issue. Benzodiazepines are often used on a short-term basis to manage anxiety and insomnia issues. Some patients will benefit from sleep aids to manage insomnia caused by gabapentin withdrawal.
Non-Medication Support Methods
Many of the practices recommended to the general public to improve overall wellness can also help to alleviate or prevent gabapentin withdrawal symptoms.
For example, maintaining a regular sleep schedule to the best of your ability and engaging in low- to moderate-intensity exercise on a regular basis may help alleviate symptoms.
Stress reduction techniques (like mindfulness and meditation), optimal nutrition, hydration, and professional therapeutic support or treatment may also help.
Recognizing Gabapentin’s Abuse Potential
Gabapentin has increasingly become a drug of abuse. While it is not a recreational drug or a powerful opiate, it can still produce euphoria-like effects at high doses. When combined with opioids or alcohol, these effects and the associated risks are multiplied.
Warning Signs of Gabapentin Misuse
- Taking higher doses than you were originally prescribed
- Seeking out and taking gabapentin without a prescription
- Seeking multiple prescriptions from different doctors
- Combining with other substances for enhanced effects
- Continuing use despite negative consequences
When Withdrawal Becomes Complicated
Some people develop complicated withdrawal patterns. Previous substance abuse history increases this risk significantly. Use of multiple substances makes withdrawal management more challenging.
Professional addiction treatment becomes necessary when (not all inclusive):
- Multiple failed quit attempts occur
- Withdrawal symptoms are severe or life-threatening
- Co-occurring mental health issues complicate recovery
- Social or occupational functioning is impaired
Find Your Path to Recovery
Gabapentin withdrawal effects can derail your recovery journey if you don’t take the proper precautions. With medical supervision and support, you can safely discontinue this medication without compromising your recovery goals. The key is to work with professionals who understand the complexities of the recovery and withdrawal processes.
Recovery from gabapentin use, abuse, and/or withdrawal is possible with the right approach. Professional treatment centers offer comprehensive programs for managing withdrawal. These programs address both physical symptoms and underlying issues with a comprehensive and compassionate approach.
Don’t let fear of withdrawal keep you trapped. Reach out for help today. Rehabilitation and detox professionals can create a safe, manageable withdrawal plan tailored to your needs.
Your health and well-being deserve professional attention. Take the first step toward freedom from gabapentin dependence. Contact a qualified treatment facility or your healthcare provider to discuss your options.