Neurontin is a medication doctors prescribe to treat nerve pain and reduce the risk of seizure. In 2016, Neurontin was the 10th-most prescribed medication in the United States.1 During that year, an estimated 64 million prescriptions were issued. Doctors identified that the drug has some potential for abuse, misuse, and overdose. Lets examine Neurontin’s effects, as well as what to do if an addiction develops.
Neurontin is a medication doctors prescribe for many different medical conditions and reasons. The medication helps to reduce the chance a person will have seizures and can also reduce some people’s nerve pain, such as pain from shingles.2
According to Healthline, an estimated 1 percent of the population misuse the drug.2 However, among those who abuse painkillers, the estimated percentage of people who misuse the drug increases to between 15 and 22 percent.
Currently, doctors think that the drug has a very low addictive potential.2 People who take it should use caution, but it isn’t nearly as addictive as other medications, such as opioid painkillers. However, Neurontin does cause withdrawal symptoms and can create a sense of intoxication. For this reason, doctors do consider it to have some potential for dependence.
The main concern is that people who are addicted to other drugs and substances, such as alcohol, opioids, or benzodiazepines (like Valium and Xanax), increase the risk of dangers from using Neurontin and these substances.
Neurontin belongs to the drug class of anticonvulsants.3 This means the medication helps to prevent seizures. Doctors don’t exactly know how it works in the body (which isn’t uncommon for a lot of medications).4 Previously, it was thought to work on GABA receptors in the body, but more recent research has proved this wrong.
Drug manufacturers also sell Neurontin under the brand names Gralise and Horizant. Its generic name is gabapentin. Some people on the street may call it “gabbies,” “morontin,” or “johnnies” based on its different generic and brand names.
The United States Drug Enforcement Agency lists medications and street drugs on a “schedule” that ranges from highly addictive and mostly illegal drugs to drugs that have a low potential for abuse. Drugs that are Schedule I have the most potential for addiction and drugs that are on Schedule V have the least potential.
Neurontin is a Schedule V drug. It wasn’t on the drug list until the FDA started conducting research on the drug and how people were using it. According to an article in the journal Risk Management Healthcare Policy, the FDA found that a significant number of people were exceeding the recommended daily dosage by as much as three times.5
Adding Neurontin to the drug schedule can change the degree of access a person may have to the drug. For example, being on the schedule means that pharmacies will restrict the number of refills and days of supply.5 Pharmacies will also report the prescription and use of the drug to any controlled substance databases a state may have, which can vary from state to state. Ideally, these changes will help keep people from diverting the drug for illegal and potentially deadly uses.
The FDA approved Neurontin for use in the United States in 1993.1 Since that time, the opioid epidemic has taken place in the United States, and now a lot of medical experts think this drug may have a role in it. According to Healthline, of people who overdosed in Kentucky, an estimated 33 percent had Neurontin in their system.1
Using it with opioids creates a significantly more dangerous combination than either medicine alone. According to an article in Risk Management Healthcare Policy, using gabapentin in combination with opioids increases the risk for respiratory depression as much as four times.5 Taking more than 900 milligrams of gabapentin and taking opioid painkillers can increase the risk for death by as much as 60 percent.5
While people are using Neurontin along with addictive and potentially fatal medicines, doctors don’t believe that itself is the drug itself is causing overdoses.1 Therefore, most doctors regard it as a safe medication when it’s taken as directed.
Neurontin works by affecting the central nervous system. It helps to “slow” it down to reduce the risk that a person will experience a seizure. The medication can also slow the transmission of pain messages in the central nervous system.1 This helps to reduce a person’s pain experience, especially in nerve pain from shingles or the herpes zoster virus.
In some ways, prescribing the drug is controversial for doctors. This is because the FDA has specifically approved gabapentin to treat medical conditions like seizures and neuropathic (nerve) pain.1 However, a lot of doctors prescribe it for other uses. This is called prescribing something “off-label.”
Some of the conditions that doctors may prescribe off-label for include:
Pain, such as chronic pain
In 2004, Pfizer (the company that makes Neurontin) settled a $400 million lawsuit because the company had been marketing the drug for uses the FDA hadn’t approved it for. While it isn’t unusual that a doctor may prescribe Neurontin off-label, the company can’t advertise that it will treat disorders the FDA hasn’t already approved.1
Neurontin prescriptions are increasing significantly. According to Reuters, in 2002, an estimated 1.2 percent of Americans were prescribed the drug. In 2015, an estimated 3.9 percent had gabapentin prescriptions.6 The increasing usage of gabapentin may be due to a growing emphasis on using non-opioid pain relievers or at least cutting back on opioid pain relievers.
