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Gabapentin Withdrawal: Symptoms, Effects, & Treatment
Gabapentin withdrawal can cause symptoms like anxiety, nausea, tremors, flu-like symptoms, and more. Gabapentin is a prescription medication marketed in the United States as Neurontin, Horizant, and Gralise.
Its FDA-approved uses include treating postherpetic neuralgia (nerve pain from shingles), partial seizures, and restless leg syndrome (in extended-release Horizant formulation) [1], but it has also been prescribed off-label for alcohol use disorder.
Gabapentin works by affecting the way nerves send messages to your brain, helping to reduce pain and prevent seizures.
This page explores gabapentin withdrawal, its symptoms, side effects, and treatment. Read on to learn how to recover from gabapentin withdrawal and how to access our comprehensive recovery detox program at California Detox.
Gabapentin abuse is uncommon. When abuse occurs, it is most often polysubstance abuse that involves alcohol, opioids, or benzodiazepines [2].
It is possible to develop a physical dependence on gabapentin, even when the medication is used as directed. The risk of dependence and severe gabapentin withdrawal symptoms upon gabapentin discontinuation increases significantly if the medication is abused.
Misusing gabapentin, especially when combined with opioids, can lead to severe side effects including dizziness, drowsiness, respiratory depression, and an increased risk of overdose​.
Research shows that withdrawal symptoms of gabapentin can occur in people who were prescribed gabapentin doses of 400mg to 8,000mg for three weeks or more [3].
The side effects of gabapentin withdrawal [4] are often similar to some symptoms of benzo and alcohol withdrawal, with all these substances acting on GABA (gamma-aminobutyric acid), which is an inhibitory neurotransmitter in the brain.
The onset, presentation, and duration of gabapentin withdrawal are influenced by factors that include:
Dose of gabapentin
Duration of use
Age
Underlying physical health conditions
Co-occurring mental health disorders
Concurrent use of other addictive substances
Detoxing from gabapentin involves eliminating the substance and toxins from the system. All cases of gabapentin withdrawal, also known as Neurontin withdrawal, are unique.
Some people may find it possible to detox at home by following a tapered schedule prescribed by a healthcare provider, particularly if they’ve been taking lower doses for shorter periods. However, in many cases it can be dangerous to try withdrawing from gabapentin at home without proper medical supervision.
If you have a history of life-threatening Neurontin withdrawal symptoms – seizures, for instance – you should engage with a supervised medical detox for gabapentin to manage withdrawal symptoms. Detoxing from gabapentin in this environment provides continuous supervision by medical professionals who are committed to keeping you as safe and comfortable as possible and helps minimize withdrawal symptoms during the detox process.
Those with pre-existing health conditions should also consider engaging with a supervised medical detoxification program.
Additionally, individuals who are addicted to multiple substances may benefit from a clinical detox when withdrawing from gabapentin. Studies show that one in five of those diagnosed with opioid addiction also report abusing gabapentin [5].
To ensure a safe and comfortable withdrawal from gabapentin, healthcare professionals suggest a gradual reduction in dosage [6]. This approach is commonly used with drugs like gabapentin that have the potential to cause adverse withdrawal effects upon discontinuation.
The tapering schedule for gabapentin can range from one week to longer, depending on the patient’s individual needs. The daily dose is typically reduced at a maximum rate of 300mg every four days, although a slower taper may be recommended for a smoother discontinuation. Ultimately, the goal of detox is to minimize the risk of withdrawal symptoms while allowing the individual to safely wean off the medication. Detox is not a substitute for treatment, but rather provides a bridge to ongoing therapy in an inpatient or outpatient setting.
Although the mechanism of action underpinning gabapentin withdrawal is not established, the presentation of withdrawal symptoms indicates the development of physical dependence in those who have been using the medication long-term.
Understanding the difference between dependence and addiction is important when discussing gabapentin withdrawal.
Physical dependence can arise in people who use certain medications or illicit drugs for more than a few weeks. Regular use leads to the body adapting and expecting the substance to be present to function properly. Once a person who is dependent stops taking the drug or reduces their dose significantly, they may experience withdrawal symptoms.
Dependence often occurs alongside tolerance, where a person’s system no longer responds to the drug as it did before. This leads to the need for higher doses to achieve the desired effect.
Physiological dependence and addiction are not interchangeable. Someone who is using a medication to treat a chronic condition may develop some physical dependence, but if they take the drug as prescribed and under medical supervision, they are not diagnosed with an addiction. Addiction (substance use disorder) involves compulsive drug-seeking behaviors that negatively impact other areas of a person’s life. Substance use disorder is a chronic and relapsing brain condition that often but not always involves physiological dependence [7].
