Gabapentin Uses, Dosage, Side Effects and Precautions

If you suffer from partial seizures, movement disorders, or have significant nerve pain, then Gabapentin may have been suggested for you.

Unfortunately, this is a drug that is often misused; this guide is meant to help you understand Gabapentin’s uses and side-effects so that you can be more informed about it before deciding if it is right for you.

What is Gabapentin?

Gabapentin is an antiepileptic drug that is designed to minimize seizures and treat neuropathic pain.

This drug has the same molecular design as the gamma-aminobutyric acid (GABA) that is released in your brain, and since this drug can cross the blood-brain barrier, it can greatly reduce the frequency of seizures that an individual is experiencing (1).

The effects of this treatment are not fully understood, but this drug is capable of increasing GABA in the brains of both humans and rodents, which is promising for individuals who suffer from seizures (2).

One of the reasons that this drug is so effective is that it binds to the calcium ions that are present in the spine and the brain, which decreases neurotransmitters in the body and thus reduces the abnormal brain activity that causes tremors and seizures (3).

What is Gabapentin Used For?

Reduces Seizures in Drug-Resistant Partial Epilepsy Patients

When an epileptic individual does not respond to traditional treatment, sometimes the seizures that they experience can only be controlled with the additional intervention (4).

If you have partial epilepsy or focal epilepsy, which is a condition when seizures are prone to occur on one side of the brain instead of on both sides, this form of treatment is often used in combination with other medications (5).

This treatment can reduce both the number of partial seizures that occur in a patient, as well as the complexity of the episodes.

In a study that was conducted with 1206 patients who have drug-resistant partial epilepsy, the number of seizures that they experienced dropped significantly when they underwent treatment (6).

This drug has also been found to protect the brain from the toxins that are known to produce a seizure in animals; these tests were conducted on rats, and the age of the rat did not significantly change the results (7, 8).

Reduces Pain

This form of treatment is great for reducing pain that you may be feeling as a result of nerve damage.

This includes neuropathic pain that may be caused by illnesses like shingles or even diabetes (9).

Fortunately, this medication is also a great relief for patients suffering from other diseases that may cause debilitating pain; this includes illnesses such as multiple sclerosis (MS), fibromyalgia, and others (10).

• Multiple Sclerosis – MS is an autoimmune disease that affects the brain, and 80 percent of all of the MS patients who have been diagnosed with this illness suffer from spasticity or severe muscle contractions that can cause extreme pain and may even impair walking and mobility. It has been discovered that this form of treatment, with a daily dose of both 300 mg and 900 mg, has reduced the number of episodes that patients with MS experience (11, 12, 13).
• Fibromyalgia – This is a disease that causes individuals to experience pain in their bodies for a period of three months or more at a time; sadly, it affects nearly two percent of the entire population. A study that was done on 150 fibromyalgia patients has determined that this form of treatment has reduced the pain that approximately one-half of the patients felt by 30 percent or more, and this improvement in pain also increased their ability to get a good night’s sleep (14, 15, 16).
• Cancer – Cancer can be painful, and in many cases, morphine is used to help ease the pain that a patient is feeling, but when taken with this treatment, the dosage that is required to enhance the patient’s quality of life can be reduced (17).

In a study of 5,914 patients who were suffering from such pain, 30 to 40 percent of the individuals who were taking a daily dose of 1,800 to 3,600 mg noted a pain reduction of at least 50 percent in “worthwhile” areas.

While these study participants experienced less pain, they also experienced fewer sleep disturbances, and less fatigue and depression.

There was also an improvement in their quality of work, quality of life, and quality of function.

Not all of the patients who participated in this study experienced the same level of relief; in fact, some felt that the side effects, which included sleepiness, dizziness, and swelling of the limbs, were too severe when compared to the benefits (18).

Another, the smaller study was conducted that focused on a group of 351 patients who suffered from at least two of the following symptoms:

• Burning pain;
• Shooting pain;
• Allodynia, or pain that is caused by stimuli that are typically painless;
• An increased sensitivity to pain.

The majority of the participants noticed a significant improvement in their neuropathic pain, as well as their quality of life (19).

There have also been a few case studies that provide evidence that this treatment reduces sciatica, which is pain that is centered in the back and can spread to below the knees.

Often this type of pain stems from pregnancy, infections, a herniated disk, or even a tumor (20).

Helps with Restless Leg Syndrome and Tremors

Restless leg syndrome causes you to move your legs involuntarily when you are trying to sleep.

The condition is known to interrupt the sleep of those with the condition, but with regular doses of Gabapentin, patients will notice decreased limb movement, a decrease in pain, and higher-quality sleep at night (21).

