Does Gabapentin Help with Opioid Withdrawal?

Opioid use disorder (OUD) is a massive problem worldwide, affecting 16 million people and directly causing more than 1 million deaths. In the US alone, it is responsible for 136 deaths every day! 

Users who try to quit opioids abruptly may experience withdrawal symptoms such as anxiety, fatigue, insomnia, and hallucinations. These symptoms can be quite uncomfortable, causing patients to reuse opioids.

Gabapentin is an anticonvulsant medication that may help ease opioid withdrawal and, as a result, help treat OUD. But is it the best option for you? Let’s break it down. 

The Bottom Line

Studies show mixed results regarding gabapentin’s effectiveness in combating opioid withdrawal. Due to its potential for dependency, risk of side effects, and the availability of other medications, we cannot recommend gabapentin for opioid withdrawal. 

However, as always, please consult your healthcare professional before taking any medication.  

What Is Gabapentin and How Does It Work?

Gabapentin is a gamma aminobutyric acid (GABA) analogue. In other words, it reduces the transmission of signals (and excitability) between brain cells, helping to prevent seizures, relieve pain, and reduce symptoms of withdrawal.

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Gabapentin Uses:

Gabapentin has an extensive list of off-label and FDA-approved uses, as follows:

What the Evidence Says: Does Gabapentin Help with Opioid Withdrawal?

Evidence on gabapentin’s effectiveness in opioid withdrawal is often conflicting. Let’s dig deeper. 

Evidence in Favor 

A clinical trial on 27 patients revealed that a 1600 mg/day dose of gabapentin (when used with methadone) reduces withdrawal symptoms. Six other studies show similar results. For example, a research study combining gabapentin with naltrexone reported significant reduction in withdrawal symptoms. In addition, another study combining gabapentin with tramadol showed reduced opioid cravings among participants. 

Evidence Against

A randomized, controlled trial on 40 participants found no significant benefit of using 900 mg/day doses of gabapentin to manage opioid withdrawal. Another trial combining gabapentin and pregabalin for opioid withdrawal showed similar results. Likewise, researchers found no significant benefit to combining buprenorphine with gabapentin to treat opioid withdrawal. 

To Sum Up

Current data is insufficient to establish the effectiveness and safety of gabapentin in treating opioid withdrawal. Healthcare professionals need additional research on how to best use gabapentin in this context, who it may benefit, and its dosage before making any recommendations. 

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Gabapentin for Opioid Withdrawal: Potential Risks

Gabapentin, like any other medication, is not free from side effects. Many risks accompany its use, including:

Gabapentin Holds Addictive Potential

Studies show gabapentin is potentially addictive with more than 50% of users reporting misuse. Dependency is due to gabapentin’s ability to induce feelings of euphoria. 

Gabapentin Can Cause Withdrawal in Infants at Birth

Research shows gabapentin is generally safe to use in pregnancy with no risks to the mother or the developing fetus. However, isolated studies report withdrawal in infants born to mothers who used gabapentin during pregnancy. According to some studies, withdrawal symptoms may affect up to 80% of infants. Here’s a list of symptoms to look out for:

• Involuntary muscle twitching
• Tongue thrusting
• Restlessness of the arms and legs
• Back arching
• Rapid eye movement
• Drowsiness
• Trouble gaining weight

Fortunately, these symptoms are usually temporary and resolve on their own. 

Gabapentin May Increase the Odds of Opioid-Related Deaths

Studies show a 60% increase in opioid-related deaths in patients that use gabapentin with opioids. Both medications — gabapentin and opioids — suppress breathing, leading to respiratory failure.

In addition, post-mortem results of 104 people who lost their lives in motor vehicle accidents showed increased levels of gabapentin in the blood. Researchers believe gabapentin was directly responsible for 47.1% of all these deaths.   

Other Side Effects of Gabapentin

Alternatives to Gabapentin for Opioid Withdrawal

Fortunately, many alternatives exist. If you are unsure whether Gabapentin is the treatment for you, here’s a list of FDA-approved medications for opioid withdrawal:

• Buprenorphine
• Methadone
• Naltrexone
• Lofexidine 
• Naloxone 

Confidant Health Can Help You Overcome Opioid Use Disorder Withdrawal

Confidant Health is a modern, virtual facility that can help you overcome opioid use disorder with evidence-based treatments. If that is what you are looking for, get in touch today!