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What is Gabapentin Used For?

Gabapentin is one of the most popular drugs on the market today due to the wide variety of applications for which it can be used. The medication belongs to a class of drugs named after itself called gabapentinoids, and it is the only medication in its class. The anticonvulsant (antiepileptic drug) medication was originally intended to treat seizures in combination with other drugs, but today, many other conditions are treated by gabapentin. Unfortunately, the rising popularity of gabapentin is not without issues. While the medication was once considered safe and non-habit forming, the opioid epidemic has led to a rise in gabapentin abuse, as addicts combine narcotics with gabapentin in order to enhance the effects of their high. Therefore, regulations around gabapentin are constantly changing as governments work to prevent abuse of the medication. Although gabapentin is very effective at providing relief from certain types of pain, the medication also comes with a long list of side effects, some of which can be serious.

Gabapentin Overview

Although often referred to as an anti-epileptic/anticonvulsant prescription drug, gabapentin belongs to its own class of drugs called gabapentinoids. The anti-seizure drug, Gabapentin mimics the chemical structure of a brain chemical called GABA, which affects the body’s nervous system. Gabapentin is sold under brand names like Gralise, Horizant, and Neurontin, each of which has specific applications and uses; gabapentin is a generic medication. Gabapentin was first approved in 1993 by the U.S. Food and Drug Administration (FDA) under the brand name Neurontin for the treatment of seizures when used in conjunction with other anticonvulsants. Today, however, gabapentin is used to treat a wide variety of non-epileptic conditions.

Conditions Treated by Gabapentin

Gabapentin is FDA-approved for the treatment of a variety of conditions, including focal seizures, neuropathic pain (including neuropathic pain caused by the herpes virus or shingles), and restless legs syndrome. The brand name versions of gabapentin are marketed separately for the treatment of different conditions. A brief description of each of the conditions treated by gabapentin and their symptoms is noted below.

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Focal Seizures

Focal seizures, which are sometimes called partial seizures, are defined as abnormal brain activity that occurs only on one side of the brain. These seizures are the most common type of seizure that people with epilepsy experience. A simple focal seizure occurs when the individual remains conscious throughout the seizure and can remember it after the fact, while a complex focal seizure sees the person lose consciousness, having no memory of the seizure after it has passed. Symptoms known to occur during focal seizures include:

  • Muscle contractions

  • Automatisms (repetitive movements) such as skin-picking or lip-smacking

  • Vision changes (double vision)

  • Odd sensations

  • Abnormal head or eye movements

Some people experience a sensation known as an aura immediately prior to experiencing a focal seizure. Auras are characterized by the perception of light or smell, and often cause the person to feel confused prior to the seizure. During an aura, some bystanders report witnessing the person staring, blinking their eyes rapidly, or stiffening their body; following the aurora, confusion or exhaustion is reported.

Neuropathy

Neuropathy, or pain caused by damage to the nerves outside of the brain and spinal cord, is often characterized by numbness or weakness in your extremities or other parts of  your body. When the weakness and numbness occurs in the extremities, it is known as peripheral neuropathy. Nonsteroidal anti-inflammatory drugs (NSAIDs), opioid pain medications, and other painkillers are not effective at treating neuropathic pain because the pain is caused by nerve damage rather than injury. Gabapentin is capable of treating several types of neuropathy, including postherpetic neuralgia, a type of pain caused by nerve damage due to shingles. Older adults are more likely to contract shingles, a disease that results from the same virus that causes chickenpox and causes a painful rash, due to weakening of the immune system as we age. Gabapentin can also be effective in the treatment of diabetic neuropathy, which is nerve pain that results from damage to the nerves caused by high blood sugar.

Restless Legs Syndrome

If you have an uncontrollable urge to move your legs because they feel uncomfortable, you might have restless legs syndrome, also known as Willis-Ekborn disease. Restless legs syndrome can affect people of any age, and symptoms typically occur in the evening or nighttime hours when a person is sitting or lying down. As a result, sleep is often disrupted. Moving the legs causes a temporary relief of uncomfortable sensations, so people often try to eliminate the feelings by stretching, jiggling their legs, pacing, or walking. 

Cost of Gabapentin?

Generic drugs like gabapentin are generally much more affordable and accessible than brand name medications, even for people who are uninsured or underinsured. Gabapentin is a generic drug, but t not all generic forms of gabapentin are interchangeable with the branded versions, such as Neurontin, as some of the branded versions treat only selected conditions.  People with private health insurance are likely to have gabapentin covered by their insurance, as are people using Medicare. The costs for a 30-day supply of Neurontin are compared to the costs for a 30-day supply of gabapentin below.

