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Gabapentin Withdrawal: Signs, Symptoms and Treatment

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Gabapentin Withdrawal Symptoms
Medically Reviewed By: Dr. Mohsin Ali, MD

Medically Reviewed By: Dr. Mohsin Ali, MD

Dr. Mohsin Ali MD is board certified in Psychiatry and Child and Adolescent Psychiatry. Trained in Syracuse NY, he has worked in Tennessee for the last sixteen years.

Table of Contents

Gabapentin, a medication frequently prescribed for conditions such as nerve pain, seizures, challenges related to alcohol use, withdrawal symptoms, and insomnia, was initially regarded as a non-addictive, safe option for managing chronic pain and various neurological disorders. By 2017, it became one of the most prescribed medications in the U.S., with over 98 million prescriptions. Despite not being federally labeled as a controlled substance by the Food and Drug Administration, several states have heightened their surveillance of gabapentin, classifying it as a controlled substance on a state level. This action stems from concerns over its potential for misuse and the development of physical dependence, culminating in gabapentin withdrawal symptoms.

What is Gabapentin?

Gabapentin, known commercially as Neurontin, Gralise, and Horizant, serves as an anticonvulsant medication designed to manage partial seizures, postherpetic neuralgia, and various forms of neuropathic pain. Additionally, the extended-release version, Horizant, is specifically sanctioned for addressing restless leg syndrome. While instances of gabapentin misuse are relatively rare, research has highlighted its potential for abuse, particularly when used alongside other substances like opioids, benzodiazepines, and alcohol.

Is There a Withdrawal Syndrome Associated with Gabapentin?

Individuals taking gabapentin according to medical advice can still develop a level of physical dependency. This dependency can significantly intensify among those who misuse or recreationally abuse gabapentin, leading to withdrawal symptoms upon cessation or reduction of use. Withdrawal has been observed in individuals consuming daily doses ranging from 400mg to 8000mg for a minimum duration of three weeks.

Symptoms experienced during gabapentin withdrawal may mirror those associated with withdrawing from alcohol and benzodiazepines. This resemblance is likely because gabapentin, along with these substances, influences the action of gamma-aminobutyric acid (GABA), a key inhibitory neurotransmitter in the brain.

Gabapentin Withdrawal Symptoms

The unique action of gabapentin on brain chemistry can lead to physiological dependence, particularly at higher dosages of this antiepileptic medication. Those who develop a physical dependence must approach discontinuation with caution, as a medically supervised tapering process is crucial to mitigate severe withdrawal symptoms. Abruptly stopping gabapentin, especially in individuals with seizure disorders, can trigger the return of seizures.

Withdrawal symptoms from gabapentin can emerge as soon as 12 hours after the last dose and may take up to 7 days to manifest. The duration and severity of these symptoms can vary widely among individuals, influenced by factors such as duration of use, dosage levels, and genetic predispositions.

Common gabapentin withdrawal symptoms include:

  • Anxiety
  • Confusion and agitation
  • Disorientation
  • Sweating and dizziness
  • Fatigue
  • Nervousness and restlessness
  • Irregular heartbeat
  • Headaches
  • Insomnia
  • Itchy skin and sensitivity to light
  • Muscle pain
  • Tremors
  • Increased risk of seizures
  • Suicidal thoughts or behaviors

Typically, the initial 24 hours may bring about the most intense withdrawal symptoms. By the third day, the severity usually decreases, though some individuals might experience prolonged anxiety, depression, or other severe symptoms such as heart rate changes or hallucinations. Most symptoms tend to diminish within the first week, yet a meticulous tapering strategy under medical supervision is paramount to preventing extreme withdrawal effects.

Modifying gabapentin dosage should only be done with a doctor’s consent. Professional medical advice is essential in navigating the discomfort associated with gabapentin withdrawal. Providing a comprehensive medical and mental health history enables healthcare providers to tailor a treatment plan that minimizes risk and supports recovery, paving the way back to improved quality of life.

Gabapentin Withdrawal Seizures

It’s crucial to consult a healthcare professional before discontinuing gabapentin. Halting its use suddenly can escalate the risk of experiencing withdrawal-related seizures, particularly among individuals with a prior history of seizure disorders. Research indicates that sudden cessation of gabapentin can lead to seizures, even in individuals who have never experienced seizures previously. This underscores the importance of medical guidance when considering stopping gabapentin to mitigate such risks effectively.