It was also discovered that patients with concurrent restless leg syndrome and kidney failure can also use this form of treatment in combination with dialysis to treat their symptoms (22).

Tremors are a similar involuntary movement, but they occur while you are conscious and attempting to conduct your daily activities.

A study involving 16 patients showed a significant reduction in tremors for those who were not taking any medication for the condition, but in the patients that used this medication as an add-on, the effect was minimal (23, 24, 25).

Gabapentin for Anxiety

There have been several studies conducted on individuals with anxiety to determine whether or not taking Gabapentin for it is beneficial.

One study on 50 females who were suffering from moderate and high levels of anxiety showed that 1,200 mg taken before a surgery could significantly lower the patient’s anxiety level about experiencing pain during the procedure (26).

Some individuals suffer from severe anxiety, which causes them to fear social situations, so they will often stay at home because they are too afraid to go out.

A small study done on eight individuals determined that a daily dose of 1,800 mg a day can help to reduce anxiety in patients with a social anxiety disorder (27).

This same dose of medication can also improve a patient’s ability to sleep, especially if the insomnia is caused by an anxiety-related disorder, but it can also help to reduce irritability, depression, anticipatory anxiety, phobic avoidance, and self-medication.

Helps to Treat Migraines

One of the gabapentin’s uses that you may not be aware of is the treatment of migraines.

A study with 143 patients found that taking 2,400 mg of the medication each day could reduce how often the patients got a migraine by nearly half (28).

In another study, similar results were discovered with a dose of 1,200 mg a day, which is half of the amount taken by the first group (29).

In fact, when it comes to headaches of any type, daily doses of this medication can reduce the release of Calcitonin gene-related peptide and substance P so that the inflammation and pain you feel when you get a headache can be minimized (30).

Helps Prevent Hot Flashes

Hot flashes are a symptom that occurs in women who are going through menopause, but they can also affect women who are undergoing hormonal changes.

This can occur simply because you are getting older, or it can be brought on by a more traumatic event in your life like breast cancer.

Regardless of the cause, hot flashes can affect your sleep, and a study looking at 58 breast cancer survivors who were experiencing hot flashes found that taking the drug on a daily basis could greatly improve the quality of sleep (31, 32).

Helps with the Hiccups

Chronic hiccupping can be disruptive to your daily life, and if you cannot get them to go away, you can even start to feel pain in your chest from the constant hiccupping.

Over the years, there have been more than a few case studies on medications like this one improving chronic hiccupping and decreasing the frequency of hiccupping episodes.

Because many of the studies were conducted on patients who were suffering from other health issues, determining how effective the treatment is for hiccups is difficult.

In one specific case, the patient had been dealing with chronic hiccupping over a period of 50 years, and when she began taking this medication in combination with the medication that she was already taking, her hiccups improved greatly.

That relief was short-lived; when she stopped taking it, the hiccups returned with the same intensity as before (33, 34, 35).

A Way to Treat Addiction

If you are suffering from an opioid addiction, fighting the withdrawal symptoms that are part of the recovery process can be difficult.

Some individuals experience chills, diarrhea, mood swings, muscle tension, and more, but according to a study that was conducted with 27 patients who were dealing with these withdrawal symptoms, taking a dose of 1,600 mg along with a dose of methadone can help reduce the symptoms, which can make dealing with the withdrawal more bearable (36).

In fact, a second study was conducted on patients with similar symptoms, but instead of 1,900 mg, they were only given 300 mg.

Even with this lower dosage, the relief from the withdrawal symptoms continued to be reduced (37).

Recent studies have also indicated that taking a daily dose of this medication may be able to prevent and treat methamphetamine addiction, as well as the addiction to nicotine and alcohol (38, 39).

How Should Gabapentin Be Stored?

For most medications, it is important to know how to store it to prevent bacterial growth and the medication becoming useless.

With this medication, there have been several studies conducted to find the best storage method for both the pill and liquid form.

Samples that were stored at 77 degrees Fahrenheit and 60 percent relative humidity did not show a change in weight after being stored in these conditions for a year.

Samples that were taken out of the original packages did differ in weight, but there was still not a significant difference in the potency of the drug.

When the medication was stored at 41 degrees Fahrenheit, crystallization became noticeable in the liquid.

This indicates that storage of the drug should always occur at room temperature, that it should not be refrigerated or frozen, and before ingesting the medication, it should always be shaken (40, 41).

Gabapentin Dosage

When you are considering the Gabapentin dosage that you need, you should know that the recommended dosage is going to depend on your body and the way that it responds to the medication.

A typical dosage is going to be between 900 and 3,600 mg a day, and oral doses of the drug should be taken three times a day.

Individuals who use this medication should be over 12 years of age, and in most situations, you should start out with a low dosage and adjust to the amount that your body needs (42).

