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Gabapentin and possible side effects

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Edited & medically reviewed by THE BALANCE Team

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CONTENTS

For many people, gabapentin is a simple anti-seizure drug they take to help them with their epilepsy and neuropathic pain. For several other people, gabapentin becomes a psychological need that develops into an unexpected source of abuse. The long-term effects of gabapentin are an example of what happens when the line between prescription use and unhealthy use is crossed.

Inside the human brain, gabapentin affects similar brain pathways as those impacted by drugs like benzodiazepines. It may; therefore, cause forgetfulness, dizziness, confusion, and drowsiness all of which can increase the risk of hurting yourself, particularly in high-risk environments. Some common side effects of gabapentin include:

diarrhea
vomiting and nausea
constipation
tremors
increases in blood pressure
flatulence
weight gain
trouble sleeping

In addition to these acute side effects, gabapentin may also produce additional unwanted issues when combined with certain other medications, such as:

Caffeine
Losartan, a medication used for treating high blood pressure
Morphine
Ethacrynic acid (Edecrin), a drug used for managing fluid retention in the body
Phenytoin (Dilantin), a medication that helps manage different types of seizures
Mefloquine, a medication for the treatment or prevention of malaria
Magnesium oxide, a supplement used for managing chronic constipation

Mentioned below is a list of all long-term gabapentin side effects in women and men:

Mood or Behavioral Changes

One of the most common gabapentin side effects in elderly and young is changes in mood or behavior. Therefore, experts always encourage people who have been using this medication for a long time to contact them as soon as they develop any new or worsening symptoms, suicidal thoughts, irritability, restlessness, or feelings of agitation. If left unchecked, these mood alterations can prove fatal as well.

Liver Abnormalities

Gabapentin is capable of interacting with the liver and negatively affecting its functions. Some common signs that this medication is reducing the efficacy of the liver include yellowing of skin and whites of the eyes, vomiting, bruising, unusual bleeding, light-colored stools, and dark urine.

Kidney Abnormalities

Because kidneys are primarily responsible for excreting gabapentin from the body through urination, they may also get affected due to its long-term use. Some signs that gabapentin use is affecting your kidneys include noticing blood in urine, changes in the frequency and amount of urine passed, trouble urinating, swelling of feet and legs, or weight gain.

Abuse and Dependence

When it comes to discussing the long-term adverse effects of gabapentin, abuse and dependence rank at the top of the list. Gabapentin continues to be a controlled substance in many states across the United States, mainly because of its sedative properties. While a lot of people use it for legitimate medical reasons, a much higher number of individuals abuse it for recreational purposes. Many among these recreational users routinely combine gabapentin with other drugs to enhance its sedative effects. Such people eventually develop a dependence on this drug which, if continued without any checks, quickly progresses to an addiction.

Once a person develops an addiction to gabapentin, it becomes impossible for them to stop using it without help. In instances where they try to quit cold turkey, most encounter painful withdrawal symptoms that are severe enough to force the individuals to restart taking gabapentin in an attempt to relieve them.

Overdose

As a person becomes more dependent on gabapentin, they start requiring an increasing amount of this drug to feel the same effects. As a result, they may attempt to increase the dose by doubling it or even more. The standard dose of gabapentin is up to 3600 mg a day and if an individual exceeds it, they may end up developing life-threatening symptoms resembling an acute case of alcohol intoxication, such as:

Sleepiness
Tremors
Slurry speech
Diarrhea
Altered mental status
Double vision
Lethargy
Dizziness

Large amounts of gabapentin also slow down breathing, making it shallower. Multiple cases have been reported in the past where people have died due to respiratory distress secondary to gabapentin overdose. If you suspect to be at risk of a gabapentin overdose, call the poison control helpline and seek immediate medical assistance at once.

Gabapentin’s side effects, such as dizziness and sedation, are extremely common in most users. However, some of them may also develop additional symptoms that may prove more life-threatening and damaging. To minimize the risk of these side effects, keep the following measures in mind:

Take gabapentin as instructed

The usual dose for gabapentin is around 300 to 1200 mg taken thrice a day. Do not take any additional medication, double the dose, or skip it without a doctor’s approval.

Inform the doctor of your past medical history

To ensure that you do not develop any adverse effects of gabapentin, tell your doctor about all the medical conditions you are suffering from. Be mindful to mention the following conditions in particular:

Kidney disease
Depression or other mood problems
Diabetes
Pregnancy or any plans for conception
Suicidal thoughts or behaviors
Lung problems
Breastfeeding
Active seizures or a history of seizures
Any history of drug or alcohol use

Inform the doctor of all medicines you are taking

This is an important thing to do as many drugs may potentially worsen the gabapentin side effects. So make sure that the doctor who is prescribing you gabapentin knows about all over-the-counter and prescription drugs along with supplements you are regularly taking, such as opioids, anxiety drugs, sedatives, or any other drug capable of causing drowsiness.