Gabapentin Withdrawal Timeline

Symptoms of withdrawal from gabapentin can manifest as quickly as 12 hours to seven days after discontinuation, with the most common onset occurring one to two days post-discontinuation.

The prompt emergence of withdrawal symptoms following the cessation of gabapentin is attributed to its brief half-life—the duration needed for the body to reduce the drug’s concentration by half. Gabapentin’s half-life spans approximately five to seven hours, though this duration may extend in individuals with renal impairment. Typically, a drug is fully purged from the system after about five half-lives, translating to roughly 35 hours for gabapentin’s complete elimination from the body post the last dose.

The experience of withdrawal symptoms can be intensified by rapid dose reduction or sudden discontinuation of gabapentin. A carefully planned, gradual tapering of the dose is advisable to mitigate the intensity of withdrawal symptoms. For some individuals, a careful tapering process extending up to 18 weeks has been necessary to cease gabapentin use while effectively managing withdrawal symptoms.

Gabapentin Withdrawal Warnings

The instances of withdrawal from gabapentin, though not extensively understood, present concerning narratives, particularly among individuals with prior psychiatric conditions or substance misuse backgrounds. Those with a history of psychiatric disorders or substance misuse should be particularly vigilant about the potential complications associated with gabapentin withdrawal.

Pre-Existing Conditions

Withdrawal from gabapentin can trigger the resurgence of symptoms associated with existing conditions such as bipolar disorder, psychosis, depression, and epilepsy. Similarly, individuals using gabapentin for pain management may experience a return to their original pain levels. For individuals with these backgrounds, a medically supervised detox in a hospital may offer a safer environment, ensuring ready access to care for any arising complications.

For those with complex histories of substance withdrawal or pre-existing medical conditions, considering an initial detox period within a hospital or a specialized inpatient detox facility could provide a safer withdrawal process.

Considerations During Pregnancy

The effects of gabapentin during pregnancy can be unpredictable, highlighting the need for caution. Notably, there has been a report of a newborn requiring neonatal intensive care following gabapentin withdrawal at birth, emphasizing the potential risks to both the mother and the infant.

Why Do Gabapentin Withdrawal Symptoms Occur?

The specific reasons behind gabapentin withdrawal remain somewhat elusive, much like the drug’s exact mechanism of action. However, the emergence of withdrawal symptoms in users indicates a progression toward physical dependence for those who consume the medication over an extended period.

Various medications and substances can cause individuals to develop a physical dependence if used for an extended duration. With continued consumption, the body adjusts, expecting the substance’s presence and depending on it for normal functioning. Withdrawal symptoms typically arise when an individual ceases or dramatically decreases their habitual intake of the drug, reflecting the body’s adjustment to its absence.

Dependence is often seen alongside tolerance, where the initial effects of the drug diminish over time, leading to increased dosages to attain the desired outcomes. It’s important to distinguish physiological dependence from addiction, as they are not synonymous. Someone could be physically dependent on a medication due to long-term use for managing a medical condition, without exhibiting compulsive use or the drug negatively impacting their life, which are hallmarks of addiction.

The risk of developing a significant dependence, and possibly abusive behavior towards gabapentin, increases with intentional misuse or recreational use. However, individuals originally prescribed gabapentin for legitimate medical reasons can also fall into patterns of misuse. If you or someone you know is struggling with gabapentin misuse, it’s crucial to consult a doctor or reach out to an addiction specialist or rehabilitation program for support and guidance.

Can You Quit Gabapentin Cold Turkey?

Contemplating an immediate halt to Gabapentin use due to addiction concerns? It’s essential to proceed with caution. Abruptly discontinuing Gabapentin, commonly known as going “cold turkey,” is highly discouraged for several critical reasons:

  • Potential for Severe Health Complications: Stopping Gabapentin suddenly can trigger a range of serious health issues, significantly impacting your well-being.
  • Risk of Seizures: For individuals using Gabapentin for seizure control or those with a predisposition, sudden cessation can lead to the return or exacerbation of seizure activity.
  • Increased Disorientation and Confusion: The withdrawal process can be disorienting, leading to heightened confusion and cognitive difficulties that complicate daily functioning.

Given these risks, the safest and most effective pathway to overcoming Gabapentin dependency involves seeking professional guidance. Our addiction treatment center in Chattanooga, TN is equipped with medical detox facility to provide the structured support necessary for a gradual and monitored withdrawal process.