Recommended Dosage for Individuals with Epilepsy

For an adult who is over the age of 12 and suffers from epilepsy, the recommended dosage is typically going to fall between 900 and 2,400 mg a day.

Doses will typically start at 300 mg a day, and then if that is not sufficient the dosage will be increased to two doses of 300 mg a day, and so forth, until the proper dosage is found for the individual.

In some cases, up to 2,400 mg, a day may be recommended, but it is not commonly required for most patients.

If the maximum dosage is required, it is typically going to be a treatment of 800 mg three times a day.

Children with epilepsy can also take this treatment if it is recommended by their physician.

Children who are three to four years of age will typically be prescribed a dose of 40 mg a day, which means roughly 13 mg three times a day.

The dosage for a child will vary based on their condition, but most children will take less than 65 mg a day (43).

Recommended Dosage for Individuals with Postherpetic Neuralgia

Individuals who suffer from postherpetic neuralgia, or a complication that can affect an individual’s nerves as a result of the shingles virus, are often prescribed a similar dose of the medication.

Typically, the dosage for this condition begins with 300 mg the first day, 300 mg twice a day on the second day, and 300 mg three times a day beginning the third day.

If the medication is not working properly, then it can still be increased as needed (44).

Recommended Dosage for Individuals with Kidney Problems

Individuals who have damaged kidneys should always start with a lower dosage than those who have healthy kidneys.

Make sure always to ask your doctor if this treatment is going to affect your kidneys so that they can offer treatment guidance.

The smallest capsule that is available is 100 mg, and this is often the dose that is suggested for individuals with kidney problems (45).

There are also 300 mg capsules and 800 mg capsules available for individuals who need a higher dosage, but these tablets are typically reserved for individuals who suffer from epilepsy or severe postherpetic neuralgia.

In India, these higher dosages are rarely prescribed.

In fact, 80 percent of the patients who are prescribed this take less than 300 mg a day (46).

Chances of an Overdose

The chances of overdosing on this medication are small because your body is not going to be able to metabolize it very well.

However, a patient who takes opioids in combination with this treatment is at a higher risk of an overdose.

The biggest risk occurs in patients taking the medication who also suffer from kidney problems.

These patients may have toxicity, and they can experience symptoms such as dizziness, a lack of energy, confusion, poor circulation, twitching, and shaking.

If the patient is receiving peritoneal dialysis, that treatment will eliminate the threat of toxicity (47, 48).

What to Do During an Overdose

Due to the long half-life of this drug, an individual who overdoses on this medication will need to receive medical attention right away.

If you are near someone who you think is experiencing an overdose, you will need first and foremost to check their airways to make sure that they are breathing.

Don’t forget to check their pulse, especially if their breathing is shallow.

If the individual is not conscious, call 911 right away.

You can also roll the individual on their side, tilt their head back to keep their airways clear and stay with the individual until help arrives.

Side Effects

Gabapentin’s side effects are typically mild, but they can affect how you function throughout the day, so it is important to know what you may experience while taking the medication.

Some of the more common side effects include (48, 49, 50, 51, 52, 53):

• Dizziness
• Poor circulation
• Sleepiness/Fatigue
• Nausea
• Memory loss
• Diarrhea
• Swelling
• Unexplained weight gain
• Infections

There have also been studies done on animals to determine whether or not the medication will negatively affect a pregnant mother.

It has been determined that it may, but since tests have not been conducted on humans, it is hard to determine exactly how the side effects differ in a pregnant woman (54).

As previously mentioned, a patient that has kidney problems will also experience side effects from the toxicity that is typically released through urine.

Such patients will need to take the medication in conjunction with dialysis so that the toxins can be removed from the body instead of building up (55).

Misuse and Getting High

We have all heard about the increase of opioid use in the US, but there has also been an increase in the misuse and abuse of this medication.

Individuals who misuse this medication are typically doing so to get a high from the drug, and it is often taken with other drugs to increase the effects of the high.

Individuals who take this drug, for this reason, will experience euphoria, relaxation, and a sense of calm like you would feel when you are using marijuana or amphetamine (56, 57).

When high doses of this medication (1,500 to 12,000 mg) are taken with alcohol, ibuprofen, morphine, methadone, baclofen, or quetiapine, euphoria can occur.

Sedation can also occur when 600 to 4,800 mg of the medication is taken with quetiapine, alcohol, marijuana, and buprenorphine (58).

Possible Withdrawal Symptoms

Anytime that you are going to stop taking a medication, you will want to reduce the amount that you are taking gradually, instead of just dropping the medication cold turkey (59).

With this medication, if you stop taking it abruptly, anxiety, nausea, and insomnia can occur.

