Gabapentin Withdrawal Timeline, Symptoms, and Treatment

Gabapentin (Neurontin) is a prescription medication that is used to treat partial seizures, neuropathic pain, restless leg syndrome, insomnia, and other conditions. It belongs to a class of drugs called anticonvulsants or antiepileptic drugs (AEDs).[1]

The medication was originally thought of as a safe, non-addictive drug that doctors could prescribe for nerve-pain-related conditions, providing a ray of hope in an ever-worsening opioid crisis. And although gabapentin is still not considered a controlled substance, it has proven itself to be a drug that comes with a slight to moderate risk for abuse and addiction.

When gabapentin addiction develops, the body gets used to having the drug in the system. Gabapentin withdrawal occurs when someone suddenly stops using the drug after long-term abuse. The gabapentin withdrawal timeline can vary in severity and duration depending on factors such as the dosage, duration of use, and overall health.

What Causes Gabapentin Withdrawal?

Withdrawal can occur when you stop using any habit-forming substance after prolonged use. However, the exact mechanism that causes withdrawal from gabapentin comes down to the way the medication affects the gamma-aminobutyric acid (GABA) in the brain.

GABA is a neurotransmitter that helps regulate central nervous system activity by reducing neuronal excitability and inhibiting nerve transmission. Excess levels of GABA reduce activity in the CNS, providing a calming and sedative effect, and gabapentin is known to increase levels of GABA in the brain.[2] In turn, the brain increases excitability to try to compensate for the depressant effects.

After using gabapentin in high doses and/or on a regular basis, the brain becomes accustomed to working harder to overcome the depressant effects of the medication. Then, if gabapentin is suddenly stopped or reduced in amount/frequency, balance in the brain is disrupted, and the brain continues to perform in an excited state. This results in uncomfortable symptoms of withdrawal as the brain needs time to adjust.

Symptoms of Gabapentin Withdrawal

Common symptoms associated with gabapentin withdrawal include:[3]

• Anxiety – Increased feelings of unease, restlessness, or worry.
• Insomnia – Difficulty falling asleep or staying asleep.
• Nausea – Feeling queasy or experiencing an urge to vomit.
• Headaches – Persistent or throbbing headaches.
• Dizziness – Feeling lightheaded, unsteady, or experiencing vertigo.
• Sweating – Increased sweating, especially during periods of sleep, rest, or physical activity, or cold sweats.
• Irritability – Becoming easily annoyed, agitated, frustrated, or having a short temper.
• Mood changes – Emotional instability, mood swings, or depression.
• Tremors – Shaking or trembling of the hands, arms, or other parts of the body.
• Flu-like symptoms – General malaise, muscle aches, fatigue, fever, or chills.
• Abdominal discomfort – Upset stomach, cramping, or abdominal pain.
• Concentration difficulties – Difficulty focusing, concentrating, general forgetfulness, or mental fog.
• Sensory disturbances or hallucinations – Changes in vision, hearing, or other sensory perceptions.
• Increased heart rate – A faster-than-normal heart rate or palpitations.
• Seizures – Sudden onset of abnormal electrical activity in the brain resulting in seizures. This is more common in individuals who were taking gabapentin to manage seizures or epilepsy. Seizures can be severe and life-threatening.

Withdrawal can be serious and should be treated as such. Never stop taking gabapentin after long-term use without a plan and guidance from a medical professional.

Gabapentin Withdrawal Timeline: How Long it Lasts and What to Expect

The onset of withdrawal can vary greatly depending on the individual. Most people begin experiencing symptoms 12-48 hours after their last dose, and most symptoms subside within 8-10 days.

A general timeline for gabapentin withdrawal is as follows.

• 12-24 hours after the last dose – Symptoms begin including anxiety, insomnia, fatigue, heart palpitations, and flu-like symptoms.

• 48-72 hours after the last dose – Symptoms peak and may include severe anxiety, agitation, confusion, disorientation, gastrointestinal upset, sensory disturbances, tremors, and seizures.

