While gabapentin is not formally approved for the treatment of an alcohol use disorder, there is some research to suggest that it does have utility in addressing symptoms associated with recovery from alcohol abuse.
It is most often used in the early stages of recovery to control withdrawal symptoms, and it may reduce cravings for alcohol.
What is Gabapentin?
Gabapentin is classified as an anticonvulsant medication, meaning that its primary use is to address seizures. It may also be used to treat restless legs syndrome and postherpetic neuralgia (the pain associated with shingles).
It is a prescription medication but not a controlled substance. The medication is best recognized by the brand name Neurontin, but there other brands of gabapentin on the market as well as generic forms.
How Does Gabapentin Work?
Gabapentin was initially designed as an analog for the neurotransmitter gamma-Aminobutyric acid (GABA), but it is not believed to work in the same manner as GABA.
Its mechanism of action is not well understood, but it is believed to reduce the firing rates of neurons in the brain by affecting the calcium channels in the neurons. It is this mechanism of action — reducing the firing rates of neurons — that leads to the medicinal effects of gabapentin, such as its ability to control seizures.
This reduction in neuronal firing can also be used to address other issues.
Is it Addictive?
Gabapentin has traditionally been viewed as a substance that has a low potential for abuse and is not addictive. However, research studies suggest that physical dependence on gabapentin does occur.
There have been documented cases of gabapentin abuse, particularly among those who abuse opioids. Individuals with chronic substance abuse issues may attempt to abuse gabapentin, particularly in conjunction with opioids or other drugs.
However, the potential for abuse of gabapentin remains relatively low compared to other drugs. Withdrawal symptoms associated with gabapentin use appear to be relatively mild compared to withdrawal from alcohol.
Is it Approved to Treat Alcohol Abuse?
No. Gabapentin is not approved by the U.S. Food and Drug Administration (FDA) to treat alcohol abuse.
Currently, only three medications are officially approved to treat alcohol abuse: Antabuse (disulfiram), ReVia (naltrexone), and Campral (acamprosate).
Gabapentin may be used off-label to treat individuals in recovery from alcohol use disorder. To date, three randomized studies present the strongest evidence that gabapentin may be useful for the treatment of alcohol abuse.
- A 2014 research study involving 150 participants found that individuals using gabapentin had higher rates of abstinence from alcohol, lower rates of heavy drinking, improved mood and sleep, and fewer cravings for alcohol compared to individuals using a placebo
- A 2007 study of 60 males who had very high alcohol use rates (average consumption of 17 drinks per day) found that individuals treated with gabapentin had fewer days of heavy drinking and drank less during the treatment period than those who were treated with a placebo. This suggested that gabapentin also reduced cravings for alcohol in the participants
- A 2015 study that described a small trial of 21 participants found that those treated with gabapentin had better sleep and fewer cravings for alcohol than those treated with a placebo.
Does Gabapentin Reduce Cravings for Alcohol?
The research does suggest that gabapentin may be able to reduce cravings for some people who are recovering from alcohol use disorder.
Per all the research studies discussed above and other research studies investigating the use of gabapentin in the treatment of substance abuse, more research needs to be done to determine how treatment with gabapentin can be useful in recovery from any substance use disorder.
Comparison to Other Medications for Alcohol Abuse
There is not a great deal of published research comparing gabapentin to other medications that are approved to treat alcohol abuse. There is a study that suggests that the use of gabapentin and naltrexone produces better results than the use of naltrexone alone in terms of reducing cravings and alcohol consumption.
ecause gabapentin is an anticonvulsant drug, it would be expected to reduce the potential for seizures as a result of withdrawal from alcohol. It could be used in place of the benzodiazepines that are commonly used to address alcohol withdrawal symptoms.
You should never use any prescription medication unless you are prescribed the medication by a physician.
Because withdrawal from alcohol can be potentially serious and even fatal, you should be closely monitored by a physician when you discontinue use of alcohol, especially during the initial stages of recovery. Your supervising doctor can determine the best medications to use during withdrawal.