SWISS MEDICAL EXPERTISE: MALLORCA, ZURICH, LONDON, OFFSHORE

9 Minutes

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Often when we are prescribed medications we casually continue to consume alcohol as part of our routine not being aware of any interaction that alcohol might have with the drug we are taking. So, next time you toss your medication in your throat and gulp alcohol an hour later, just stop and ask yourself have you consulted your doctor about having a drink or done research on your part if the prescribed medicine can be taken with alcohol?

The correct approach is to withhold all your drinking activities till you are sure about how the drug reacts in your body. Once you are sure that there are no potential side effects of your medication then you may imbibe in moderation. Gabapentin is a drug that actively interacts with the central nervous system. Since alcohol is a known depressant of the central nervous system it is suggested to avoid using alcohol and to familiarize yourself with the troubles that may result from the interaction of gabapentin and alcohol. 

Pills in front of a medicine bottle.

Gabapentin sold under the brand name Neurontin among others, is an anti-epilepsy medication also known as an anti-convulsant. Gabapentin is a prescription medicine used to treat epilepsy in adults and children older than three years of age. Gabapentin is also used to treat neuropathic pain (nerve pain) that results from shingles or herpes which was not responsive to traditional medications like opioids. 

Additionally, it is used as an off-label medicine to treat various other conditions including Attention Deficit Hyperactivity Disorder (ADHD), bipolar disorder, migraine headaches, restless leg syndrome, and drug and alcohol withdrawal. 

Gabapentin has a molecular structure similar to GABA- a neurotransmitter in the brain. Neurotransmitters are chemicals that are responsible for carrying the signals and messages across the neurons. GABA is considered an inhibitory neurotransmitter because it depresses certain signals in your brain resulting in a calming effect, thus, creating a feeling of well-being.

Related: Ambien And Alcohol mixing Side Effects

The precise mechanism of action of gabapentin is not known but what is known is, that it works similar to neurotransmitter GABA in the brain and reduces the rate of impulse transmission thus preventing seizures in epilepsy. The GABA-like activity of the drug helps in reducing the pain caused after shingles or herpes as seen in post-herpetic neuralgia, and neuropathic pain seen in diabetes. 

Neurontin (gabapentin) has been a wonderful drug in terms of treating epilepsy and other ailments. But like every other drug, some side effects are experienced after the use of this drug. However, these side effects may not be present in everyone and their presentation may vary. 

Some of the common side effects associated with Neurontin are as follows:

  • nausea 
  • vomiting
  • drowsiness
  • dizziness
  • headache
  • irritability
  • sedation
  • rash
  • hyponatremia (decreased sodium concentration in the blood)
  • weight gain 
  • slurred speech
  • ataxia (loss of coordination)
  • double vision or blurred vision
  • anxiety
  • constipation
  • impaired thinking and judgment 
  • diarrhea

These side effects are most profound at the beginning of taking the drug and typically they tend to wear off as you continue taking the drug over time. If some side effect persists and interferes with your normal routine then you need to consult your doctor who may lower your dose or may change the medication if Neurontin does not suit you. 

One of the adverse effects of Neurontin and other anti-epileptic drugs is the tendency of developing suicidal behavior, and suicidal ideation. In addition, all anti-epileptic medications have been associated with multi-organ hypersensitivity reactions characterized by rash, fever, and systemic organ involvement. 

Awareness of the anti-epilepsy medication that you are using and the knowledge of its potential drug-drug interaction is vital for a successful treatment. 

Alcohol is known to amplify the potential side effects associated with Neurontin. Mixing alcohol and Neurontin results in increased dizziness, drowsiness, and hampered thinking and decision-making ability. Since alcohol heightens the adverse effects of gabapentin it is suggested to not mix the two substances. 

Moreover, gabapentin is used as an off-label medication to treat alcohol withdrawal as an alternative to benzodiazepines. A study done in 2007 had rendered anti-convulsants such as gabapentin rather ineffective in reducing craving while treating alcohol withdrawal. The study suggested that gabapentin produced no effect on cravings and drinking and was similar to placebo in managing alcoholism. 

However, the study conducted by Barbara et al in 2017 reported the safety and efficacy of gabapentin in the novel treatment of alcohol use disorder. It was observed that gabapentin provides unique benefits of reducing insomnia associated with alcohol withdrawal by producing a calming effect and mitigating the negative effects of alcoholism. 

You are advised not to drink alcohol with gabapentin. The manufacturer of Neurontin, Pfizer, advises against mixing alcohol and gabapentin, explaining that alcohol and other medicines that cause sleepiness, dizziness should be avoided with gabapentin as they worsen the drowsiness, dizziness, and confused state caused by the medicine.

