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What is Gabapentin?

Gabapentin belongs to a class of medications called anticonvulsants. Common brand names for this drug include Gralise®, Horizant®, and Neurontin®.  

Gabapentin

This drug helps to treat various medical conditions. For example, it can facilitate the management of certain forms of seizures in individuals who have epilepsy. However, healthcare providers may also prescribe this drug for: 

  • Postherpetic neuralgia (PHN) individuals with PHN experience burning, stabbing pain that could continue for months or years after a shingles attack.  
  • Restless leg syndrome (RLS) individuals with RLS feel discomfort and restlessness/excitation in the legs, particularly during the night or sitting or lying down. 

Other uses of gabapentin include: 

  • Pain relief for diabetic neuropathy (numbness or tingling sensation resulting from nerve damage in individuals with diabetes)
  • Prevent hot flashes caused by breast cancer treatments or menopause 

While gabapentin may seem like benzodiazepines or opiates, since they have some analgesic (pain relief) effects, the drug does not impact the neurotransmitter gamma-aminobutyric acid (GABA) binding, uptake, or degradation. This aspect lowers the likelihood of gabapentin misuse. 

Side Effects of Gabapentin

Using gabapentin can cause different side effects, including:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Headaches
  • Double or blurred vision
  • Memory difficulties
  • Strange thoughts 
  • Anxiety
  • Nausea
  • Stronger appetite
  • Weight gain

Some of the more serious side effects of the drug include:

  • Rash
  • Itching
  • Respiratory problems (breathing or swallowing)
  • Seizures
  • Swelling of the face, throat, tongue, lips, or eyes

Central nervous system depressants, such as antihistamines or muscle relaxants, can interact with gabapentin and result in stronger side effects. It is best to seek medical advice before mixing medications or even alcohol. 

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Is Gabapentin Addictive?

Gabapentin can create dependency, and individuals who stop taking the drug may report withdrawal symptoms like anxiety, insomnia, nausea, pain, and sweating. 

For individuals who use gabapentin to treat seizures, it is important not to stop taking the medication suddenly. Quitting gabapentin all at once could result in more frequent seizures. Therefore, clinicians may taper an individual’s dose over at least a week to minimize the risk of such symptoms. 

Additionally, some cases of gabapentin misuse and abuse have been reported. Many of the individuals who took higher than recommended doses of gabapentin had had a history of poly-substance abuse (using multiple drugs) or sought to alleviate withdrawal symptoms from other substances.  

Nonetheless, while gabapentin is structurally similar to the neurotransmitter GABA, it does not act in the same way that other substances like opioids or benzodiazepines do. 

Is Gabapentin an Effective Treatment for Alcohol Withdrawal?

While the answer to this question is not conclusive, early evidence from a study published in a leading medical journal (Journal of the American Medical Association) suggests that gabapentin may help treat alcohol withdrawal and promote alcohol abstinence. 

In the study, a randomized clinical trial explored gabapentin against a placebo in individuals experiencing high alcohol withdrawal symptoms. While 1% of the placebo participants reported total abstinence, 41% of the gabapentin participants reached total abstinence. 

This study is promising, and data (combined with other studies) imply beneficial effects of gabapentin use in individuals with an alcohol use disorder (AUD). However, more studies are needed, especially in individuals with AUD with more severe liver disease and those with psychiatric and health conditions. 

Finally, as the study authors report, supportive counseling or Alcoholics Anonymous (AA) attendance may have contributed to retention in treatment. 

Can I Drink Alcohol While Taking Gabapentin?

No. Individuals taking gabapentin should not consume alcoholic beverages or other medication types that can cause drowsiness or dizziness. Drinking alcohol could increase the severity of symptoms, as well as the risk of overdose or death. 

Gabapentin and Alcohol Side Effects

Gabapentin is a type of drug that could cause drowsiness or dizziness, slow thought processes, and lead to a loss of coordination. Additionally, individuals using this drug could experience changes in mental health. Some report suicidal thoughts or experience irritability or depression. 

As alcohol is a CNS depressant, the beverage has similar side effects, and gabapentin-alcohol interactions could have harmful, life-threatening effects on the body. 

In more severe cases, alcohol and gabapentin use could cause respiratory depression (difficulty breathing or swallowing), and death may occur. 

Individuals should avoid consuming alcohol while taking gabapentin. 

Risks of Mixing Gabapentin and Alcohol 

There are multiple risks associated with gabapentin and alcohol. Because of gabapentin-alcohol interactions, individuals may experience worse and unwanted side effects. 

Also, the risk of death by overdose is possible. Should individuals overdose on gabapentin, alcohol consumption may heighten the severity of these symptoms:

  • Lethargy
  • Tremors
  • Diarrhea
  • Ataxia (lack of muscle control or coordination)
  • Drowsiness
  • Unconsciousness
  • Irritability

Lastly, the risk of gabapentin-alcohol interactions is higher in women and the elderly. Both women and the elderly cannot metabolize alcohol efficiently. This means that alcoholic beverages can be present in the body for longer periods and interact with gabapentin.

Drinking alcohol could speed up the drug release rate from gabapentin enacarbil extended-release tables, raising the risk of stronger CNS effects.

Treatment for Gabapentin and Alcohol Use Disorder (AUD)

If you or a loved one experience difficulties with gabapentin and alcohol abuse and dependence, many addiction treatments are available, such as:

  • Supervised detoxification or withdrawal process
  • Rehab and support groups 
  • Outpatient clinics
  • Medical therapy
  • Counseling 
  • Medication-assisted treatment (MAT)

Medication-assisted treatment has been shown to reduce alcohol use among individuals living with alcohol addiction. It could provide the support needed to respect alcohol abstinence. Additionally, cognitive-behavioral therapy (CBT) sessions may give individuals the coping skills to help deal with triggers or scenarios that could bring about alcohol consumption. 

Naltrexone, acamprosate, and disulfiram are possible prescription drugs for AUD treatment.

While recovery is never easy, it is possible with the right support, care, and medical guidance.

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Resources

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Anton RF, Latham P, Voronin K, et al. Efficacy of Gabapentin for the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Randomized Clinical Trial. JAMA Intern Med. 2020;180(5):728–736. doi:10.1001/jamainternmed.2020.0249

“Gabapentin: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, 15 May 2020, medlineplus.gov/druginfo/meds/a694007.html

National Center for Biotechnology Information. "PubChem Compound Summary for CID 3446, Gabapentin" PubChem, https://pubchem.ncbi.nlm.nih.gov/compound/Gabapentin. Accessed 26 January, 2021.

NEURONTIN (Gabapentin). Food and Drug Administration, www.accessdata.fda.gov/drugsatfda_docs/label/2017/020235s064_020882s047_021129s046lbl.pdf.

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