Gabapentin Detox

During detox, gabapentin is gradually expelled from the body. While some individuals may successfully undergo detoxification at home by adhering to a gabapentin tapering protocol outlined by their healthcare provider, attempting detox at home can be perilous for others.

Individuals with a history of severe withdrawal symptoms from gabapentin, such as seizures, or those with other underlying health conditions, should undergo detoxification in a setting that allows for constant medical oversight. A medically supervised gabapentin detox offers around-the-clock care from compassionate medical staff, ensuring both safety and comfort throughout the detox process.

Medically supervised detox becomes particularly crucial for those dealing with gabapentin addiction to multiple substances, known as polysubstance abuse. Individuals with an opioid use disorder, for instance, face a heightened risk of misusing gabapentin. Our outpatient detox program at Iris Wellness Group, provide the necessary support for individuals needing to detox from gabapentin alongside other substances, facilitating a safer and more controlled withdrawal experience.

Gabapentin Withdrawal Treatment

Battling Gabapentin withdrawal requires immediate intervention by skilled addiction treatment professionals. An integrated approach combining medication-assisted therapy, personalized counseling, and evidence-based behavioral therapies is crucial in addressing the multifaceted symptoms associated with Gabapentin withdrawal. Below are options for treatment for gabapentin withdrawal:

Gradual Dose Reduction (Tapering Off)

One of the cornerstone strategies in managing Gabapentin withdrawal involves carefully tapering the dosage over a period. This methodical decrease in dose helps mitigate the intensity of withdrawal symptoms, offering a smoother transition away from dependence on the medication. The process of tapering needs to be closely monitored by healthcare professionals to adjust the pace according to the individual’s response and ensure safety throughout the withdrawal period.

Medication Support

To alleviate the discomfort and medical complications that may arise during Gabapentin withdrawal, specific medications can be prescribed. This might include medications to ease anxiety, counteract nausea, and improve sleep quality, among others. The selection of these medications is tailored to each individual’s symptoms and overall health profile, ensuring an approach that addresses the physical challenges of withdrawal with precision.

Therapy Options

Addressing the psychological impacts of discontinuing Gabapentin is equally important. Therapy sessions, particularly cognitive-behavioral therapy (CBT), offer invaluable support. CBT focuses on unraveling negative thought patterns and behaviors that contribute to dependency, equipping individuals with coping strategies to manage stress and anxiety effectively. This therapeutic intervention is instrumental in fostering mental resilience and promoting long-term recovery.

Comprehensive Recovery Support

Beyond immediate withdrawal management, recovery from Gabapentin addiction involves ongoing support and relapse prevention strategies. Engaging in support groups, continuing therapy, and developing a sustainable wellness plan are all critical components of a robust recovery journey.

If you or a loved one is grappling with Gabapentin withdrawal, reaching out for professional help is the first step toward reclaiming control of your life. Iris Wellness Group offers a compassionate and comprehensive treatment program tailored to meet the unique needs of those dealing with substance use disorders. Don’t navigate this journey alone—our team of dedicated specialists is here to provide the guidance and support necessary for a successful recovery. Contact us today and embark on the path to wellness and freedom from addiction.

Overcoming Gabapentin Addiction in Chattanooga, TN with Iris Wellness Group

Are you seeking freedom from Gabapentin addiction in Chattanooga, TN? Iris Wellness Group is here to guide you from the beginning of your detox journey to lasting recovery and everything in between. Our outpatient detox and outpatient rehab program creates a supportive space tailored to combat the psychological aspects of addiction. You’ll receive a personalized treatment plan that includes a mix of individual and group therapyfamily counseling, psychotherapeutic approaches, holistic practices, and medication-assisted treatment. Upon completion, you’ll have a solid foundation of relapse prevention techniques and ongoing therapeutic support to navigate life post-recovery.

Embarking on the path to recovery from gabapentin addiction may seem challenging, but with the right support system and resources, it’s entirely within your reach. Our addiction specialists are dedicated to delivering comprehensive care that ensures a safe withdrawal phase and promotes sustainable health and well-being. With our professional guidance, you’re set to emerge stronger, revitalized, and fully equipped to lead a life of fulfillment. Ready to take back control from addiction? Contact Iris Wellness Group at 423-919-9549 or submit our online form today. Start your recovery journey with us and step into a brighter, addiction-free future.

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