Alcohol is excessively drunk in the US. According to the 2019 National Survey on Drug Use and Health (NSDUH), 85.6% of people who were aged 18 and older had drunk alcohol at some point in their lifetime. More often than not these people take alcohol with their medications without knowing the possible interaction of alcohol with medicine such as Neurontin and this results in unwanted consequences

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There has been limited data to predict the association of alcohol and Gabapentin but what is of significance is the fact that alcohol is a depressant. Being a depressant drug means that alcohol has an inhibitory effect on the central nervous system. This results in the slowing of certain parts of the brain having depressing effects on certain organ systems in the body.

Gabapentin and Alcohol, both are known to cause depression of the central nervous system along with causing respiratory distress. Mixing the two accentuates the possible side effects associated with each one of them. 

Since central nervous system depressants are known to cause slowing of body’s responses resulting in drowsiness, dizziness, sluggishness, impaired thinking, and judgment these effects are marked when Neurontin and alcohol are concomitantly used.

You are not supposed to do tasks that involve attentiveness and alertness of mind while you are combining gabapentin and alcohol since you will experience decreased concentration and focus after mixing the two. As a result, you should not drive and lift heavy weights or do any mechanical activity that might increase your risk of an accident. When alcohol and Neurontin are used together there is an increased risk of falls due to loss of balance and coordination. 

Additionally, there is also an increased risk of seizures with alcohol abuse and withdrawals. So using alcohol with gabapentin can render the medicine useless for the treatment of epilepsy since it aggravates the medical condition for which the drug is being used. 

For all these reasons it is suggested to not take alcohol with gabapentin.

The side effects of gabapentin are heightened with alcohol so you may face greater difficulty in dealing with the effects that were present with gabapentin alone.

Neurontin is known to cause respiratory distress and alcohol synergize this effect leading to worsening of this condition. Respiratory depression is the state when your body does not have enough oxygen. As a result, vital organs in your body face difficulties in managing and regulating normal bodily functions.

One of the many side effects is that decreased oxygen impacts the brain by delivering it less than the maximum requirement which results in brain damage, and possibly coma or death ensues. 

You will experience memory issues and trouble forming your thoughts. Since Gabapentin hampers the brain’s cognitive ability, and alcohol add more potential to this effect, you will face difficulty learning new information and will have a hard time processing the already learned facts. This is because both, Neurontin and alcohol depress the brain and its power to think and reason. You will also have difficulty in thinking and judgment and will have a clouded brain.

Loss of balance and coordination results in falls and your gait is affected. You may not be stable on your own as gabapentin and alcohol dampen the motor control activity of the brain resulting in sluggish and uncoordinated movements.

You may experience depression and suicidal thoughts as a side effect of mixing Neurontin and alcohol. FDA has warned against the potential of having suicidal ideation in people using anti-epileptics such as gabapentin and this adverse effect is accentuated by the use of alcohol. 

Concomitant use of the two can even result in addiction and poly-substance abuse due to the effect of alcohol and Neurontin to produce a high by creating a feeling of euphoria and a sense of well-being. 

Gabapentin hangover refers to the state of drowsiness in which a person stays even after a good night’s sleep. Since this drug has the potential to cause drowsiness and sedation, chances are that it will make you feel sleepy but this effect has been noticed in the initial period of starting the drug. Soon the body adjusts to gabapentin and this effect wears off, mitigating the side effect to a tolerable limit.

It is suggested that you should first observe the side effects that gabapentin has on your body. Only then you can know whether you can drink alcohol in moderation or would have to avoid alcohol completely while you are taking gabapentin. 

Gabapentin has the potential for addiction even though lesser in comparison to its opioid counterparts. When gabapentin is used in excess and more frequently, it causes dependency and has the risk of overdose. Gabapentin is often used for recreational purposes when combined with alcohol or opioids. On the streets, Gabapentin is known as gabbies or jammies. When you misuse gabapentin, your body becomes habitual of it and it finds it difficult to function without the excessive dose of the drug.

Gabapentin Addiction and Withdrawal Symptoms

You will even experience withdrawal effects when you try leaving the drug hence it is suggested not to go ‘cold turkey’ and seek medical help for your condition as your doctor will taper off the dose lightly. The best solution, however, is to enroll yourself in a medical detox program where medical professionals help you in alleviating your withdrawal effects and ease the process for you.

People with the following medical condition should not take Neurontin:

  • Gabapentin (Neurontin) is eliminated through the kidney so people who have chronic kidney (stage 3A, 3B, stage 4, and stage 5) disease or going through dialysis should avoid taking this drug.
  • People with Chronic Obstructive Pulmonary Disease (COPD) or decreased lung functioning are advised against using Gabapentin. FDA warns that gabapentin has the potential to cause respiratory distress and people with prior lung disease are at an increased risk of facing respiratory distress which can lead to coma and death.
  • People with myasthenia gravis which is a muscular disorder should avoid taking Neurontin.
  • People with depression or suicidal thoughts should avoid taking this drug since their condition aggravate as Neurontin is known to cause these side effects.

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