For this reason, talk to your healthcare provider as soon as you know you are pregnant. You and your healthcare provider will determine if you should take gabapentin during your pregnancy or change to a different medication. Read the full prescription information leaflet that comes with your medication. Never hesitate to ask your healthcare provider or pharmacist if you have any questions about gabapentin. Gabapentin is a prescription medication known as a gamma aminobutyric acid (GABA) analogue. GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals.
Off-label uses of gabapentinoids
Understanding its uses, prevalence, and unique considerations for elderly patients is crucial for ensuring safe and effective treatment. A 2019 study found little evidence that gabapentinoids should be used off-label to treat pain and said their effectiveness was often exaggerated by prescribing guidelines. The CDC’s 2016 opioid guideline recommended gabapentin and pregabalin dozens of times as alternatives to opioids, without saying a word about their abuse or side effects. In 2018, Michael Johansen, MD, a researcher and family medicine physician, was one of the first to warn that gabapentinoids were being overprescribed, despite little of evidence of their safety and efficacy for pain conditions. Johansen was particularly concerned the drugs were being given to older adults who were long-time users of opioids and benzodiazepines, a class of anti-anxiety medication.
There is insufficient evidence to recommend the use of gabapentin for MDD, GAD, PTSD, or OCD. There is sufficient evidence to consider the use of gabapentin for social anxiety disorder and, potentially, severe panic disorder after other treatment options have failed. An extensive literature review was conducted, primarily of articles searchable in PubMed, relating to psychiatric uses, safety, and adverse effects of gabapentin.
Gabapentinoid use in high-risk populations
- The drug interaction data described in this section were obtained from studies involving healthy adults and adult patients with epilepsy.
- Children between 3 and 12 years of age taking certain forms of gabapentin may have emotional changes; school performance changes; or develop aggressive behavior, restlessness, hyperactivity, or concentration problems.
- Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and dose should be adjusted based on creatinine clearance values in these patients.
- While gabapentin can be effective for many elderly patients, it’s not always the best or only option.
Some people take other medications with gabapentin to control epilepsy symptoms. Of the people who’ve misused the drug, most had a history of substance misuse or used gabapentin to help with withdrawal symptoms from other substances. This team-based approach is key to optimizing the use of gabapentin and maintaining the overall health and well-being of elderly patients. By implementing a thorough monitoring plan, caregivers and healthcare providers can work together to ensure that gabapentin continues to be safe and beneficial for the patient. Healthcare providers should work closely with elderly patients to explore all available options and find the most appropriate treatment plan.
It is crucial not to stop taking gabapentin suddenly, as this can increase the risk of seizures. A gradual tapering process under the guidance of a doctor is recommended to ensure safety during discontinuation. Among search results with relevant titles, abstracts were reviewed. Full-text articles were retrieved for further investigation as needed.
Refractory focal epilepsy
Gabapentin was administered orally to mice and rats in 2-year carcinogenicity studies. No evidence of drug-related carcinogenicity was observed in mice treated at doses up to 2000 mg/kg/day. At 2000 mg/kg, the plasma gabapentin exposure (AUC) in mice was approximately 2 times that in humans at the MRHD of 3600 mg/day. In rats, increases in the incidence of pancreatic acinar cell adenoma and carcinoma were found in male rats receiving the highest dose (2000 mg/kg), but not at doses of 250 or 1000 mg/kg/day.
6 Suicidal Behavior and Ideation
Emergency help should be sought to manage the overdose effectively. Gabapentin is available in various forms, including oral capsule and oral tablet, which are commonly used for different conditions. Generic gabapentin is also available, providing a cost-effective option alongside branded versions like Gralise and Neurontin.
Gabapentin is not appreciably metabolized nor does it interfere with the metabolism of commonly coadministered antiepileptic drugs see Clinical Pharmacology (12.3). As Johansen found in his earlier study, gabapetinoid use was much more likely in patients who were co-prescribed opioids, muscle relaxants, benzodiazepines or anti-depressants for chronic pain or mental health conditions. The likelihood of a patient being prescribed a gabapentinoid also rises sharply after age 50. Pregabalin (Lyrica) and gabapentin (Neurontin) are both gabapentinoids, a class of nerve medication initially developed to treat epileptic seizures. Sales of Lyrica and Neurontin tripled a decade ago, when they were touted as safer alternatives to opioids and prescribed off-label for a variety of pain conditions. Adverse effects reported with gabapentin gastroretentive tablets generally similar across all age groups except for peripheral edema, which tended to increase with age.
Comprehensive Guide to Gabapentin Uses, Risks, and Side Effects
Stopping a seizure medicine suddenly in a patient who has epilepsy can cause seizures that will not stop (status epilepticus). Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.
Confusion And Drowsiness: Recognizing The Signs
- The imprinting ink contains shellac, dehydrated alcohol, isopropyl alcohol, butyl alcohol, propylene glycol, strong ammonia solution, black iron oxide, potassium hydroxide.
- Call your healthcare provider right away if you have any of the following symptoms.
- These side effects can be particularly troublesome for older adults, potentially leading to dehydration, poor nutrition, or exacerbation of existing digestive problems.
- Inform your providers of all medications you take, including prescription and over-the-counter, as well as supplements, vitamins and herbal products.
In studies in which rats received oral doses of gabapentin (500 to 2,000 mg/kg/day) during pregnancy, adverse effect on offspring development (increased incidences of hydroureter and/or hydronephrosis) were observed at all doses. When pregnant mice received oral doses of gabapentin (500, 1,000, or 3,000 mg/kg/day) during the period of organogenesis, embryofetal toxicity (increased incidences of skeletal variations) was observed at the two highest doses. The no-effect dose for embryofetal developmental toxicity in mice (500 mg/kg/day) is less than the maximum recommended human dose (MRHD) of 3,600 mg on a body surface area (mg/m2) basis. Prescribers and patients should be aware that patients’ ability to assess their own driving competence, as well as their ability to assess the degree of somnolence caused by gabapentin, can be imperfect. Animal Data When pregnant mice received oral doses of gabapentin (500, 1,000, or 3,000 mg/kg/day) during the period of organogenesis, embryofetal toxicity (increased incidences of skeletal variations) was observed at the two highest doses. There were no clinically important differences between men and women in the types and incidence of adverse reactions.
Tell your healthcare provider about any recent and current mental health problems, especially if you have had thoughts gabepentin: uses, dosage, safety, and more of suicide, have ever attempted suicide, or have depression or mood problems. For gabapentin oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. If you are unsure whether or not to take your medicine with food, ask your healthcare provider.
Like other antiepileptic drugs, Gabapentin capsules may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Although no formal analysis by gender has been performed, estimates of response (Response Ratio) derived from clinical trials (398 men, 307 women) indicate no important gender differences exist. There was no consistent pattern indicating that age had any effect on the response to gabapentin. There were insufficient numbers of patients of races other than Caucasian to permit a comparison of efficacy among racial groups. The drug interaction data described in this section were obtained from studies involving healthy adults and adult patients with epilepsy. No inhibition of any of the other isoforms tested was observed at gabapentin concentrations up to 171 mcg/mL (approximately 15 times the Cmax at 3,600 mg/day).