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Insights on Gabapentin Withdrawal [What to Expect]
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Insights on Gabapentin Withdrawal [What to Expect]

Written by Seth Fletcher on May 17, 2024
Medical editor Dr. Chintan Shah
Last update: May 17, 2024

Gabapentin is a prescription medication used to treat epileptic seizures, neuropathic pain, and other forms of nerve damage. It is also used off-label to treat fibromyalgia, hot flashes, anxiety, and other physical and mental health concerns. Gabapentin is marketed under the brand names Neurontin, Horizant, and Gralise. 

Gabapentin is popular for its unique ability to tackle multiple conditions and is considered a less addictive alternative to opioids. However, its euphoric and relaxing effects come with the potential for abuse and dependence. So, when a person stops taking gabapentin suddenly, they may experience withdrawal, depending on how long they’ve been using the drug and whether they’ve developed physical dependence. So, what happens when you stop taking gabapentin? CCFA explains gabapentin withdrawal and how to wean off gabapentin safely.

Key Takeaways

  • Gabapentin withdrawal occurs when a person using the drug suddenly stops taking their medication
  • The severity of withdrawal symptoms depends on the dosage the individual was taking and the duration of use
  • Tapering off gabapentin helps to minimize withdrawal symptoms 
  • Most people with gabapentin withdrawal will feel better once the drug has completely left their system

What is Gabapentin Withdrawal?

Gabapentin withdrawal is a set of symptoms that can occur when someone who has been taking gabapentin suddenly stops using the medication. While gabapentin is a prescription-only medication, some people abuse the drug for its euphoric potential. Opioid users may also use gabapentin to achieve a more intense high. Like most addictive drugs, using gabapentin for recreational purposes or without a prescription can lead to dependence. 

Gabapentin’s mechanism of action is not fully understood, but it produces depressant effects on the central nervous system and changes the brain’s structure over time, leading to dependence. When a person who is dependent on the drug suddenly stops using or reduces their dosage, they may experience withdrawal from gabapentin.

Causes of Gabapentin Withdrawal

Gabapentin withdrawal occurs when the brain becomes dependent on the medication and has to adapt to functioning without it. Gabapentin is thought to increase the amount of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that regulates brain activity. Over time, the brain becomes accustomed to this increased GABA level, and when the medication is abruptly stopped, it takes some time to readjust. During this time, gabapentin withdrawal symptoms can occur. In some cases, people who have been taking it for a long time may experience withdrawal symptoms from gabapentin even when they taper off.

What Factors Can Affect Gabapentin Withdrawal

Several factors can affect whether a person experiences withdrawal from gabapentin or how severe these symptoms will be. The most important factors are how long a person has been taking gabapentin and how much they’ve been taking. The longer someone has been taking gabapentin and the higher their dose, the more likely they are to experience severe withdrawal after stopping gabapentin use.

Other factors that can affect withdrawal symptoms:

  • Age
  • Overall health
  • Use of other medications
  • Lifestyle factors (diet, exercise habits, sleep)
  • The presence of medical conditions like anxiety or chronic pain

How Long Does Gabapentin Withdrawal Last?

The length of time that gabapentin can vary significantly among individuals. Generally, symptoms will begin within 12 to 24 hours after the last dose and may continue for days or weeks. In rare cases, people may experience withdrawal symptoms for months. These symptoms typically peak within three to seven days and gradually fade over the next few weeks. Most people will have little to no symptoms after a month of coming off gabapentin.

Gabapentin Withdrawal Symptoms

Withdrawal symptoms of gabapentin include:

Anxiety and Agitation

Gabapentin works to reduce anxiety by increasing the amount of GABA, which regulates mood and reduces stress. When someone stops taking gabapentin, their GABA levels can drop, leading to anxiety and agitation. They may feel nervous and on edge or have trouble relaxing.  

Irritability

The disruption of brain chemistry from gabapentin withdrawal can leave a person irritable and unstable. Irritability can manifest as crankiness, moodiness, and a short temper. People may feel frustrated easily and tend to snap at others. They may also feel on edge and be more sensitive to stimuli. This symptom is usually at its worst during the first few days of withdrawal. 

