Is Gabapentin Addictive?

Gabapentin can be addictive, although the chances of this happening at a doctor-prescribed dose are low.

Gabapentin, known under the brand names Neurontin, Horizant, and Gralise, is an anticonvulsant and works on the brain to prevent seizures. It has been approved by the Food and Drug Administration to treat epilepsy and neuropathy, or pain related to nerve damage.

Although gabapentin is labeled for these purposes, it’s also commonly used off-label to treat other conditions, including anxiety and insomnia.

Because it can treat a broad range of ailments and has a low potential for addiction, it has become one of the most prescribed drugs in the United States. In a PubMed literature search from 1993 to 2015, all cases of gabapentin addiction were in patients who had a previous history of alcohol, cocaine, or opioid abuse. On average, the patients were taking more than 3000 mg/d, up to 10x the normal range.

At Kick, we prescribe gabapentin for sleep, typically at doses of only 100 mg - 300 mg. Using the drug at such a low dose further reduces the risk of addiction, dependency, and side effects.

Following a PubMed literature search (1993 to October 2015), “All the cases of [gabapentin] addiction were in patients who had a previous history of alcohol, cocaine, or opioid abuse.”

Signs you may be forming an addiction to gabapentin

Dependence is usually characterized by tolerance. Over time, a higher dose of the drug is needed to feel the same effects. Although addiction to gabapentin is very rare, it’s still possible, and more common in those taking higher doses than prescribed or when combined with other CNS depressants like opioids and alcohol.

Most people don’t realize they have a problem until they stop taking gabapentin or reduce their dose and experience withdrawal symptoms. In addition to withdrawal symptoms, addiction can also include acting impulsively, having impaired control over use, and continuing to use despite experiencing harm.

There are a few signs that show you could be forming an addiction to gabapentin. The most notable include:

• Needing to take more gabapentin to get relief, even if your prescription hasn’t been increased
• Feeling agitated between doses
• Being unwilling to stop taking the drug, despite noticing significant side effects
• Taking gabapentin without having any symptoms requiring the medication
• Looking for other ways to get more gabapentin
• Feeling like you can’t be yourself without gabapentin
• Feeling like you can’t perform or live up to expectations without gabapentin
• Feeling like you need to take more than necessary to control symptoms

Habit forming, dependence, and addiction explained

Addiction doesn’t just happen, and it’s not always linear. Below are the most common stages of addiction, but it’s important to note that not everyone who reaches one stage will reach the next. I.e., someone can form a habit without forming an addiction.

That said, the typical course of addiction is habit formation, dependence, and addiction.

Habit formation is the building block of addiction. It’s defined as a routine or regular behavior that gets harder to give up the longer the behavior continues. This stage is most characterized by using a substance as a reward system, which sets off feel-good neurotransmitters and reinforces the continued behavior.

Eventually, as this habit continues, a physical or emotional dependence develops. This can show itself through emotional “triggers” that set off a biochemical change in the brain and strongly influence decisions. Dependence can also take the form of physical withdrawal symptoms between doses.

At the dependence stage, people experience a mental and/or physical shift from their extended drug use. They can still decide whether or not to continue using the drug or ignore it, but the choice is increasingly more difficult, and the decision making itself may be impaired.

At the final stage – addiction – the need to use the drug is nearly impossible to ignore and use continues even when risk outweighs reward. It has been described by the American Society of Addiction Medicine as:

…a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.

The key difference between dependence and addiction is that addiction is when drug use becomes an uncontrollable need, even when it causes harm.

Helpful resources if you’re struggling with a gabapentin addiction

Quitting gabapentin “cold turkey” is not recommended and can be potentially dangerous for those who have taken the drug for extended periods of time and at higher doses. If you have a physical dependence or are taking gabapentin to treat epilepsy, seek medical supervision because you can potentially experience severe withdrawal symptoms.

Some potential withdrawal symptoms include:

• Irritability
• Anxiety
• Agitation
• Heart palpitations
• Fever
• Hallucinations

For those with a seizure disorder, abruptly stopping use of gabapentin can lead to an increase in, rebound, or emergence of continuous seizures.

If you or someone you love is struggling with addiction, there are resources available to help. Speak directly to your doctor or contact a nearby addiction center who can offer a safe, medically supervised detox program.

You can locate your nearest center by using American Addiction Centers and AddictionCenter.com.

Frequently asked questions about gabapentin

Here are some answers to the most frequently asked questions about gabapentin use and addiction.