Author: Gary Jackson

Does gabapentin help you sleep?

A study published by The Annals of Pharmacotherapy reported that addiction to and abuse of gabapentin were most likely to occur in individuals who had a history of addiction to other substances, including alcohol, cocaine, and opioids. Rates of gabapentin misuse were 1.1 percent in the general population and 22 percent in drug abuse treatment centers. People who abuse gabapentin often take extremely high doses of the drug or combine it with illicit substances to enhance its effects. Having said that, there does appear to be one patient population with increased risk of gabapentinoid misuse. A variety of data sources and publications suggest that opioid abusers are more likely to misuse and abuse the gabapentinoids [57]. Recent years have seen a dramatic escalation of off-label prescribing for gabapentin and pregabalin (gabapentinoids) owing in part to generic versions of each being released over the past two decades, but also in part as a response to increasing calls for multimodal and non-opioid pain management strategies.

No matter why you’re taking it, the efficacy of gabapentin relies on its ability to reduce nerve cell excitability, which can lead to drowsiness. When not taken as a sleep medicine, you might find that gabapentin’s calming effects negatively impact your life. It also increases total sleep time thanks to fewer awakenings and its ability to help individuals go to sleep faster. Lastly, one of the key effects of gabapentin is that you’ll enter slow-wave sleep sooner and stay in it longer.

Is Gabapentin Addictive?

Serious breathing problems can happen if you take gabapentin with drugs that cause severe sleepiness or decreased awareness. Some examples include narcotic opioids, anti-anxiety medicines, antidepressants, and antihistamines. If you are 65 years of age or older and/or have a condition that affects your lungs, such as chronic obstructive pulmonary disease (COPD), there is an increased risk for breathing problems.

• It has also been used “off-label” to treat other conditions like fibromyalgia, anxiety, alcoholism or other types of nerve pain.
• If you’re taking gabapentin, it’s important to recognize that your tolerability for the drug increases quickly and can lead to physical dependence even with a prescribed dose.
• Your doctor can help you cope with sleeping problems caused by gabapentin and might ask you to try a few different techniques, such as keeping a sleep journal.

In this context, several recent articles have been published alleging widespread misuse, with speculations on the unappreciated addictive potential of the gabapentinoid class of drugs. Reports of a 1% population-level abuse prevalence stem from a single internet survey in the UK, and the vanishingly small adverse event outcomes data do not support such frequency. In this targeted narrative review, we aim to disabuse pain physicians and other clinicians, pharmacists, and policymakers of both the positive and negative myths concerning gabapentinoid medications. The overall safety of the gabapentinoid class of medications, with no known cardiopulmonary nor other end-organ toxicity (outside the context of extreme overdosing), is demonstrated by its considerable therapeutic index and amplified by its lack of hepatic metabolism [35]. The lack of cytochrome P450 inhibition or induction of metabolism of other drugs is a critical and rare feature of the class, in sharp contradistinction to the actions of many other agents including the antidepressants.

How common is gabapentin addiction?

Gabapentin may also be used as an alternative to opioid medications to help manage pain. “Off-label” use means it may be prescribed by your doctor for a generally accepted use not specifically approved by the FDA or listed in the package labeling. Mixing gabapentin with drugs or alcohol is dangerous as different medication combinations change how the drug works within the body. Not only can the combination be uncomfortable, but it could prove deadly, with some medications substantially increasing your risk of overdose.

Given the direct impact sleep quality has on mental health (especially depression and anxiety), gabapentin is considered highly effective as a sleep aid for individuals suffering from certain disorders, such as insomnia. However, other sleeping pills exist if you have trouble sleeping for other reasons. That may be why it has been prescribed for people with insomnia, even though it is not approved for that use. However, gabapentin enacarbil (Horizant) has been approved by the Food and Drug Administration (FDA) to treat a sleep disorder called restless legs syndrome (RLS). To put these numbers into perspective, over 195 million gabapentin prescriptions and 47 million pregabalin prescriptions were written in the USA during that time period [44].

Treatment Process

Gabapentin works by affecting chemicals and nerves in the body that are involved in the cause of seizures and in some types of nerve pain. The brand name treatments Horizant and Gralise are extended-release formulations of gabapentin, but are not approved for the treatment of epilepsy. Gabapentin is considered highly effective for the treatment of insomnia for a few reasons. First and foremost, it improves sleep quality by reducing spontaneous arousal in the brain. Gabapentin is available as both a brand name product and a generic product (chemically the same, usually lower cost than the brand name product).

• In a survey, documented cases of withdrawal symptoms were reported in people who took daily doses between 400 mg to 8000 mg for at least 3 weeks.
• The Journal of Clinical Psychiatry reported on another study in which individuals treated for alcoholism with gabapentin showed a significant reduction in how much they drank and a greater rate of abstinence than those in the placebo group.
• These (and other anticonvulsants) carry substantial advantage over the tradition-rich benzodiazepines in terms of increased safety/no interactions with alcohol, but also in terms of no evident cross-substance dependence and transfer of addiction [35, 57].
• GABA helps reduce excitability in the brain, so gabapentin works by mirroring this chemical.