Take gabapentin with food

If gabapentin is triggering digestive issues, such as vomiting, nausea, and stomach problems, try combining it with food.

Avoid taking gabapentin with antacids

Depending on the exact type of antacid you are using, they can increase the risk of side effects or decrease the efficacy of gabapentin. If you cannot skip antacids, take them at least two hours after consuming gabapentin.

Be mindful of all risky activities

Some common side effects of gabapentin include vision changes, dizziness, and sedation. These impairments can make it risky for you to involve in certain activities, such as operating heavy machinery, driving, or engaging in a presumably hazardous activity that requires full attention,

Say no to alcohol

Do not combine gabapentin with alcohol as the combination can further enhance the risk of impairment and may put your life at stake.

Avoid combining it with other sedatives

Apart from alcohol, gabapentin must not be combined with any medicines that trigger sedation. This includes all prescription and over-the-counter medications along with dietary supplements, such as antihistamines, kava, valerian, and melatonin.

Keep close tabs on your breathing pattern

One of the most important effects of gabapentin is slowed breathing, especially if it is taken in high doses. Seek medical help the minute you notice any sign of respiratory issues, such as blue skin, shallow breathing, blue lips, difficulty breathing, or any noticeable changes in the heart rate.

Do not skip gabapentin

If you have been using gabapentin for a long time, skipping its dose can lead to withdrawal symptoms, especially if you do it suddenly. If you feel like this medication is not working or causing too many side effects, try seeking medical advice before stopping gabapentin. An expert can help you avoid these withdrawal effects by progressively tapering the dose.

Because of the potential hazards associated with gabapentin, it may not be the right medication for people in certain circumstances. For example, anyone allergic to gabapentin may not be able to tolerate it even once. Other people might be able to use it for some time but may end up developing side effects or other issues secondary to their pre-existing issues. In such cases, a doctor will prescribe them gabapentin very cautiously and monitor them closely and regularly.

Some people who require additional monitoring and special care while using gabapentin include the following:

Because of a high risk of suicidal thoughts, people with a history of suicide attempts or depression may require additional monitoring for high-risk behaviors. This is because suicidality becomes a much greater risk when gabapentin is used for seizure management.
People with pre-existing kidney issues may need to take reduced doses of gabapentin to keep their renal functions intact. The medication is primarily cleared from the body through the kidneys so if the kidneys are impaired, it may increase the risk of side effects. This is particularly true for people with glomerular filtration rates below 30 mL/min who may not benefit much from extended-release gabapentin.
Because gabapentin can slow down the breathing rate, people with pre-existing lung issues may require frequent monitoring while taking gabapentin.
Pregnant women must always talk to their healthcare provider regarding the benefits and risks of taking gabapentin throughout their pregnancy. Animal models suggest that using this medication can cause birth defects in people; however, there is no evidence to support this claim in humans.
Nursing women might be safe to take gabapentin but they should inform the prescribing doctor about breastfeeding at the time of receiving a prescription. Gabapentin can get into breastmilk but there is not enough evidence that suggests it harms the breastfeeding infant.
Gabapentin has been approved by the FDA for children at least 3 years old for seizure prevention. The use of this medication in infants younger than this cut-off limit has not been determined as effective or safe as yet.
Gabapentin is an effective and safe drug for people falling into the older age group category. However, some of them may require dose adjustments depending on their pre-existing issues, such as kidney problems.

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FAQs

What is the most common side effect of gabapentin?

Sedation or dizziness is the number one and the most common side effect of gabapentin reported by the majority of people taking it.

Can I drink alcohol while taking gabapentin?

It is best to avoid consuming alcohol while taking gabapentin as combining both could lead to dizziness and increased sleepiness.

Can I take gabapentin if I’m pregnant or thinking of becoming pregnant in the future?

At the moment, experts are not sure if gabapentin can harm an unborn baby. Animal studies suggest its potential to cause birth defects in developing fetuses; however, no such research study has been pursued in humans. Therefore, it is always best to talk to a healthcare provider and ask them if you should be using gabapentin during pregnancy.

Does gabapentin pass into breast milk?

Yes, gabapentin can pass into breast milk and enter your baby’s body. This is why it is crucial to discuss the pros and cons of this medication before taking it if you are breastfeeding.

Is gabapentin safe for long-term use?

Gabapentin is not safe for long-term use as it can trigger multiple issues in the body, such as liver and kidney problems. Moreover, due to its sedative nature, many people may end up becoming dependent on it and struggle to stop its use.

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