More recently, the opioid epidemic has motivated many doctors to prescribe gabapentin as an alternative painkiller, which has also been met with some criticism. There are reasons, therefore, to be skeptical of non-FDA indicated uses of gabapentin. The meta-analyses of the single-group pretest-posttest results yielded significant SMDs for both cravings and withdrawal. However, the meta-analyses of the independent groups’ posttest and independent groups’ pretest-posttest outcomes on cravings did not result in any significant SMDs—studies that included withdrawal as an outcome variable had only a single-group pretest-posttest design, and no studies on withdrawal had either of the other 2 research design types. Substantial heterogeneity for all of the meta-analyses was demonstrated by the significant Q statistics and high I2 values.
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Future studies should evaluate sleep changes and mood during early recovery as mediators of gabapentin efficacy. Alcohol consumption affects sleep both in healthy populations and in patients with alcohol use disorder (AUD). However, sleep has typically not been considered within AUD pharmacotherapy trials. We used data from a completed gabapentin clinical treatment trial to explore the medication’s effect on patient-rated insomnia measured by a standard insomnia rating (Insomnia Severity Index ISI) and whether this influenced gabapentin’s effects on alcohol consumption. We had published several studies suggesting it would be added to other medications with some success, but it looked like only in those with alcohol withdrawal symptoms prior to treatment,” he said.
Effectiveness of Gabapentin in Reducing Cravings and Withdrawal in Alcohol Use Disorder: A Meta-Analytic Review
You might feel fine at first, then suddenly develop serious symptoms 24 to 72 hours later. In a supervised setting, your team can see early warning signs and treat problems before they become emergencies. “Caution is recommended in individuals with lung disease, sleep apnea or kidney problems,” says Mackey; though in many cases, this just means carefully “adjusting doses.” It’s also often considered a habit-forming and sometimes even addictive drug, which, along with misuse, dependence, and other concerns, are why several U.S. states now classify gabapentin as a controlled substance or a drug that requires closer monitoring. Food and Drug Administration (FDA) originally approved the drug under the brand name Neurontin in 1993 to treat seizures, but in 2002 also approved it for postherpetic neuralgia, “which is prolonged pain after a bout of shingles.” In people experiencing nerve pain after having had shingles, gabapentin is thought to change the way pain signals are sent through the body and brain.
What You Need to Know About Alcohol Detox Programs in Utah
Utilizing mixed-effects models, this study assessed medication effects on ISI over the trial. Finally, given our previous finding of alcohol withdrawal influencing gabapentin efficacy, we added change in ISI as a potential “moderator” of the interaction of medication effects and alcohol withdrawal on drinking. Larger-sampled, double-blinded studies are required to more reliably demonstrate gabapentin’s efficacy in the treatment of alcohol withdrawal and craving.
Regardless, if a person has a history of suicidal feelings they should discuss this with a doctor before starting this medication. While a little-known, this is a highly effective treatment that our medical establishment has all but hidden from patients. While not everyone responds well to it, a greater awareness of the use of this medication can improve recovery odds for many people. “Gabapentin at higher doses can cause an uncomfortable withdrawal when one quits taking it. However, for some people with an addiction history, gabapentin is a Alcohol Withdrawal safe alternative to benzodiazepines, which over the long term can be physically and psychologically addictive,” she said. Dr. Meredith Sagan, an addiction psychiatrist at Alo House Recovery Centers in Southern California, says gabapentin is most effective with benzodiazepine medications commonly used for withdrawal.
How Do You Take Gabapentin for Alcohol Use Disorder?
Not only is gabapentin not addictive like opioids or benzodiazepines, but it is also not a prohibited drug in and of itself. However, before using the medicine, there are several crucial factors to consider. Alcohol misuse is the fifth leading risk factor for premature death and disability worldwide.
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- None of the Food and Drug Administration-approved medications have been formally studied in patients with liver disease.
- A complicating factor is that, for patients with chronic liver disease, it may be difficult to distinguish between AWD and hepatic encephalopathy (HE).
- A related version known as gabapentin enacarbil (brand name Horizant) “is also approved for restless legs syndrome,” says Dr. Sean Mackey, chief of the division of pain medicine at Stanford Health Care.
- Anxiety, tremors, sleeplessness, and seizures are among the symptoms that may arise from alcohol withdrawal.
Our study is also one of the few to directly compare gabapentin monotherapy vs benzodiazepines. The primary outcome demonstrates a slightly shorter LOS for patients treated for AWS with gabapentin compared with benzodiazepines, with no difference in adverse outcomes including seizures, delirium tremens, or ICU transfers. Maximum CIWA scores were 2.2 points lower in the gabapentin group, although the clinical significance of this finding is unclear. First, this study carries the inherent limitations of retrospective observational studies. Secondly, with only 79 of the 4364 patients in our study receiving gabapentin, there is a potential risk of bias in the results. Finally, we could not assess post-discharge outcomes to determine recurrence or readmission rates.
This section collects any data citations, data availability statements, or supplementary materials included in this article. With all the pain I was in I was borderline suicidal, so I opted not to take them, as that was one of the side effects. When the pharmacist was reading (them) before handing it over, I literally started to cry,” she explained. Seeking help for addiction may feel daunting or even scary, but several organizations can provide support. “It can have substantial side effects, especially in older adults, including causing excessive sedation and falls,” says Steinman. Other possible effects include dizziness, leg swelling, blurred vision and cognitive problems such as confusion or memory issues.