For many people, what started as a supposed “lifesaver” to treat seizures or nerve pain quickly turned into a living nightmare.
Those who claim “Gabapentin ruined my life” are likely individuals who have developed gabapentin dependence and felt the fallout firsthand.
Below, we’re exploring the dangers of gabapentin misuse so you can be aware if it happens to be a part of your treatment plan.
What Is Gabapentin?
Gabapentin (sold under the brand names Neurontin, Horizant, and Gralise) is an anticonvulsant medication used to treat partial seizures and nerve pain.
Take note that the different brand name versions and generics aren’t interchangeable. Each one is specifically approved to treat certain conditions and not others.
- Neurontin (gabapentin) prevents partial seizures in patients who have epilepsy. It can also ease most nerve pains, including post-shingles pain.
- Gralise (gabapentin) once-a-day tablet is prescribed for postherpetic neuralgia (PHN), a common complication of shingles (herpes zoster). It’s best taken with your evening meal for gradual overnight release.
- Horizant (gabapentin enacarbil) extended-release capsules target moderate to severe restless legs syndrome (RLS) and PHN. RLS is the irresistible urge to move your legs to relieve unpleasant sensations there like tingling, aching, or twitching.
Your doctor should prescribe the specific formulation based on its approval. Taking the wrong pill could mean under-treating your issue or opening yourself up to side effects for off-label use.
How Does Gabapentin Work?
Scientists still aren’t 100% certain about gabapentin’s precise mechanisms of action. But here’s what we do know so far: Gabapentin was initially designed to mimic the effects of the neurotransmitter GABA (gamma-aminobutyric acid) in the brain.
GABA’s job is to reduce over-excitable nerve signals in the brain. Weirdly, gabapentin doesn’t latch onto or directly affect GABA’s receptors like you’d expect. It seems to take a more roundabout approach.
One theory is that it binds to “calcium channel” gateways on nerve cells instead. Blocking some calcium flow prevents those cells from releasing too many “excited” chemicals that can trigger seizures or amplify pain signals.
Some research also hints that gabapentin interacts with other critical signaling pathways in damaged nerves to help quiet down that overactive, painful misfiring. In short, gabapentin appears to hit the brakes on nerve activity gone haywire through multiple tricks.
Common Gabapentin Side Effects
Even if you’re taking gabapentin as prescribed, some fairly common side effects can occur. They can vary in severity, but usually include:
- Dizziness or sleepiness
- Brain fog (confusion or poor focus)
- Headaches
- Fatigue or lack of energy
- Nausea, vomiting, or stomach upset
- Dry mouth
- Weight gain
- Swelling in hands or feet
- Back or joint pain
- General flu-like symptoms
It’s a broad range, but drowsiness and brain fog are among the most commonly reported. Some mild symptoms should resolve within a few days as your body adjusts to the medication. Your doctor may even start you on a lower dose to make that transition smoother before increasing it.
Also, it would be best if you didn’t drive or operate heavy machinery unless you know for sure how gabapentin affects you.
Another thing to watch out for is allergic reactions, such as:
- Skin rash or hives
- Itching
- Yellowing of skin
- Fever
- Weight gain
- Unusual bruising or bleeding
- Frequent infections
- Unexpected severe muscle pain
- Difficulty getting or keeping an erection
You should call your doctor ASAP if you’re having severe allergic reactions or your symptoms don’t go away.
If you’re having anaphylaxis, a life-threatening allergic reaction that starts almost immediately after taking gabapentin, call 911 or get emergency medical help right away. Below are the warning signs of anaphylaxis:
- Slurred speech or trouble swallowing
- Hoarseness
- Swollen lips or tongue
- Trouble breathing
- Fainting
- Pale or bluish skin, lips, or tongue
Serious Gabapentin Side Effects
Gabapentin can alter your mental function and personality in unsettling ways.
Do you notice disturbing mood changes like agitation, violent outbursts, or wanting to harm yourself? One of the biggest concerns is an increased risk of suicidal thoughts or behaviors with gabapentin. It’s relatively rare, but that doesn’t make it less scary.
You should also report sudden changes in mood and behavior, especially if they’re new or worsening. The following symptoms are particularly worrying in children:
- Aggression
- Irritability
- Crying
- Hyperactivity or mania (intense moods or energy levels)
- Depression
- Change in school performance
- Mood swings
Adults may also experience some of these symptoms, plus:
- Insomnia
- Delusions
- Hallucinations
- Blurred vision
- Clumsiness or incoordination resulting in falls or accidents
- Memory loss
- Trouble thinking or concentrating
- Severe fatigue and muscle weakness
- Frequent infections
- Seizures
- Severe fatigue or weakness
Many tolerate gabapentin just fine, but being aware of the full range of potential reactions is vital for its safe use.
Most people won’t experience the worst-case scenarios. But even “milder” effects like debilitating fatigue and unexplained muscle weakness or pain can still seriously degrade your quality of life.