Costs of a 30-Day Supply of Neurontin and Gabapentin

 

Neurontin

Gabapentin

100 mg oral capsules

$76.20

$11.90

300 mg oral capsules

$187.80

$10.16

400 mg oral capsules

$217.20

$24.48

 

Possible Side Effects of Gabapentin

Side effects associated with gabapentin generally fall into two categories: side effects that do not require medical attention and side effects requiring medical attention. Common side effects not requiring medical attention include, but are not limited to:

  • Delusions

  • Dementia

  • Effect breast milk supply

  • Blurred vision

  • Cold or flu-like symptoms

  • Increased appetite

  • Back pain

  • Lower back or side pain

  • Swelling of the hands, feet, or lower legs

  • Hoarseness

  • Lack or loss of strength

  • Body aches or pain

  • Burning, itching or dry eyes

  • Trembling or shaking

  • Accidental injury

  • Bloated or full feeling

  • Constipation

  • Viral infection

  • Clumsiness or unsteadiness

  • Congestion

  • Change in vision

  • Change in walking or balance

  • Hostility

  • Jerky movements

  • Fever

  • Nausea and vomiting

  • Trouble speaking

Side effects requiring medical attention include:

  • Allergic reaction

  • Black tarry stools

  • Drug interaction

  • Chest pain

  • Clumsiness or unsteadiness

  • Continuous uncontrollable eye movements

  • Chills

  • Cough

  • Pain or swelling in the extremities

  • Painful or difficult urination

  • Depression, irritability, or other mood or mental changes

  • Fever

  • Loss of memory

  • Sore throat

  • Unusual bleeding or bruising

  • Hyperactivity or increase in body movements in children

  • Rapidly changing moods in children

  • Trouble breathing

  • Unusual tiredness or weakness

  • Aggressive behavior in children

  • Sores, ulcers, or white spots on the lips or in the mouth

  • Swollen glands

  • Anxiety in children

  • Depression in children

  • False sense of security in children

  • Concentration issues in children

  • Crying in children

  • Overreacting/overly emotional in children

  • Restlessness in children

  • Distrust in children

Risks Associated With Gabapentin

This is not an over-the-counter drug because there are numerous risks associated with the use of gabapentin, but one of the most common and serious is the possibility of abuse of the medication. This can include not waiting enough time between the next doses or drug interactions.  Gabapentin abuse is more likely to occur in people who are already addicted to opioids or other drugs. People abuse gabapentin because the medication is said to produce a calming effect that is comparable to the high received from marijuana. 

Adverse effects of gabapentin abuse include:

  • Tremors

  • Dizziness

  • Drowsiness

  • Coordination problems

  • Depression

  • Dizziness 

  • Poor coordination

  • Forgetfulness

  • Suicidal thoughts or behaviors

  • Changes in mood

  • Inability to feel pleasure

  • Anxiety

  • Difficulty speaking

People taking gabapentin are more likely to experience suicidal thoughts, ideation, and behaviors. If you notice significant changes in your mood or behavior while taking gabapentin, talk to your doctor.

People taking gabapentin should not drive or operate heavy machinery until they know how the medication makes them feel. Gabapentin can reduce your reaction time and cause drowsiness or dizziness. 

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a life-threatening reaction to gabapentin characterized by multiorgan hypersensitivity. If you notice symptoms of DRESS such as a rash, fever, or swollen lymph nodes, seek medical attention immediately.

People taking gabapentin should not be drinking alcohol while taking the medication, as the effects of alcohol can be exacerbated. Some people feel sleepy when taking gabapentin, which is also enhanced by alcohol. When combined with gabapentin, alcohol can also cause feelings of dizziness and trouble concentrating.

If you are taking gabapentin for seizures, do not stop taking gabapentin suddenly, as a missed dose increases the risk of experiencing a condition called status epilepticus. So make sure to get your refills and store at room temperature. Status epilepticus is a condition that causes short or long seizures lasting for 30 minutes or more, and it is a medical emergency.  Children between the ages of three and twelve who take gabapentin to control their seizures are more likely to experience changes in behavior. 

Make sure to tell your doctor if you have kidney disease or kidney problems, as gabapentin can rise to dangerous levels in the blood if your kidneys are not functioning properly.

References:

https://www.webmd.com/drugs/2/drug-14208-8217/gabapentin-oral/gabapentin-oral/details 

https://www.drugs.com/gabapentin.html 

https://www.healthline.com/health/gabapentin-oral-capsule 

https://www.mayoclinic.org/drugs-supplements/gabapentin-oral-route/description/drg-20064011 

https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview 

https://www.medicinenet.com/generic_drugs_are_they_as_good_as_brand-names/views.htm 

https://www.epilepsy.com/learn/types-seizures/focal-onset-aware-seizures-aka-simple-partial-seizures 

https://www.medicalnewstoday.com/articles/147963 

https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168

Published July 31st, 2020 by Bridget Reed
Fact Checked by Chris Riley

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