Gabapentin is an anticonvulsant (antiseizure) medication approved by the FDA to treat several conditions. Doctors sometimes prescribe gabapentin “off-label” to treat other conditions as well. A 2022 report stated that gabapentin was among the 10 most commonly prescribed medications in the U.S.
What is gabapentin and what is it used for?
Gabapentin is used to control seizures, to treat nerve pain that can happen after having had shingles, and to treat a condition called restless legs syndrome.
In addition to these FDA-approved uses, doctors sometimes prescribe gabapentin off-label. Off-label use means there is some evidence to show that a drug may be medically appropriate to treat conditions other than those for which it was approved.
Gabapentin is sold under the brand name Neurontin and is available as a generic product as well. (Generic medications are chemically the same as brand-name drugs but may cost less.) Gabapentin is also available as an extended-release tablet that works for a longer length of time; this is the only formulation that is approved for restless legs syndrome.
Gabapentin is taken by mouth and comes in capsule, tablet, and liquid form.
Conditions treated with Gabapentin
Gabapentin is FDA-approved as Neurontin to treat partial seizures in adults and children with epilepsy. Partial seizures are convulsions that originate from a single location in the brain.
Neurontin is also approved to treat a type of nerve pain called postherpetic neuralgia, or PHN. PHN can happen after a person has had shingles, an infection from the same virus as chickenpox that causes a painful rash or blisters. Nerve pain from PHN can last for months, or even longer, after the rash has gone away.
An extended-release form of gabapentin is also FDA-approved to treat PHN.
Another extended-release form of gabapentin is FDA-approved to treat restless legs syndrome. This condition causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them around, especially at night, which disrupts sleep.
Off-label uses for gabapentin
Doctors often prescribe gabapentin off-label to treat conditions such as:
- pain from diabetic neuropathy, which is numbness or uncomfortable tingling caused by nerve damage from diabetes
- nerve pain in the neck and back from conditions such as sciatica, a painful compression of the sciatic nerve
- hot flashes, which are sudden feelings of heat and sweating that can happen in women after menopause and in those being treated for breast cancer
- mood disorders such as anxiety
- alcohol addiction.
How Gabapentin Works
In people with partial seizures, gabapentin works by decreasing abnormal activity in the brain. Experts believe gabapentin may cause brain cells to produce more of a chemical called GABA, which reduces abnormal electrical activity of brain cells.
In people experiencing nerve pain after having had shingles, gabapentin is thought to change the way pain signals are sent through the body and brain.
It’s not entirely clear how gabapentin works to treat restless legs syndrome.
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Blacklist
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Some bad guy sent us bounced checks or money orders. We will blacklist them without any hesitate because we have to pay the pharm their drug fee plus disposal fee, and we have to pay the processor fine too.
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Side effects of Gabapentin
Common side effects of gabapentin include:
- drowsiness or dizziness
- headache or blurred vision
- nausea, vomiting, diarrhea, constipation
- dry mouth
- weight gain
- swelling of the hands, feet, or ankles
- back or joint pain
- flulike symptoms such as fever or body aches.
Rare but serious side effects
Rare but serious side effects of gabapentin include:
- rash, itching, or yellowing of the skin
- swelling of the face and throat, a condition called angioedema
- problems speaking or swallowing
- changes in memory, ability to concentrate, or personality.
Gabapentin may cause breathing problems in people who use opioid pain medicines and those with chronic obstructive pulmonary disease (COPD). Older adults who take gabapentin also are at higher risk of breathing problems.
Because gabapentin can enhance the psychological effect of opioids, it has the potential to be abused and has contributed to drug overdose deaths.
Drugs such as gabapentin have been linked in rare cases to an increased risk of suicidal thoughts or behaviors. If you take gabapentin, you or your family should tell the doctor about any unusual changes in your mood, such as agitation, violence, aggression, depression, or talking about wanting to hurt yourself.
Safely stopping treatment with Gabapentin
If you stop taking gabapentin suddenly, there is a chance of having seizures. Instead, you may need to gradually reduce how much gabapentin you take until you stop it completely. Your doctor can advise you on how to safely stop treatment with gabapentin.
Does gabapentin help treat nerve pain?
Gabapentin can help relieve nerve pain in some people with postherpetic neuralgia (nerve pain after shingles) and peripheral diabetic neuropathy (nerve pain in the feet in people with diabetes). A Cochrane review reported that 3 to 4 patients out of every 10 with either of these conditions experienced at least a 50% reduction in pain intensity when prescribed gabapentin at dosages of 1800mg-3600 mg/day (gabapentin encarbil: 1200mg-3600 mg/day). This compared with only 1 or 2 out of every 10 given a placebo (an inactive treatment). People who had an improvement in pain relief with gabapentin are also expected to experience an improvement in sleep, fatigue, and in their mood.
This same Cochrane review reported that over half of those treated with gabapentin did not experience any worthwhile pain relief, but did experience side effects.
What type of nerve pain is gabapentin approved to treat?
Gabapentin is approved to treat nerve pain (neuralgia) that results from nerve damage. Gabapentin may be used to treat:
- Nerve pain caused by a herpes zoster viral infection, also known as shingles. This pain is called post-herpetic neuralgia (PHN), and it can be severe and chronic
- Nerve pain as a result of diabetic neuropathy, which happens when nerves in the feet damaged by diabetes cause chronic burning pain.
How does gabapentin work in nerve pain?
The exact way that gabapentin works to relieve pain is not known. It may change the way the body senses and reacts to pain. Gabapentin is used to manage long-term (chronic) pain, not to be taken for pain as needed. Chronic pain can interfere with sleep and work, and lead to depression.
How quickly does gabapentin work?
Studies show that pain relief may start within one week and reach a maximum effect in about 4 weeks. It can take this long because gabapentin is usually started at a low dose and gradually increased over time until it works.
For treating neuralgia, gabapentin is often started at 300 mg per day and gradually raised by 300 mg per day. One 2017 review of 37 studies found that pain relief usually occurs at a dose of 1,200 mg or more.
The same review compared gabapentin to an inactive medicine (placebo) in almost 6,000 adults with chronic pain from PHN or diabetic neuropathy. Study participants were given either gabapentin or a placebo for 4 to at least 12 weeks. The results showed that 30-40% of people taking gabapentin were able to reduce their pain by half or more, compared to 10-20% of people taking the placebo.
Although some people may get significant relief, others may have side effects without relief of pain. More than half of people taking gabapentin did not get significant relief and had side effects from the drug.
According to the review, about 60% of people taking gabapentin had side effects, including:
- Dizziness
- Sleepiness
- Water retention (edema)
- Clumsiness while walking (ataxia)
It does not typically make pain worse: In trials comparing gabapentin side effects to placebo side effects, only 1% of people reported increased pain, and this was the same for gabapentin and placebo.
Once you find the dose that relieves neuralgia for you, it is important not to stop taking it suddenly. Stopping suddenly can lead to withdrawal symptoms such as:
- Anxiety
- Insomnia
- Nausea
- Pain
- Sweating
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