In recent years, gabapentin has been studied, and it has become popular for use in treating certain mental health disorders, including addiction. It has been promoted by some as helpful in getting through detox and in avoiding relapse to substance abuse. On the other hand, there are some concerns about how the drug works and whether it, too, can become the focus of addiction.
Those who are in addiction treatment may not know much about this drug and how it can affect them. In recovery, it can be helpful to understand how the drug affects the individuals who use it, so they know what to expect.
What Is Gabapentin?
Originally, gabapentin – the generic version of a medication used in brand name prescriptions Neurontin and Horizant, among others – was developed as an anticonvulsant to treat epileptic seizures. A potent drug for nervous system issues, it can also be used for restless leg syndrome and various kinds of nerve-based pain, as described on Drugs.com.
The action of gabapentin is not fully understood, but what is known is that it seems to stabilize brain activity through release of certain neurotransmitters, including those in the GABA system, which can lead to its anticonvulsive and pain control capabilities. However, the drug does not bind to GABA or other neurotransmitter receptors in the brain, so it was originally thought that the drug would not be implicated in addiction.
Gabapentin for Mental Health Care
As demonstrated in a report from the Medical Psychiatry Series, recent studies and practices have indicated that gabapentin can also be useful in treating a variety of psychiatric disorders, such as anxiety and depression. In addition, several trials have been performed that show gabapentin can be useful in helping people in addiction treatment to detox, particularly in withdrawal from alcohol and other depressants, like benzodiazepines.
A study from JAMA Internal Medicine shows that people recovering from alcoholism who used gabapentin were more likely to either fully abstain from or at least avoid heavy use of alcohol. For those who took 900 mg of the drug, 11.1 percent abstained completely, while 29.6 percent avoided heavy use. For those who took 1800 mg, the results were even more dramatic: 17 percent abstained while 44.7 percent were able to avoid heavy drinking.
Another study from the American Journal of Drug and Alcohol Abuse demonstrated that gabapentin can help in treating addiction to benzodiazepines for people who are in methadone maintenance treatment for opioid addiction. Because benzodiazepines are highly addictive, this is thought to be a relatively safe option for helping to avoid further addiction complications in these individuals.
Because gabapentin affects neurotransmitters that create a sense of sedation or relaxation in the body, the side effects are similar to those of depressants or alcohol. The National Library of Medicine’s Medline Plus includes a long list of side effects that can result from using gabapentin. These include:
- Drowsiness, tiredness or weakness, dizziness, or unsteadiness
- Headaches, memory issues, unusual thoughts, or anxiety
- Red or itchy eyes and double vision
- Ear pain and muscle or joint pain
- Digestive issues, increased appetite and weight gain, and heartburn
- Dry mouth, fever, and flu-like symptoms
It is possible that a person taking gabapentin can experience severe side effects, including allergic reactions that involve rashes or inflammation of the face and throat that can interfere with breathing or swallowing. In this case, medical help should be sought immediately. Even though the drug was developed to treat seizures, side effects of use can include seizures, and these require immediate medical intervention.
Another side effect of gabapentin use that has been reported in some cases is the potential for addiction. An article from Medscape indicates several cases that appear to demonstrate behaviors associated with addiction in those who have taken long-term gabapentin. Most of the individuals discussed also had histories of substance abuse. Some admitted to using the drug to make other drugs, like methadone, more potent.
Withdrawal symptoms also occurred for a number of these people when gabapentin use was stopped. These symptoms indicate that the body has become dependent on the drug, which contributes to addiction.
The mechanism through which gabapentin might cause addiction is not known. At stated above, it does not appear to interact with the main areas of brain chemistry that are understood to contribute to addiction. More research is needed to determine how addiction to the drug is occurring. Nevertheless, it is apparent that addiction is possible, particularly for those who have a history of or tendency toward addiction. For this reason, care should be taken in using the drug if these conditions exist.
Determining whether an individual has become addicted to gabapentin can be assessed through withdrawal symptoms (side effects of stopping use of the drug). The Medscape article indicates that these can include:
- Disorientation or confusion
- Irregular heartbeat
- Excitability and agitation
These symptoms can be uncomfortable enough to require hospitalization for some individuals to manage the worst elements of detox from the drug.
According to Mayo Clinic, it is also risky to stop taking gabapentin – or any antiepileptic drug – abruptly, as this can lead to increased seizures. Stopping gabapentin for any reason should be done under the care of a professional who has experience with gabapentin use and abuse.
For the reasons above, gabapentin use should not be initiated without the help of a doctor or other medical professional who understands the risks of using this drug. Working with a medical professional can help in controlling or managing side effects that the individual might experience. Medical support can also make sure that any serious side effects are noted immediately, and the individual can be taken off the drug safely without risk of more serious withdrawal symptoms and side effects.
When receiving gabapentin for addiction treatment, it is important to follow the prescription instructions accurately to decrease the chances for developing addiction. Staying in close collaboration with the treating professional about potential issues regarding addiction to gabapentin is also important.
Finally, if addiction to gabapentin – or the potential for addiction – is suspected, there are other options to treat alcohol and benzodiazepine addiction and other mental health conditions. These treatment options are supported by research as effective in helping individuals get control over substance abuse and avoid relapse back to use in the future. Finding a research-based, certified, and experienced treatment program is the first step toward obtaining successful individualized treatment for addiction.