These symptoms will typically appear 48 hours after you stop taking the medication, but they can occur between as soon as 12 hours after your last dose to nearly a week later (60).

In addition to these symptoms, you may also experience irritability, confusion, sweating, high blood pressure, tremors, gastrointestinal issues, disorientation, immobility, and even seizures.

If you are experiencing withdrawal while pregnant, your baby may also experience withdrawal symptoms when he or she is born (61).

Is this Medication Considered a Narcotic?

This drug is not officially considered a narcotic in the United States because, according to the FDA, a narcotic is defined to be one or more of the following (62):

• Opiates and their derivatives, such as morphine and heroin;
• Coca leaves and extracts with derivatives;
• Cocaine, ecgonine, and their derivatives, isomers, and salts;
• Poppy straw.

When the definition of what a narcotic is expanded, it could refer to any addictive or controlling drug that is designed to treat pain and that also affects your behavior and mood when used.

Effectively, a narcotic is the same as an opioid, but it is often seen in a more negative light (63).

This medication is designed to be prescribed to you by your doctor, but it is often sold as a street drug, which is why it is often abused (64, 65).

In addition, it is also often taken in conjunction with opioids (66).

Is this an Addictive Medication?

Though this medication can be addictive if it is misused, only one percent of the population misuses it (67).

The individuals who do so often experiment with anywhere from three to twenty times more than the recommended dose that would typically be prescribed (68).

In fact, one study found that 50 percent of individuals who misuse the medication use it recreationally or for self-medication.

Others combine it with alcohol, heroin, or opioids; these individuals are at the highest risk of becoming addicted (69, 70).

It has been discovered that about one in every five opioid abusers also abuses this medication, and when you combine these two types of substances, your chances of overdose increase.

Respiratory problems can occur, which can lead to death (71).

Addiction to this drug is possible, even in individuals who have no history of drug or alcohol addiction or abuse (72).

May Increase Alcohol Dependency

Though there is some basis to prove that this medication can help treat addictions, there have been studies conducted on rats indicating that taking this medication in conjunction with alcohol can create the risk of becoming dependent on alcohol (73).

Taking the drug with alcohol can also increase the effects that the alcohol has on your body, which means that taking both substances together could impair your coordination, your dexterity, and your ability to function normally.

May Affect Depression and Suicidal Thoughts

A study was conducted on depression that took both psychiatric and non-psychiatric patients into account, and neither of the groups showed an increase in the number of suicides.

In fact, there was actually a decrease in suicide risks amongst psychiatric patients (74).

There was a larger study that was done on nearly double the number of patients as the one previously mentioned; this determined that there was an increase of suicide attempts and violent deaths potentially due to the medication, which means that whether the drug causes depression and suicidal thoughts is controversial (75).

Interaction with Other Drugs

Taking this medication while using other drugs can affect you differently, as well.

As previously discussed, when the medication is combined with opioids, breathing issues can arise, which increase the risk of overdose and death (76).

In addition, when you take antacids with this medication, its effectiveness will be decreased greatly.

So if you are prescribed the medication, you will want to avoid taking an antacid for at least two hours (77).

Other Forms of this Medication

Pregabalin, which is a drug very similar to this one, is absorbed by the body more quickly, and is, therefore, more effective (78).

This medication is actually absorbed into the small intestine as well as the colon, instead of just the small intestine (79).

When it is absorbed more efficiently, individuals will not need to take as high a dosage.

In fact, most doses of pregabalin are between 75 and 600 mg a day.

Instead of three doses a day, individuals who take pregabalin will only need to take two a day, and the size of the dose does not affect how much of the medication is absorbed into your body.

Because of this, Pregabalin may be more effective in treating neuropathic pain, epilepsy, fibromyalgia, and anxiety, but the same side effects are going to be present (80, 81).

Regardless of which drug you take, neither will be able to be metabolized properly in your body, which means that the substance will be excreted when you urinate (82).

Gabapentin for Dogs and Cats

Do you have a pet who suffers from chronic pain?

Several studies have indicated that gabapentin for dogs will help reduce pain significantly when combined with morphine.

This treatment allows you to reduce the morphine that you are giving to your dog for pain management (83).

However, the treatment did not seem to work better than placebos after a surgical procedure (84).

This medication was also found to be extremely effective in dogs with epilepsy that were not responding well to other forms of treatment (85).

Conclusion

Gabapentin is a drug that is designed to be used to treat seizures and pain, so if you feel that it could be helpful for you to take this medication for your pain, you should consult your doctor to see if they feel that it is right for you.

The information here is not designed to diagnose or prescribe a treatment for you; it is simply meant to educate you so that the medication is not misused.