Don’t brush these symptoms off as no big deal. Changes in mental status or personality are huge red flags—get those evaluated immediately before they escalate to an emergency.
Is Gabapentin Addictive?
To be clear, gabapentin isn’t an opioid, narcotic, or controlled substance in most states. But like opioids, gabapentin affects the same brain pathways or neurotransmitters as opioids, which are super addictive.
That means gabapentin does carry a risk of misuse, dependence, or addiction in some people. And this is why the following states have scheduled it as a controlled substance:
- Alabama
- Kentucky
- Michigan
- North Dakota
- Tennessee
- Virginia
- West Virginia
There are more and more people using gabapentin to catch a buzz or amplify the high of other drugs. Some take it to enhance the euphoric effects of opioid painkillers. In hefty doses, gabapentin can mimic a marijuana-like high.
Even when taken as prescribed, your body can become physically dependent on gabapentin over time. Abruptly stopping taking it can have adverse withdrawal symptoms.
When people can no longer get scripts from their healthcare providers, they turn to illegal means to score gabapentin. Some visit multiple doctors to get prescriptions, a tactic called doctor shopping. Others try to get gabapentin off the streets, where it’s known as “Gabbie” or “Johnny.”
What Caused Gabapentin Misuse?
When gabapentin came out, it was marketed as this completely safe, non-addictive medication with little to no abuse potential. Since the FDA approved the drug, doctors began dispensing gabapentin for all kinds of off-label use, even with mixed results.
However, the evidence of pretty concerning risks is piling up. It has quickly become quite clear that gabapentin can lead to dependence and substance use disorder, a more acceptable term for drug addiction.
Even worse, the CDC found that gabapentin-related overdose deaths doubled from 2019 to 2020 as its use skyrocketed.
Part of the problem is overprescribing the drug off-label when safer, better first-line treatment options are available. In 2004, Pfizer pleaded guilty and agreed to pay $430 million in penalty for promoting Neurontin for off-label uses.
It was found that 90% of Neurontin’s sales came from non-approved treatments for health problems, including bipolar disorder and attention deficit disorder.
Does Gabapentin Cause Withdrawal Symptoms?
We’ve already established that gabapentin can cause dependence and addiction. So, when you take it away abruptly, there’s a rebound effect that can trigger some pretty unpleasant and even dangerous withdrawal reactions.
Common gabapentin withdrawal symptoms include:
- Anxiety
- Insomnia
- Restlessness or fatigue
- Irritability
- Nausea
- Headache or dizziness
- Sweating
- Tremors
- Light sensitivity
- Irregular heartbeat
- Muscle pain
In rare cases, gabapentin also triggers seizures. This is especially concerning since gabapentin is an anti-seizure medication to begin with!
The risk of going through withdrawal seems to increase the longer you’ve been on gabapentin and the higher the dosage. Older adults may also be more susceptible to having severe discontinuation symptoms.
That’s why I can’t stress enough the importance of tapering off gabapentin slowly under medical supervision. Tapering your dose over weeks or months allows your brain to readjust to your usual self.
Not everyone will experience withdrawal from gabapentin. But it’s just not worth the gamble of finding out the hard way by quitting it suddenly on your own. Work closely with your prescribing doctor on a safe, medically approved treatment plan if you need to discontinue gabapentin.
The bottom line is that gabapentin is powerful stuff your body can get used to. Quitting it cold turkey, even if you’re on a low dose, can disrupt your brain chemistry and cause problems.
What Medications Interact With Gabapentin?
There’s quite a list of drugs that can cause interactions with gabapentin. On top of it are drugs that can make you feel drowsy or less alert, including:
- Narcotic painkillers (oxycodone, hydrocodone, morphine)
- Anti-anxiety meds or sedatives (benzodiazepines, barbiturates, sleeping aids)
- Antidepressants (Prozac, Zoloft)
- Antipsychotic drugs (clozapine, haloperidol, promazine)
- Anti-malaria (mefloquine)
- Muscle relaxants (cyclobenzaprine, methocarbamol)
- Some over-the-counter antihistamines for colds and allergies (loratadine, diphenhydramine)
- Supplements (Ashwagandha, passionflower, valerian)
Here are a few more reminders to consider before starting gabapentin:
- Give your doctor or pharmacist a full rundown of any other medications, supplements, or OTC drugs you take. That way, they can rule out possible interactions.
- Try to space out gabapentin from antacids by at least 2 hours since they can mess with how your body absorbs gabapentin.
- Reduce your caffeine intake, which can interfere with sleep and crank up specific side effects like drowsiness.
- Skip the alcohol when you’re on gabapentin—it adds more respiratory risk.
What Are the Long-Term Effects of Gabapentin?
Long-term use of gabapentin can cause serious risks.
On a mental level, behavioral changes and mood swings are common after taking gabapentin for a while. You might struggle with anxiety, depression, irritability, or just a general feeling of being unlike your usual self.
Gabapentin can also put this hazy cloud over your memory and cognitive abilities after prolonged use. People describe having trouble concentrating, feeling scatterbrained, and struggling to recall things.