The groups of people who were prescribed Neurontin in increasing amounts include older adults, those with diabetes, and patients who had multiple health problems.6
While some people use the drug as an alternate to pain medications, other people use it as a way to increase the effects of pain medications on the body.5 Neurontin enhances the effects of opioids and other central nervous system depressants on the body.5
Some people report going through mood changes when they take the drug.6 This includes having thoughts of suicide. For this reason, doctors don’t recommend suddenly stopping the use of Neurontin, even if a person isn’t having symptoms.
Other possible short-term effects include the following:
Severe tingling or numbness in the hands and feet
As a general rule, the more of a substance that is taken, the greater the risk of developing side effects.6
Neurontin shouldn’t be taken with alcohol, sleeping pills, or painkillers because they could negatively affect breathing. Always talk to a doctor first before taking this drug with these medications or drinks.
Neurontin is considered a safe drug when taken as prescribed. However, there is still a potential for toxicity and long-term health effects. According to Medical News Today, people who have kidney disease and take Neurontin may be at greater risk for developing kidney damage.3 For this reason, doctors may not prescribe it to people with kidney failure. Another option is for the dosage to be reduced. Damaged kidneys are unable to filter the medication as quickly, which can lead to a buildup in the body.
Other potential long-term effects include the following:
As a general rule, the more a person takes, the greater the chances that a person could have a short- or long-term problem.
It is possible, but not likely, to overdose on Neurontin alone. There have been some reports that taking the drug in very, very large amounts could cause an overdose due to toxicity. It’s important to note that taking the drug in larger amounts isn’t as toxic as taking excessive amounts of other anti-convulsants can be, according to the Massachusetts/Rhode Island Poison Control System.4 It is important to know that taking Neurontin and opioids does increase the risk of overdose in general.
If Neurontin use suddenly stops, it can increase the likelihood of having a seizure. It is important to talk to a doctor before stopping. If a doctor prescribed the drug for seizures, another medication might be needed to reduce the risk of having seizures when reducing or stopping Neurontin.
Most doctors will recommend an approach for stopping called tapering.7 This involves slowly cutting back on the amounts taken on a daily or weekly basis. A doctor can evaluate exactly how much of the drug is taken daily and develop a plan.
Neurontin can cause withdrawal symptoms, one of the most serious of which being increased seizure risk. It is important to tell trusted friends or family members before cutting use back, so they know to call 911 if you have seizure-like symptoms.7
Some of the potential withdrawal symptoms include:
It is important to remember that Neurontin is a central nervous system depressant. When a person stops taking it, its effects in slowing the central nervous system go away. Most of the withdrawal symptoms are related to the fact that the central nervous system is at least temporarily sped up.
Withdrawal symptoms usually start anywhere from 12 hours to 7 days after a person stops taking the drug.7 Suddenly stopping increases the likelihood of experiencing severe symptoms, which is why doctors recommend a gradual tapering of the medication. If the drug has been used for more than six weeks or has been taken in high dosages, some withdrawal symptoms are to be expected.
If you or someone you love takes Neurontin and is concerned about its side effects, has found a new anti-seizure medication, or simply wishes to stop taking it, a doctor can develop a tapering plan that will help reduce usage. This may take several weeks, but this method of stopping Neurontin reduces the risk of seizures.
If Neurontin is being used as a means to increase the high from opioids, it may be beneficial to consider either outpatient or inpatient rehabilitation as an approach to help cut back usage. Through these programs, a medical expert collaborates with you to create a tapering plan. Therapies work to address the underlying causes of addiction.
Examples of mental health counseling can include learning ways to deal with pain that do not include taking medications or learning to cope with anxiety in ways that do not involve taking medications. These approaches can dramatically help a person who is struggling with substance abuse.
Because the concept that Neurontin could be problematic is a more recent discovery, not much research has been done on the best practices for stopping usage. As more research is done in the continued fight against opioid abuse, more information will likely be available.
Neurontin is a medication that has the potential to make opioids and other central nervous system depressants (like alcohol) more dangerous. As researchers are identifying ways that Neurontin can increase the potential for overdose, many states are increasing their monitoring of how doctors prescribe the medication. If you are concerned about Neurontin use, it is important to talk to a doctor or treatment center. Medications can help with tapering to address some withdrawal symptoms. Recovery is possible.