Gabapentin Withdrawal: Symptoms, Timeline, and Treatment

Gabapentin is a structural analogue of gamma-aminobutyric acid (GABA) but does not bind to GABA receptors or directly affect GABAergic transmission. It is also widely known by the brand name Neurontin. When you take gabapentin continually, your body develops a tolerance to the drug. Gabapentin withdrawal is the process you go through when you stop using the drug after taking it continually. You might experience emotional and physical medication withdrawal symptoms at this time.

What is gabapentin used for?

Gabapentin (Neurontin) is FDA-approved for the adjunctive treatment of partial-onset seizures and for postherpetic neuralgia, while its prodrug, gabapentin enacarbil (Horizant), is approved for the treatment of restless legs syndrome and postherpetic neuralgia. Gabapentin is used off-label to manage symptoms of alcohol withdrawal and to support abstinence in early recovery. However, it is not approved as a first-line agent for alcohol detox.

How addictive is gabapentin?

Gabapentin was originally believed to have low abuse potential, but increasing evidence suggests it can be addictive, especially when used in high doses or with other substances. Gabapentin addiction or dependence can start in different ways, but it is possible to overcome it.

Gabapentin Withdrawal Symptoms

Gabapentin withdrawal symptoms can range in severity. Some people, like those who take gabapentin for a short amount of time, won’t experience withdrawal symptoms at all, whereas they can be severe for others and may require treatment. Possible symptoms of gabapentin withdrawal include, but are not limited to, the following.[1]

• Trouble sleeping (insomnia)
• High blood pressure
• Flu-like symptoms
• Heart palpitations
• Irritability or agitation
• Depressed mood
• Dizziness
• Increased anxiety
• Stomach pain
• Body aches
• Headaches
• Nausea
• Excessive sweating
• Light sensitivity
• Restlessness
• Dizziness
• Seizures

You might be more likely to experience gabapentin withdrawal symptoms if you take the drug in higher doses. Those most likely to experience gabapentin withdrawal include people who abuse, misuse, or have a physical dependence on the drug.

How Long Does Gabapentin Withdrawal Last?

Most of the time, acute gabapentin withdrawal symptoms will start within about 12 hours to seven days after your last time taking the drug.[2] Getting off of gabapentin can be challenging, but gabapentin withdrawal symptoms typically resolve over time.

However, the duration can vary and may persist longer in some individuals as part of post-acute withdrawal syndrome (PAWS). The tapering duration varies depending on dosage, duration of use, and individual tolerance, and may range from several days to several months under medical supervision. Remember that this is for your safety and well-being; it is not something to rush.

Factors Affecting the Gabapentin Withdrawal Timeline

Various factors can affect your personal gabapentin withdrawal timeline, or how long you experience withdrawal symptoms for. These include, but are not limited to, how much gabapentin you take, your age (an older adult may be at an increased risk), and how long you’ve been taking gabapentin for.[3] Those who use higher doses of gabapentin can generally expect the tapering process to take longer due to the need to decrease the dose gradually.

Post-Acute Withdrawal and Gabapentin

While acute detox refers to the initial withdrawal process, post-acute withdrawal refers to lingering symptoms that occur in some people after stopping gabapentin or any other drug. These symptoms do not pose immediate physical danger, the way severe acute withdrawal symptoms like seizures might. Instead, they generally refer to prolonged feelings of anxiety, depression, or ongoing issues with sleep that some people might notice for a longer period after acute withdrawal is over.

Treatment for Gabapentin Withdrawal

There are no FDA-approved medications specifically for gabapentin withdrawal, but supportive pharmacological treatments may be used to manage individual symptoms, such as clonidine for anxiety or propranolol for palpitations. Instead, a tapering process is the recommended treatment for gabapentin withdrawal symptoms.

During the tapering process, a medical or mental health professional will work with you to reduce the dose of gabapentin you take in small steps until you are completely off of it. This slow and steady approach minimizes the chance of dangerous or severe withdrawal symptoms, like withdrawal seizures, which can occur in those who get off of gabapentin cold turkey.

What Is Gabapentin Detox?

There are different types of detox services. Acute detox, also known as medical detox, provides 24/7 medical supervision in an inpatient environment. Sub-acute detox, on the other hand, refers to outpatient or ambulatory detox services.

Gabapentin detox can occur in either inpatient or outpatient settings, but inpatient care is generally preferred for individuals at risk of seizures, severe withdrawal symptoms, or polysubstance use. Medical detox is likely best for you during the initial stages of discontinuation if you:

• Can’t refrain from gabapentin use during an at-home detox process
• Are at risk of moderate to severe gabapentin withdrawal symptoms

Others can follow the tapering regimen recommended by their provider(s) at home. Going through the discontinuation process on an outpatient basis means you can begin outpatient treatment immediately. Substance use treatment professionals can help you determine the right detox program for you if you are not sure.

The safest way to navigate gabapentin withdrawal is to work with a healthcare provider or addiction treatment professional. They can guide you through the tapering process by informing you of the correct dosage and when to decrease it. Treatment professionals can also provide emotional support and medical monitoring as needed.

Make sure that you tell your treatment center about any other medications you take, as well as any illicit substances you use. Treatment providers are not here to judge, but they are here to keep you safe; polysubstance use can impact the treatment process, alongside your risk of addiction and overdose.

How long is Gabapentin detox?

Most people can expect to stay in medical (inpatient) detox for 1-2 weeks, until their body starts to stabilize and acute withdrawal symptoms begin to subside. The tapering process may take longer, but it can be conducted on an outpatient basis, meaning you won’t have to live on-site at a treatment center and can continue participating in daily life activities.

Inpatient and Outpatient Treatment for Gabapentin Abuse

Gabapentin was initially marketed with low abuse potential, but mounting post-market evidence has shown significant misuse, especially in combination with opioids. If you have or think that you might be experiencing gabapentin abuse or misuse, continued treatment is strongly recommended after detox. Evidence-based addiction treatment programs address the underlying causes of drug use and promote long-term sobriety.

Treatment options for gabapentin addiction most often include inpatient and outpatient rehab programs. Support groups can also benefit those facing substance abuse in any form. Our treatment center can help you or your loved one get the personalized care they need for gabapentin abuse.

Find Help For Substance Misuse

Although gabapentin has legitimate medical uses, it does come with the risk of physical dependence, addiction, and abuse. Those who use gabapentin in high amounts (e.g., 3,000 mg) for an extended period will likely require a tapering approach to help them get off the medication safely. Working with medical professionals during the withdrawal process is strongly recommended. If you experience gabapentin misuse, abuse, or addiction, substance abuse treatment is essential.

Frequently Asked Questions About Gabapentin Withdrawal