Gabapentin: Abuse, Dependence, and Withdrawal

Objective: To identify case reports and studies regarding patients who abused, became dependent on, or experienced withdrawal from gabapentin. Data Sources: A PubMed literature search (1993 to October 2015) was performed using the search terms gabapentin, withdrawal, dependence, and addiction. Additional references were identified from a review of literature citations. Study Selection: All English-language case reports and studies were evaluated. Data Synthesis: A total of 18 case reports or case series were identified regarding addiction to or withdrawal from gabapentin. All the cases of addiction were in patients who had a previous history of alcohol, cocaine, or opioid abuse. On average, the patients were taking more than 3000 mg/d (600-8000 mg/d). Two surveys reported that the misuse of gabapentin was 1.1% in the general population and 22% in drug abuse treatment centers. Withdrawal, when reported, occurred within 12 hours to 7 days of discontinuation of the medication. Conclusion: There have been numerous documented cases of gabapentin abuse, dependence, and withdrawal. Even though gabapentin is sometimes considered as a treatment option for alcohol and substance abuse, it is important to monitor for drug-seeking behaviors. A history of alcohol or substance abuse appears to be an important part of a patient's medical history when evaluating their risk for addiction and dependence behaviors. Health care providers need to be aware of this risk in their patients and monitor their patients for signs of abuse and dependence along with withdrawal symptoms.