What are Gabapentin Withdrawal Symptoms

Even those who take gabapentin as prescribed may develop some physical dependence; however, those who misuse it or abuse it recreationally may experience significant levels of dependence and withdrawal symptoms when they try to quit or slow its use.

There are documented cases of withdrawal symptoms in people who took daily doses between 400mg to 8000mg for at least 3 weeks.

The gabapentin withdrawal syndrome may resemble some of the symptoms of alcohol and benzodiazepine withdrawal. This similarity may be due to the fact that gabapentin and these other substances all act on gamma-aminobutyric acid, or GABA, which is an inhibitory neurotransmitter in the brain.

The primary withdrawal symptoms associated with gabapentin use include:

      • Anxiety.
      • Agitation.
      • Insomnia.
      • Fatigue.
      • Restlessness.
      • Irritability.
      • Dizziness.
      • Headache.
      • Sensitivity to light.
      • Sweating.
      • Irregular heartbeat.
      • Nausea.
      • Pain.

In addition, people who are taking gabapentin for seizures and suddenly stop taking it may experience a rebound in or increased frequency of seizure activity, including continuous, uncontrollable seizures (status epilepticus).

Withdrawal usually occurs within 12 hours to 7 days after quitting the medication. Though a withdrawal timeline hasn’t been clearly documented, some studies have noted symptoms that last up to 10 days.

Factors that can affect withdrawal include:

      • Age.
      • Dose.
      • Length of use.
      • Medical or mental health problems.
      • Concurrent use of other drugs or alcohol.

 In some cases, individuals who are at risk of or are already displaying severe withdrawal symptoms may require intensive inpatient monitoring and medical withdrawal management if complications arise.

Experts recommend gradually smaller doses of gabapentin to safely and comfortably wean a person off the medication. Such tapering schedules are commonly used with medications like gabapentin that have the potential to produce adverse withdrawal effects when being discontinued.

Gabapentin use can be phased out over a period of one week, but the exact schedule will depend on the person’s particular situation. Slower tapers may allow for a safer discontinuation of the drug. Experts recommend reducing the daily dose at a maximum rate of 300mg every 4 days.

How Long Does Gabapentin Withdrawal Last?

ase reports have shown that gabapentin withdrawal can last for up to 5 days or longer, but the duration has not been well established in human studies. The symptoms and how long they last depend on how much of the drug you are taking and for how long you’ve been taking it.

Gabapentin withdrawal is not a common problem unless you are abusing the drug.

Abuse means taking gabapentin in higher than prescribed amounts and taking it for reasons not intended by your doctor.

A study on gabapentin abuse from 1993 through 2015 showed that people who experienced withdrawal were taking an average of 3,000 mg (600 to 8,000 mg) of gabapentin per day, but some case reports mention withdrawal symptoms at 400 mg per day.

What happens when you suddenly stop taking gabapentin?

If you are taking gabapentin at a normal dose prescribed by your doctor and you don’t have a history of substance abuse, you are less likely to have withdrawal symptoms when you stop taking it.

Higher doses and a history of substance problems pose more risk for abuse. You can start to build up a tolerance to the drug, and you may need to take even more of it to get the desired effect. This is called physical dependence.

Your brain cells (neurons) become dependent on a high dose of the drug for normal functioning. When the drug is stopped, your brain becomes temporarily disorganized. If you start to feel that you need more of the drug to function, stopping suddenly is more likely to lead to withdrawal symptoms.

Withdrawal symptoms may start within 12 hours or take up to 7 days to begin after stopping suddenly. Symptoms commonly include:

  • Restlessness (agitation)
  • Disorientation
  • Confusion

Various case reports describe these other symptoms of gabapentin withdrawal:

  • Headache
  • Body/stomach pain
  • Anxiety
  • Heart palpitations
  • Sweating
  • Muscle twitching
  • Light sensitivity
  • Restless limb movements
  • Nervousness

What is the treatment for gabapentin withdrawal?

There are no approved medications to treat gabapentin withdrawal. The only reliable treatment is to slowly taper the drug under the supervision of your doctor, usually a substance abuse specialist. Sometimes gabapentin is restarted to ease withdrawal symptoms before tapering off.

There is no evidence to show that other drugs or supplements — such as magnesium or CBD oil — are helpful in treating withdrawal symptoms.

Most case reports show that withdrawal patients went back onto gabapentin to relieve their symptoms. But there may be unreported cases of gabapentin withdrawal, as not everyone seeks treatment.

How can I avoid gabapentin withdrawal?

The best way to avoid gabapentin withdrawal is to only take the drug in the dose prescribed by your doctor for its approved uses.

Gabapentin is a prescription medication approved to treat certain types of seizures and nerve pain that follows a herpes infection (postherpetic neuralgia). A long-acting form is used to treat restless legs syndrome. The most common brand name is Neurontin.

Gabapentin is also prescribed and used for unapproved reasons. These are called off-label uses. Off-label uses for gabapentin include:

  • Substance abuse treatment
  • Migraine headaches
  • Fibromyalgia
  • Mental health disorders
  • Insomnia

People with a history of drug or alcohol abuse may be at increased risk for:

  • Tolerance
  • Self-dose escalation
  • Drug-seeking behavior
  • Withdrawal symptoms