Drug addiction has become a major source of concern for many. With the rise in substance abuse rates and many people hooked on recreational drugs, it is quite important to be certain if your medication has addiction potential.
In this article, we discuss the drug Gabapentin and answer the question about whether you can ‘get hooked on’ it.
What Is Gabapentin?
First of all, Gabapentin is a prescription medication, meaning you should never use it without a doctor’s prescription. It belongs to the class of anticonvulsants, used in the treatment of epileptic seizures.
Gabapentin is also used in the treatment of neuropathic pain (Nerve pain), and to prevent migraine in some patients. A migraine usually presents as a throbbing headache on one side of the head.
It has also been shown to be effective in alcohol withdrawal and dependence.
The usual dose of gabapentin prescribed for use is within the range of 900mg – 3600mg maximum daily dose. Typically, your doctor prescribes a lower dose and increases the dose gradually.
Now to the real question.
Is Gabapentin Addictive?
The answer to this is NO! By drug design or structure, Gabapentin is not considered to be addictive. While it may not get you addicted, you can become dependent on it. Okay, let’s clarify the terminologies.
When you use a drug for a long period of time, your body can get used to it so much that your body would elicit some withdrawal symptoms when you stop using the drug. It is your body’s way of telling you it misses the drug. This is dependence. Dependence can be physical or psychological.
Physical dependence involves physical withdrawal symptoms such as fatigue. It is like changing your schedule.
Imagine your normal wake up time is 6 am, and then you decide to start waking up by 4 am. For a few days, you would feel really uncomfortable waking up by 4 am, because your body is not used to it. You would have to be really determined not to go back to bed. However, after a while, your body adjusts and it no longer feels uncomfortable.
Psychological dependence involves psychological or emotional withdrawal symptoms. It comes with feelings of confusion, anxiety and sometimes hallucinations.
Addiction, on the other hand, is a chronic illness characterized by a person’s compulsive use of a drug despite adverse consequences. If an addict stops a drug (or no longer has access to it), there usually would be a trigger of physical and psychological withdrawal symptoms such as a state of unease, dissatisfaction, or a reduced capacity to experience pleasure.
Due to their structure, some drugs are more prone to cause addiction than others. When gabapentin is combined for use with these drugs, addiction is inevitable. Examples of such drugs include opioids like morphine and generally have high addictive potentials.
A person who is dependent on a drug is not necessarily addicted to it. But a person who is addicted to a drug is dependent on that drug.
How Does One Become Dependent On Gabapentin?
In order to fully comprehend how dependence occurs with Gabapentin, let us first understand how gabapentin works to elicit its pharmacological use.
Gabapentin works in the brain and nervous system. It affects the buildup of electrical signals in the nerve cells, as well as the activity of some neurotransmitters in the brain such as Gamma-Aminobutyric Acid (GABA) and Glutamate.
Neurotransmitters are chemicals messengers found in the body and are involved in transmitting messages between nerve cells. GABA is a neurotransmitter which decreases nerve excitation. It helps keep the nerve activity in the brain in balance. Gabapentin increases the production of GABA.
Glutamate is a neurotransmitter which increases nerve excitation. It is thought to play a key role in causing epileptic seizures and transmitting pain signals to the brain. Gabapentin reduces the production of glutamate.
By increasing GABA and reducing Glutamate, Gabapentin helps the body to be calm.
With consistent use of Gabapentin, the brain adjusts to the increased level of GABA neurotransmitter, such that when Gabapentin is not used and GABA level drops, the brain would ‘revolt’, giving rise to withdrawal symptoms.
The higher the dose you use before withdrawal, the worse the withdrawal symptoms. Some of these withdrawal symptoms are stated below
Common Withdrawal Symptoms Of Gabapentin
- Anxiety or depression
- Changes in appetite
- Crying spells
- Muscle pain or spasms
- Abdominal pain
- Suicidal thoughts
The length and severity of gabapentin withdrawal is usually dependent on a number of factors such as;
- Length of drug use
- The daily dose
- Other associated medical conditions
- Concurrent use of other medications
How To Manage Gabapentin Dependence
If you think you are dependent on gabapentin here are two things you should consider:
1. Do Not Quit On Your Own
This may be the best piece of advice anyone would ever give you on evading the withdrawal symptoms associated with quitting gabapentin. Do not try to quit without your doctor’s approval.
Getting off drug dependence is a serious issue and should not be attempted alone, without both medical advice and support. To flout this advice is to expose yourself to withdrawal symptoms, which usually starts within 12 hours of discontinuing the drug.
2. Discuss with Your Doctor
When you discuss with your doctor, he considers your current dosage regimen and designs a tapering schedule that eventually helps you quit with minimal withdrawal effects.
A tapering schedule gradually reduces the dose of gabapentin you are required to take daily. It is a way of helping the body get accustomed to the absence of the medication gradually.
How to Manage Gabapentin Withdrawal Symptoms
If you choose to quit “cold turkey” – this means you wake up one day and just decide you’re done with gabapentin, here are steps to manage the withdrawal symptoms that may follow –
1. Symptomatic Treatment
Treatment or management of each withdrawal symptom may be necessary to help alleviate the symptoms while they last.
The doctor may prescribe an antihistamine for nausea. vomiting, and vertigo symptoms; a muscle relaxant for the muscle spasms continually being experienced. This helps buy time while the effect of the gabapentin in the bloodstream gradually wears off.
2. Relapse And Taper Off
As weird and as odd as this may sound, the best treatment for Gabapentin withdrawal is Gabapentin itself. Return to your initial dose of the medication and have a one-on-one with your doctor to discuss your tapering schedule.
This would help manage the withdrawal symptoms. Your doctor may also consider switching medications as you gradually cut down on Gabapentin.
3. Seek Help in a Specialized Treatment Centre
If you have been combining Gabapentin use with other addictive substances, you may need to check yourself into a specialized facility that helps with treatment for addiction. These facilities have comprehensive addiction treatment plans which help you to get off drug addiction.
They usually include individualized and group therapy sessions aimed at an in-depth understanding of the whys of addiction.
Here, you are exposed to a team of certified clinicians – Psychiatrists, Therapists, Psychologists, Pharmacists and Nurses who are constantly available to help you develop strategies for dealing with the triggers and the cravings.
Gabapentin is not an addictive drug, however, your body can become dependent on it. The risk of dependence is greater the higher the dose and the longer you use the medication.
In all, Gabapentin should be used with caution in patients who have a high potential for drug abuse because of the dependent nature of the drug.
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