Insomnia

Insomnia is one of the early symptoms of gabapentin withdrawal and can last for several days or weeks. When GABA levels drop due to drug use cessation, it can make it difficult to fall asleep and stay asleep. In some cases, insomnia from gabapentin withdrawal can be severe, causing fatigue and making it difficult to function during the day.

Fatigue

The body uses more energy as it tries to adapt to the absence of gabapentin. People going through withdrawal may lack the vigour to do simple tasks. They may also find it challenging to concentrate, focus, or relax. The fatigue may last for days to weeks, and getting enough rest and limiting physical activity is essential.

Nausea and Vomiting

Nausea and vomiting are two of the most common symptoms of withdrawal from drugs. They are due to the body’s attempt to rid itself of the drug. For gabapentin withdrawal, nausea may be mild or severe and may be accompanied by stomach cramps and diarrhea. Vomiting will occur if the body cannot tolerate the nausea. Staying hydrated by drinking plenty of fluids if you’re experiencing these symptoms is essential.

Headaches

Changes in brain chemistry may also cause mild to severe headaches. The headaches may be accompanied by sensitivity to light and sound. Some people may also experience dizziness and blurred vision. Rest, proper hydration, and over-the-counter pain relievers may help reduce headaches. 

Nightmares

Some people going through gabapentin withdrawal may experience nightmares or vivid dreams; this is thought to occur due to the disruption of the body’s sleep cycle and heightened stress levels. It’s helpful to try to relax before bedtime while avoiding large meals or caffeine. 

Drug Cravings

Like other types of prescription drug addiction, people going through prescription drug addiction may experience drug cravings. These cravings are caused by the brain’s desire to recreate the feelings of euphoria they experience when taking the drug. Gabapentin is addictive, and these cravings may be intense and persistent. Specific people, places, or circumstances may trigger cravings. For example, a person taking gabapentin in the evenings may find that they crave the drug more at night. 

Increased Heart Rate

Autonomic nervous system changes due to gabapentin withdrawal may increase heart rate and blood pressure. These symptoms may be distressing, and seeking medical help is crucial if they're severe or last for more than a few minutes. In most cases, the symptoms will return to normal after withdrawal. 

Seizures

Seizures are one of the more serious potential complications and side effects of gabapentin withdrawal. They are caused by changes in the brain’s electrical activity. The brain may be more susceptible to seizures due to changes in neurotransmitter levels. 

In rare situations, a person may experience a severe life-threatening condition known as status epilepticus. It occurs when a person experiences repeated seizures without regaining consciousness between them. Status epilepticus is a medical emergency and usually requires hospitalization. 

When stopping gabapentin, some of the other side effects include:

  • Dilated pupils
  • Muscle aches
  • Restlessness
  • Sweating 
  • Difficulty concentrating

People experiencing gabapentin withdrawal will experience these symptoms differently. Some people may have most of these symptoms, while others have only a few. The severity of symptoms depends on how much gabapentin they’ve used and how long they’ve been using it.

Gabapentin Withdrawal Timeline

Gabapentin’s withdrawal timeline varies for everyone, but there are general patterns that can be observed:

12 to 24 Hours

The first stage of withdrawal begins 12 to 24 hours after the last dose. During this stage, people may experience disorientation, anxiety, nausea, and vomiting. 

Day Three to Seven

After a few days, the symptoms may begin to subside, although some people may experience intense withdrawal symptoms for up to a week. The symptoms at this stage may include insomnia, increased heart rate, and sweating. 

After One Week

Symptoms should have subsided, but people with co-occurring mental health disorders may still struggle with depression, anxiety, or fatigue weeks to months after withdrawal.

Gabapentin Withdrawal Treatment

There is no specific medication for gabapentin withdrawal, but there are several options for treatment. The first step is to taper off gabapentin slowly. To taper means gradually reducing the dose over time instead of stopping abruptly. Tapering off of gabapentin can help to reduce the severity of symptoms. 

In cases where tapering is not enough to prevent withdrawal, doctors may prescribe other medications like benzodiazepines to help manage symptoms. These medications should only be used as prescribed, as they may also be addictive. 

Doctors may also recommend lifestyle changes to help with gabapentin withdrawal. These changes may include regular exercise, eating a healthy diet, and avoiding stimulants like caffeine. Getting enough rest and finding ways to avoid stress is also important.

