Gabapentin: Uses, Risks, Misuse & Addiction Potential

What Is Gabapentin?

Gabapentin (brand name Neurontin) is a prescription medication originally developed as an anticonvulsant (anti-seizure drug). It was FDA-approved in 1993 and has since become one of the most prescribed medications in the United States, with over 69 million prescriptions dispensed annually — making it the 6th most prescribed drug in the country.

While gabapentin is not federally scheduled, it has attracted growing concern for misuse, particularly among people with opioid use disorders. Several states have individually classified it as a controlled substance due to rising abuse patterns.

How Gabapentin Works

Despite its name suggesting GABA activity, gabapentin does not directly act on GABA receptors. Instead, it binds to the alpha-2-delta (α2δ) subunit of voltage-gated calcium channels in the nervous system. This:

• Reduces excitatory neurotransmitter release (glutamate, norepinephrine, substance P)
• Dampens overactive nerve signals responsible for seizures and neuropathic pain
• Produces calming, anxiolytic effects at higher doses
• May indirectly increase GABA levels in certain brain regions

Medical Uses

FDA-approved uses:

• Epilepsy (adjunctive therapy for partial seizures)
• Postherpetic neuralgia (nerve pain after shingles)

Common off-label uses:

• Neuropathic pain (diabetic neuropathy, fibromyalgia)
• Anxiety disorders
• Restless leg syndrome
• Alcohol withdrawal management
• Hot flashes
• Migraine prevention
• Opioid withdrawal symptom management

Gabapentin Side Effects

Common Side Effects

• Drowsiness and fatigue
• Dizziness and coordination problems
• Blurred or double vision
• Weight gain
• Peripheral edema (swelling in hands/feet)
• Difficulty concentrating
• Tremor

Serious Side Effects

• Respiratory depression — especially when combined with opioids, benzodiazepines, or alcohol
• Suicidal thoughts — FDA black box warning for all anticonvulsants
• Severe allergic reactions (DRESS syndrome)
• Withdrawal seizures if stopped abruptly

Is Gabapentin a Controlled Substance?

Federally: No. Gabapentin is not a federally controlled substance, though the DEA has considered scheduling it.

State level: As of 2024, the following states have classified gabapentin as a Schedule V controlled substance:

• Alabama, Connecticut, Kentucky, Michigan, Minnesota, Nebraska, North Dakota, Ohio, Tennessee, Utah, Virginia, West Virginia

Learn more in the detailed guide section above for the latest state-by-state gabapentin scheduling information.

Gabapentin Misuse and Abuse

Gabapentin misuse has increased significantly. At doses above 900–1200 mg, users report:

• Mild euphoria similar to marijuana or a low dose of a benzodiazepine
• Relaxation and reduced anxiety
• Dissociative or "floaty" feelings
• Enhanced sociability

Gabapentin is particularly misused by people with opioid use disorder because it potentiates the effects of opioids, methadone, and buprenorphine. Studies show that 15–22% of people who misuse opioids also misuse gabapentin.

Gabapentin and Opioids

In December 2019, the FDA issued a serious warning about the risk of respiratory depression and death when gabapentinoids are used with opioids. Key findings:

• Co-use of gabapentin with opioids increases overdose death risk
• 12–18% of opioid overdose deaths involved gabapentin
• Gabapentin is frequently found in post-mortem toxicology of overdose victims
• The combination depresses breathing more than either drug alone

Gabapentin Withdrawal

Abrupt discontinuation can cause:

• Days 1–2: Anxiety, insomnia, nausea, sweating, body aches
• Days 3–5: Peak symptoms — irritability, tremor, headache, and in severe cases, seizures
• Days 6–14: Gradual improvement; lingering anxiety and sleep disturbance

Medical recommendation: Taper over at least 1 week (reducing by 300 mg every 2–3 days). Longer tapers for high-dose users.

Gabapentin Cost

Formulation	30-Day Supply (Generic)	Brand Name (Neurontin)
100 mg (3x/day)	$4–$10	$200+
300 mg (3x/day)	$10–$30	$400+
600 mg (3x/day)	$15–$45	$600+
800 mg (3x/day)	$20–$55	$800+

See the detailed cost breakdown in the table above for current gabapentin pricing.

Treatment for Gabapentin Dependence

• Medical taper — gradual dose reduction under physician supervision
• Cognitive-behavioral therapy — addressing underlying anxiety or pain that drove misuse
• Integrated treatment — if co-occurring with opioid use disorder, combining gabapentin taper with MAT
• Outpatient programs — most cases can be managed outpatient
• Behavioral therapy — CBT for addressing underlying pain and coping

Gabapentin Statistics

• Over 69 million gabapentin prescriptions dispensed annually in the U.S.
• 6th most prescribed medication in the United States
• 15–22% of opioid misusers also misuse gabapentin
• 12–18% of opioid overdose deaths involved gabapentin
• Gabapentin misuse increased over 3,000% from 2008 to 2019 in Kentucky
• At least 12 states have classified it as a controlled substance

Frequently Asked Questions