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How long does gabapentin withdrawal last?

Medically reviewed by Carmen Pope, BPharm. Last updated on July 26, 2023.

Official answer

by Drugs.com

Case reports have shown that gabapentin withdrawal can last for 5 to 10 days or longer, but the duration has not been well established in human studies. Symptoms may start within 12 hours to 7 days after stopping gabapentin. The withdrawal symptoms you develop and how long they last depend on how much of the drug you are taking and for how long you’ve been taking it.

Gabapentin withdrawal is typically not a problem unless you have been taking the medication for a prolonged period, have developed a physical dependence, or have been misusing the drug. Misusing means taking gabapentin in higher than prescribed amounts or taking it for reasons not intended by your doctor.

A study on gabapentin abuse from 1993 through 2015 showed that people who experienced withdrawal were taking an average of 3,000 mg (600 to 8,000 mg) of gabapentin per day, but some case reports mention withdrawal symptoms after taking dosages of 400 to 800 mg per day for at least 3 weeks.

The gabapentin withdrawal syndrome has some similarities with symptoms of alcohol and benzodiazepine withdrawal. This may be due to the fact that all three substances act on gamma-aminobutyric acid, or GABA, an inhibitory neurotransmitter in the brain.

What happens when you suddenly stop taking gabapentin?

If you are taking gabapentin at a normal dose prescribed by your doctor and you don’t have a history of substance abuse, you are less likely to have withdrawal symptoms when you stop taking it.

Higher doses, physical dependence, and a history of substance problems pose more risk for abuse. Physical dependence is when you start to build up a tolerance to the drug, and you may need to take even more of it to get the desired effect.

Your brain cells (neurons) become dependent on a high dose of the drug for normal functioning. When the drug is stopped, your brain becomes temporarily disorganized. If you start to feel that you need more of the drug to function, stopping suddenly is more likely to lead to withdrawal symptoms.

Withdrawal symptoms may start within 12 hours or take up to 7 days to begin after stopping suddenly. Symptoms commonly include:

  • Restlessness (agitation)
  • Anxiety
  • Disorientation
  • Dizziness
  • Confusion
  • Nausea
  • Headaches
  • Sleeplessness.

Various case reports describe these other symptoms of gabapentin withdrawal:

  • Body/stomach pain
  • Heart palpitations
  • Sweating
  • Muscle twitching
  • Light sensitivity
  • Restless limb movements
  • Nervousness.

Related Questions

What is the treatment for gabapentin withdrawal?

There are no approved medications to treat gabapentin withdrawal. The only reliable treatment is to slowly taper the drug under the supervision of your doctor, usually a substance abuse specialist. Sometimes gabapentin is restarted to ease withdrawal symptoms before tapering off.

There is no evidence to show that other drugs or supplements — such as magnesium or CBD oil — are helpful in treating withdrawal symptoms.

Most case reports show that withdrawal patients went back onto gabapentin to relieve their symptoms. But there may be unreported cases of gabapentin withdrawal, as not everyone seeks treatment.

How can I avoid gabapentin withdrawal?

The best way to avoid gabapentin withdrawal is to only take the drug in the dose prescribed by your doctor for its approved uses. Experts recommend reducing the daily dose at a maximum rate of 300mg every 4 days.

Gabapentin is a prescription medication approved to treat certain types of seizures and nerve pain that follows a herpes infection (postherpetic neuralgia). A long-acting form is used to treat restless legs syndrome. The most common brand name is Neurontin.

Gabapentin is also prescribed and used for unapproved reasons. These are called off-label uses. Off-label uses for gabapentin include:

  • Substance abuse treatment
  • Migraine headaches
  • Fibromyalgia
  • Mental health disorders
  • Insomnia.

People with a history of drug or alcohol abuse may be at increased risk for:

  • Tolerance
  • Self-dose escalation
  • Drug-seeking behavior
  • Withdrawal symptoms.
References
 
  1. DailyMed. Neurontin. July 12, 2022. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee9ad9ed-6d9f-4ee1-9d7f-cfad438df388. [Accessed August 19, 2022].
  2. See S, Hendriks E, Hsiung L. Akathisia Induced by Gabapentin Withdrawal. Annals of Pharmacotherapy. 2011;45(6):e31. https://doi.org/10.1345%2Faph.1Q057.
  3. Hellwig TR, Hammerquist R, Termaat J. Withdrawal symptoms after gabapentin discontinuation, American Journal of Health-System Pharmacy. 2010 June;67(11): 910–912. https://doi.org/10.2146/ajhp090313. [Accessed August 19, 2022].
  4. Mah L, Hart M. Gabapentin Withdrawal: Case Report in an Older Adult and Review of the Literature. Journal of the American Geriatric Society. 2013 Sept 12;61(9):1635-1637. https://doi.org/10.1111/jgs.12427. [Accessed August 19, 2022].
  5. Peckham MP, Evoy KE, Ochs L, et al. Gabapentin for Off-Label Use: Evidence-Based Cause for Concern? Substance Abuse: Research and Treatment. 2018 September 23;12. https://doi.org/10.1177%2F1178221818801311 [Accessed August 19, 2022].
  6. Wagener D. Gabapentin Withdrawal Symptoms, Signs & Side Effects. Updated August 18, 2022. American Addiction Centers. https://americanaddictioncenters.org/neurontin-abuse/gabapentin-cause-withdrawal-symptoms [Accessed August 19, 2022].

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