Some people may benefit from therapy or counselling during gabapentin addiction treatment. Therapy helps the individual get to the root of gabapentin addiction or abuse and equips them with healthier coping skills.

When to Consult a Medical Professional 

You should consult a medical professional if you notice the following when using gabapentin:

  • Trying to stop gabapentin use multiple times unsuccessfully 
  • Using gabapentin for reasons other than prescribed 
  • Using gabapentin for non-medical reasons
  • Going for frequent prescription refills
  • Having intense cravings to use gabapentin 
  • Talking about using the drug often
  • Spending a great deal of time and money obtaining and using gabapentin
  • Decreased productivity at work or school due to gabapentin use
  • Continued gabapentin use despite adverse consequences on one’s health, work, or studies
  • Needing increased amounts of the drug to get the same effects – tolerance
  • Becoming dependent on gabapentin; unable to go about your daily activities without gabapentin
  • Experiencing withdrawal symptoms that stop when you start using the drug again

Our Tips on Managing Withdrawal from Gabapentin Effectively

Some tips to help you manage gabapentin withdrawal effectively include:

  • Do not withdraw from gabapentin at once. Taper off slowly to reduce withdrawal symptoms
  • Drink plenty of fluids to stay hydrated throughout the withdrawal period
  • Exercise regularly to reduce anxiety and stress
  • Eat a healthy diet rich in fruits, vegetables, and whole grains
  • Consider taking supplements such as omega-3 fatty acids, magnesium, and vitamin B
  • Spend time outside in nature – take a break from screens and electronics 
  • Consider relaxation techniques, such as meditation, deep breathing, or yoga
  • Speak to a professional if your symptoms do not subside
  • Seek support from friends, family, or a support group 

Gabapentin withdrawal is a challenging and uncomfortable process. Fortunately, there are ways to manage the symptoms and come out feeling better. If you’re not clear on how to get off gabapentin, it may be necessary to speak to a professional about your specific situation.The Canadian Centre for Addictions offers medical detox for gabapentin abuse and addiction in an environment that inspires lasting change. We help our clients understand their addictions and the healthier coping strategies available by engaging them in one-on-one counselling with certified counsellors, psychiatrists, and mental health professionals. Call 1-855-499-9446  to learn more about how we treat problems related to gabapentin abuse and addiction.

FAQ

Is gabapentin hard to get off of?

Gabapentin can be hard to get off of, especially if you’ve been taking it for a long time or at a high dose. The withdrawal symptoms can be uncomfortable and may last weeks to months. However, you can make the process easier and reduce the severity of symptoms by gradually tapering off the drug instead of stopping "cold turkey".

What is the biggest side effect of gabapentin?

Drowsiness is one of the most significant side effects of gabapentin. It is particularly problematic for those who use the drug during the day, as it can interfere with their work and daily activities. Other side effects of gabapentin include dizziness, headaches, nausea, and vomiting.

How much is too much gabapentin a day?

The amount of gabapentin that is considered too much depends on the individual. Most doctors start their patients on a low dose of the drug and increase the dose gradually as needed. The maximum recommended dose of gabapentin is 3600 mg per day, split into three doses. It’s essential to follow your doctor’s instructions so you don’t overdose on pills. You should also report any side effects or concerns to your doctor.

Can gabapentin cause weight gain?

Yes. Gabapentin may lead to weight gain in rare cases, as the drug can cause increased appetite and water retention in the limbs. Individuals on gabapentin may gain some weight a few weeks into their treatment.

Does gabapentin affect hormones?

There is no definitive research on gabapentin's effects on hormones. However, some studies have suggested that it may affect levels of hormones such as cortisol, testosterone, and estrogen. This study found that gabapentin was associated with decreased testosterone levels in men, while another could not find a link between gabapentin and lower cortisol levels.

Certified Addiction Counsellor

Seth brings many years of professional experience working the front lines of addiction in both the government and privatized sectors.

Dr. Chintan is a Board Certified Family Physician with an interest in holistic and preventative care as well as healthcare systems. Credentialed Physician with both American & Canadian Board of Family Medicine. Adjunct Professor in the Department of Family Medicine at the Schulich School of Medicine & Dentistry. Telemedicine clinician.

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