• 4-5 days after the last dose – Some symptoms may begin to resolve, but confusion, agitation, anxiety, and cravings may persist.

• 5-10 days after the last dose – Symptoms will slowly resolve, and most people feel better after 10 days.

Facts that Affect the Length of Gabapentin Withdrawal

How long gabapentin withdrawal lasts may vary depending on unique factors, such as:

• Extent of gabapentin use – Using gabapentin more frequently, in higher doses, or for longer periods of time can increase the length and severity of withdrawal.
• Overall health – Each person’s body is unique. Factors such as age, weight, body fat, metabolism, and genetic markers can all affect how quickly withdrawal symptoms appear and how long they last.
• Underlying health conditions – Certain medical conditions, such as epilepsy or neurological disorders, may be associated with more severe and long-lasting withdrawal symptoms.
• Polysubstance abuse – Using gabapentin alongside other drugs or alcohol can increase the amount of time it takes to overcome withdrawal.

Managing Gabapentin Withdrawal Symptoms

The best way to manage gabapentin withdrawal is to follow a tapering schedule under the guidance of a healthcare professional. Your doctor can help you gradually reduce your dosage over a period of time, which allows your body to slowly adjust to smaller and smaller doses, effectively minimizing withdrawal symptoms.

However, if you are addicted to gabapentin, you may be unable to follow your doctor’s tapering schedule because of an inability to control or regulate your drug use. As a result, you may need to detox in a medical detox center or addiction treatment facility.

A detox center can taper your dose of gabapentin to reduce the severity of withdrawal symptoms while monitoring you to prevent relapse. They can also prescribe symptom-specific treatments that may help you manage your symptoms, such as:

• Magnesium – There is research showing that magnesium supplements can help reduce the severity of withdrawal symptoms, ease muscle aches, and promote restful sleep.[4]
• Lorazepam (Ativan) – Lorazepam is a benzodiazepine medication that affects GABA neurotransmitters in the same way gabapentin does. In some cases, lorazepam may help reduce seizures associated with gabapentin withdrawal and other symptoms, such as anxiety.[5]
• Nonsteroidal anti-inflammatory drugs (NSAIDs) – These medications, such as ibuprofen or naproxen, can help manage any physical discomfort or pain associated with withdrawal symptoms.
• Healthy diet – Eating a healthy diet can improve your energy and mood by supplying your body with the nutrients it needs to recover.
• Exercise – Light physical activity can decrease pain and stiffness while stabilizing energy levels and mood. It can also help increase dopamine levels which may be depleted during withdrawal.

Locate Help for Gabapentin Abuse and Addiction Today

Overcoming gabapentin withdrawal can be challenging and even dangerous on your own, but you don’t have to endure it alone. A professional drug and alcohol detox center can facilitate a safe, comfortable, and easy detoxification experience.

New Jersey Addiction Intervention partners with some of the top-rated drug and alcohol detox centers in the nation. Our trusted detox facilities offer around-the-clock care under the guidance of licensed healthcare professionals who can treat any symptoms you experience.

If you or someone you love needs help with gabapentin addiction, we’re here to help. Please contact us today to learn more about your treatment options so you can begin your road to recovery.

References:

1. U.S. Food and Drug Administration (FDA): NEURONTIN (gabapentin), Retrieved June 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020235s064_020882s047_021129s046lbl.pdf
2. National Library of Medicine: GABA Receptor, Retrieved June 2023 from https://www.ncbi.nlm.nih.gov/books/NBK526124/
3. Journal of Clinical Neuropharmacology: Gabapentin Withdrawal Syndrome, Retrieved June 2023 from https://journals.lww.com/clinicalneuropharm/Abstract/2001/07000/Gabapentin_Withdrawal_Syndrome.11.aspx
4. National Library of Medicine: Magnesium in drug abuse and addiction, Retrieved June 2023 from https://www.ncbi.nlm.nih.gov/books/NBK507260/
5. National Library of Medicine: Lorazepam, Retrieved June 2023 from https://www.ncbi.nlm.nih.gov/books/NBK532890/