Those who intentionally misuse or abuse gabapentin are more likely to develop significant gabapentin dependence, but abusive patterns of use may also emerge in people who were initially prescribed the drug before transitioning to gabapentin abuse.
When gabapentin use is abruptly discontinued or the dosage is rapidly reduced, a person may experience withdrawal symptoms. These may be physical symptoms or psychological symptoms. The following is a list of common and rare withdrawal symptoms associated with gabapentin:
Common symptoms:
Anxiety
Panic attacks
Confusion
Disorientation
Fatigue
Headache
Nausea
Excessive sweating
Mood swings
Agitation
Sleep disturbances or disrupted sleep patterns
Rare symptoms:
Chest pain
High blood pressure
Symptoms resembling upper respiratory tract infections
Note: Those who take gabapentin to manage seizures and suddenly stop taking it may experience a rebound in or increased frequency of seizure activity, including continuous, uncontrollable seizures (status epilepticus).
Gabapentin withdrawal symptoms typically occur within 12 hours to 7 days after discontinuing the medication. In some cases, withdrawal symptoms may last up to 10 days. If you are considering discontinuing gabapentin or experiencing withdrawal symptoms, consult with your healthcare provider to ensure proper management of the condition.
The treatment for gabapentin withdrawal typically involves a combination of medications and supportive therapies to manage the withdrawal symptoms and promote overall well-being. The specific approach to treatment may vary depending on the severity of the symptoms and your medical history.
Medical detoxification: In cases of severe gabapentin withdrawal symptoms, medical detoxification may be necessary. This involves a gradual tapering of the medication under the supervision of a healthcare professional to minimize the risk of seizures or other complications. Engage with gabapentin detox at an inpatient drug rehab like California Detox or at a licensed medical detox center.
Medications: Certain medications like benzodiazepines, anticonvulsants, and anti-nausea medications may be used to alleviate specific withdrawal symptoms.
Supportive therapies: Therapy sessions can help you to understand your addiction, learn coping strategies, and manage symptoms of any underlying mental health disorders. These may include group therapy, family therapy, CBT (cognitive-behavioral therapy), and Dialectical Behavior Therapy (DBT), which combines cognitive-behavioral techniques with mindfulness practices.
Ongoing support: After completing treatment, you may benefit from a strong support system, such as attending support groups or participating in aftercare programs. This can help prevent relapse and promote long-term recovery.
In some cases, individuals who are at high risk of experiencing or are already displaying severe withdrawal symptoms may require intensive inpatient monitoring and medical withdrawal management if complications arise during the detoxification process.
If you or someone you know is struggling with addiction to gabapentin, California Detox in Southern California is here to help you move beyond substance use disorder. Our detox and addiction recovery centers are committed to providing comprehensive recovery detox and inpatient programs for prescription drug addiction.
We offer a medically supervised detox program in a structured environment that ensures the safest and most comfortable pathway to detoxification and ongoing recovery. Once your system is cleared of addictive substances like gabapentin, you can transition directly into one of our specialized treatment programs for substance use disorder, including:
30-day inpatient program
IOP (intensive outpatient program)
If you are struggling with both addiction and a co-occurring mental health condition such as anxiety or depression, our dual diagnosis treatment program in Southern California offers a coordinated and integrated approach to care. We will work with you to develop an individualized treatment plan that may include interventions such as:
MAT (medication-assisted treatment)
Talk therapies like CBT or DBT
Group and individual counseling
Family therapy
Holistic therapies
At California Detox, we understand that everyone’s recovery journey is unique, and we tailor our treatment plans to suit your individual needs. Upon completion of your program, we will help you transition to a less intensive form of therapy or sober living, armed with relapse prevention strategies and a comprehensive aftercare plan designed to help you achieve long-term sobriety. We are committed to helping you every step of the way, from detox to discharge and beyond.
If you are ready to take the first step towards lasting recovery from gabapentin addiction, place your trust in California Detox. Contact us today at 888-995-4208 to speak with our admissions team.
[1] https://www.horizant.com/hcp/restless-legs-syndrome
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573873/
[3] https://pubmed.ncbi.nlm.nih.gov/21652784/
[4] https://alpha-psychiatry.com/en/gabapentin-withdrawal-in-a-depressed-patient-a-case-report-131471
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333539/
[6] https://www.hey.nhs.uk/wp/wp-content/uploads/2016/03/pregabalin.pdf
[7] https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addicti
Why I should relocate for rehab?
