Gabapentin is used to treat epilepsy.
It’s also taken for nerve pain, which can be caused by different conditions, including diabetes and shingles. Nerve pain can also happen after an injury.
In epilepsy, it’s thought that gabapentin stops seizures by reducing the abnormal electrical activity in the brain.
With nerve pain, it’s thought to block pain by affecting the pain messages travelling through the brain and down the spine.
Gabapentin is available on prescription. It comes as tablets, capsules and a liquid that you swallow.
What is gabapentin used for?
Gabapentin is recommended for use in focal seizures and neuropathic pain. Gabapentin is widely prescribed off-label in the US and UK, for example, for the treatment of non-neuropathic pain, anxiety disorders and bipolar disorder. There is concern regarding gabapentin’s off-label use due to the lack of strong scientific evidence for its efficacy in multiple conditions and its proven side effects.
Gabapentin is approved for the treatment of focal seizures; however, it is not effective for generalized epilepsy.
Gabapentin is recommended as a first-line treatment for chronic neuropathic pain by various medical authorities. This is a general recommendation applicable to all neuropathic pain syndromes except for trigeminal neuralgia, where it may be used as a second- or third-line agent.
In regard to the specific diagnoses, a systematic review has found evidence for gabapentin to provide pain relief for some patients with postherpetic neuralgia and diabetic neuropathy. Gabapentin is approved for the former indication in the US. In addition to these two neuropathies, European Federation of Neurological Societies guideline notes gabapentin effectiveness for central pain. A combination of gabapentin with an opioid or nortriptyline may work better than either drug alone.
Gabapentin shows substantial benefit (at least 50% pain relief or a patient global impression of change (PGIC) “very much improved”) for neuropathic pain (postherpetic neuralgia or peripheral diabetic neuropathy) in 30–40% of subjects treated as compared to those treated with placebo.
Evidence finds little or no benefit and significant risk in those with chronic low back pain or sciatica. Gabapentin is not effective in HIV-associated sensory neuropathy and neuropathic pain due to cancer.
There is a small amount of research on the use of gabapentin for the treatment of anxiety disorders.
Gabapentin is effective for the long-term treatment of social anxiety disorder and in reducing preoperative anxiety.
In a controlled trial of breast cancer survivors with anxiety, and in a trial for social phobia,gabapentin significantly reduced anxiety levels.
For panic disorder, gabapentin has produced mixed results.
Gabapentin is effective in treating sleep disorders such as insomnia and restless legs syndrome that are the result of an underlying illness. At the same time it comes with a high risk of discontinuation and withdrawal symptoms.
Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal.
Gabapentin is moderately effective in reducing the symptoms of alcohol withdrawal and associated craving. The evidence in favor of gabapentin is weak in the treatment of alcoholism: it does not contribute to the achievement of abstinence, and the data on the relapse of heavy drinking and percent of days abstinent do not robustly favor gabapentin; it only decreases the percent days of heavy drinking.
Gabapentin is ineffective in cocaine dependence and methamphetamine use, and it does not increase the rate of smoking cessation. Gabapentin does not significantly reduce the symptoms of opiate withdrawal. There is insufficient evidence for its use in cannabis dependence.
Gabapentin is recommended as a first-line treatment of the acquired pendular nystagmus, torsional nystagmus, and infantile nystagmus; however, it does not work in periodic alternating nystagmus.
Gabapentin decreases the frequency of hot flashes in both menopausal women and patients with breast cancer. However, antidepressants have similar efficacy, and treatment with estrogen more effectively prevents hot flashes.
Gabapentin reduces spasticity in multiple sclerosis and is prescribed as one of the first-line options. It is an established treatment of restless legs syndrome. Gabapentin alleviates itching in kidney failure (uremic pruritus) and itching of other causes. It may be an option in essential or orthostatic tremor. Although the efficacy of Gabapentin for insomnia has not been established, it does alleviate sleep disorder in patients with medical illness.
Gabapentin does not appear to provide benefit for bipolar disorder, complex regional pain syndrome, post-surgical pain, or tinnitus, or prevent episodic migraine in adults.
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How gabapentin works ?
Gabapentin is an anticonvulsant drug that controls electrical activity in the brain’s neurotransmitters, which send signals between nerve cells. Calming nerve activity may reduce the occurrence and intensity of seizures and reduce nerve pain related to other conditions.
Common side effects of gabapentin
Feeling drowsy, tired, or weak
Unwanted eye movements
Diarrhea or constipation
Swelling in hands, feet, ankles, or legs
Flu-like symptoms (sneezing, runny nose, coughing, sore throat, fever)
Red, itchy eyes
If you experience symptoms of an allergic reaction, including severe itching; swelling in the face, tongue, throat, lips, or eyes; rash; hoarseness; difficulty swallowing or breathing; seizures; or blue-tinged skin, lips, or fingernails, contact your doctor immediately.
Gabapentin dosage information
Capsule (100 mg, 300 mg, 400 mg)
Tablet (600 mg, 800 mg)
Solution (250 mg/5 mL)
Always check to make sure you’re taking the correct form of gabapentin in the accurate dosage. Ask your pharmacist or doctor if you have questions.
Adults and children may experience sudden mood or behavioral changes when taking gabapentin. Contact your doctor immediately if you or your child experience panic attacks, agitation, new or worsening irritability, aggressive or violent behavior, suicidal thoughts, or other unusual behavior or mood changes.
Gabapentin How to Use
It’s important to read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist, before you begin taking gabapentin and each time you get a refill. If you have any questions, ask your clinician or pharmacist.
Take gabapentin by mouth, either with or without food as directed by your licensed medical professional. Your dosage is based on your medical condition, as well as your response to treatment. In children, the dosage is also based on their weight.
If you are taking the tablet form of gabapentin and your licensed medical professional directs you to split the tablet in half, take the other half-tablet at your next scheduled dose. Be sure to discard remaining half-tablets if you haven’t used them within 28 days of splitting them. If you are taking the capsules, always swallow them whole with plenty of water.
It is very important to follow your licensed medical professional’s dosing instructions exactly. During the first few days taking gabapentin, your licensed medical professional may gradually increase your dose so that your body can adjust to the medication. To minimize the occurrence of side effects, take the very first dose at bedtime.
To get the most benefit, take this medication regularly. Gabapentin will work best when the amount of medication in your body is kept at a constant level. Therefore, take gabapentin at evenly spaced intervals at the same time(s) every day as prescribed. If taking this medication three times per day to control seizures, do not let more than 12 hours pass between doses, or you may increase the risk of having a seizure.
Do not increase your dose or take this medication more frequently without consulting your licensed medical professional. Your risk of serious side effects can increase, and your condition will not improve any faster.
Do not stop taking this medication without consulting your licensed medical professional. Some conditions can become worse when gabapentin is stopped suddenly. If you wish to stop taking gabapentin, your dose may need to be gradually decreased.
Antacids containing aluminum or magnesium may interfere with the absorption of this medication. Therefore, if you are also taking an antacid, it is best to take gabapentin at least 2 hours after taking the antacid.
Different forms of gabapentin (such as immediate-release, sustained-release, enacarbil sustained-release) are absorbed in the body differently. Do not switch from one form to the other without consulting your licensed medical professional.
Tell your licensed medical professional if your condition does not improve or if it worsens.
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