The physical effects are no joke, either. Muscle weakness or loss of muscle tone seems to happen for a lot of long-term gabapentin users.
If you’ve been on gabapentin for months or years, keep a very close eye out for any of these changes.
How Long Does Gabapentin Stay in Your System?
Gabapentin is metabolized in the kidney instead of being broken down by the liver like most drugs. This is why it doesn’t stay long in your body. Your kidneys filter out gabapentin unchanged, and you pee it out in its original form.
The half-life of gabapentin is 5–7 hours, meaning it takes that long to break it down to half its concentration. Considering this, gabapentin should clear out of your system within 48 hours.
Now, urine tests can sometimes detect traces of gabapentin for up to three days after. In effect, the higher the dose of gabapentin, the more will be present in the urine.
What if you’re on extended-release gabapentin? Well, it’ll remain in your system longer since this formulation releases the drug gradually over a certain period.
Of course, decreased kidney function can slow down your ability to excrete gabapentin. In contrast, heavier individuals tend to get rid of it much faster. Drinking lots of fluids can also help flush it out quicker.
Who Should Avoid Gabapentin?
Gabapentin is probably not a good option if you’ve ever struggled with substance abuse in the past, especially with prescription opioids. It’s best to avoid it if you’ve had depression, suicidal thoughts, or other behavioral problems.
People with kidney issues or on hemodialysis also need to be careful, as gabapentin is filtered through the kidneys.
Most doctors advise against taking gabapentin while pregnant or breastfeeding unless the benefits seriously outweigh the risks to the baby. The same goes for when you’re trying to get pregnant.
And, stay away from gabapentin if you’ve ever had an allergic reaction to it or any of its ingredients before. As with any medication, be honest with your doctor about your complete medical history before starting gabapentin.
Is There a Safer Alternative to Gabapentin?
Your doctor may explore other prescription medications in place of gabapentin. They may consider certain antidepressants (Cymbalta, Elavil), anti-seizure meds (Klonopin, Lyrica), or topical pain relievers (Lidoderm patch).
Each has potential side effects to weigh but may be better suited for your particular condition.
If you want to avoid pharmaceutical drugs altogether, the following alternatives are worth exploring:
- Capsaicin (found in cayenne pepper) can relieve pain for nerve conditions you’d use gabapentin for. The active ingredient seems to help quiet those misfiring pain signals.
- Some vitamin supplements have shown promise for nerve pain management. For example, vitamin B12 can improve nerve function, while zinc can regulate pain pathways in the brain and nerves.
- Yoga can reduce the need for nerve pain meds when practiced regularly.
What Is the Safest Way to Quit Gabapentin?
The absolute safest approach to quitting gabapentin is to go through a gradual dosage taper planned out carefully with your prescribing doctor. This way, your brain, and body can slowly readjust readjusting without it.
Your doctor will likely have you reduce your dosage by a small amount, maybe 100–300 mg, every four days. They’ll monitor how you tolerate each dosage drop before scaling back further. The taper can take several weeks or even a few months.
During this period, be hypervigilant about new or worsening symptoms. Let your doctor know so they can adjust your dosage schedule.
FAQs
Can Gabapentin Cause Serious Brain Damage?
There’s no concrete proof that gabapentin damages your brain. However, an animal study raises concerns about neurodegeneration in adults with chronic gabapentin use.
Does Gabapentin Make You Forget Things?
Memory problems and brain fog are common side effects, especially at higher doses. The good news is that they usually go away once you stop taking gabapentin.
However, don’t quit on your own. Consult your doctor so they can wean you off gabapentin safely if you need to.
Can You Overdose on Gabapentin?
Yes, gabapentin can lead to an overdose and even be fatal in high amounts, especially when mixed with opioids. The toxic dose can vary from person to person based on age, weight, or other meds you’re taking.
What Is the New Warning on Gabapentin?
In 2019, the FDA required a boxed warning for gabapentin about potential breathing problems in older patients and those with respiratory issues. If you already have COPD (chronic obstructive lung disorder), taking gabapentin can cause flare-ups or worsen the condition.
The risk increases if you’re also taking an opioid or depressant with gabapentin. If you’re on these drugs, your doctor will start you on a low dose and monitor you for any respiratory symptoms.
Final Thoughts
I hope that with this guide, you’ll never have to say, “Gabapentin ruined my life.”
Look, gabapentin can be incredibly helpful for managing several conditions when appropriately used. But we can’t also stick our heads in the sand and act like it’s a harmless little pill without any risks.
The hard truth is that gabapentin requires the same caution as any psychoactive medication with the potential for misuse. It’s not technically a narcotic, but it’s not something to take lightly.
So, here are a few takeaways to keep in mind:
- Be upfront with your doctor about any history of substance abuse issues.
- Only use gabapentin for approved medical reasons and under strict supervision.
- Follow the dosing instructions in the letter.
- When it comes time to stop taking it, have a plan for weaning yourself off gabapentin safely. Again, talk to your doctor.
