Gabapentin: The Good, the Bad and the Ugly

Gabapentin: The Good, the Bad and the Ugly

finding balance
Gabapentin, a generic for Neurontin, is frequently prescribed for fibromyalgia. This drug has been shown to reduce pain, but it does have a number of drawbacks. I’ve been on gabapentin for over two years and it does provide some relief, but I’m concerned about the side effects.

If you currently take the drug or are thinking about starting, here are a few things you should know:

The Good: For a lot of fibromyalgia warriors, this drug has been a lifesaver. It is an anticonvulsant and an antiepileptic, and the same type of drug as Lyrica. Some other uses for gabapentin include seizures, nerve pain, migraines, anxiety disorders, hot flashes, and restless legs.

Even though pain reduction is a huge plus, there are some negative side effects similar to those possible with Neurontin that you should be aware of.

The Bad: I’ve experienced a few side effects ranging from insignificant or embarrassing to distressing. Anxiety, muscle pain, sweating, dry mouth, and insomnia are just a few of the many side effects you may encounter. You may also experience loss of balance, headaches, nausea, blurred vision, swelling of the breasts, and jerky movements. I can’t forget to mention the weight gain, skin rashes, and high-blood pressure that may occur.

Recently I’ve been struggling with mouth issues. For some reason, this drug can cause you to stick out your tongue and purse your lips without you realizing you are doing it. Involuntary eye rolling is another fun reaction. My face got me into trouble at work a few weeks ago. My boss accused me of rolling my eyes and making faces at him during a meeting. I wasn’t aware I was doing either of those things. How embarrassing!  

The Ugly: Gabapentin can be habit-forming. If you wish to stop taking this medication, make sure to see your doctor first. You will need to wean yourself off slowly. I tried to reduce my dosage by only one pill a day and ended up getting sicker than a dog. The withdrawal symptoms were horrible. My doctor suggested I start by reducing each dose by 100 milligrams and after two weeks, reduce by another 100 milligrams, and so on.

Another ugly truth is what this drug can do to your unborn child if you take this while you are pregnant. Studies have shown that it interferes with the formation of brain synapses, which mainly occur during gestation and the first few years of life. This 2009 study by Stanford University raises some alarming questions regarding the use of this drug. I’ve seen differing opinions regarding the formation of synapses in adults, but regardless, care should be taken when on this medication.

Risk of suicide is also listed as an adverse reaction of gabapentin. In 2008, the FDA announced that, “The U.S. Food and Drug Administration today announced it will require the manufacturers of antiepileptic drugs to add to these products’ prescribing information, or labeling, a warning that their use increases risk of suicidal thoughts and behaviors (suicidality). The action includes all antiepileptic drugs including those used to treat psychiatric disorders, migraine headaches and other conditions, as well as epilepsy.” 

Because of my worries regarding the many side effects and after having to explain my eye rolling and nasty expressions, I decided to end my association with this so-called therapy. I have enough issues already.

For me, the negative side effects outweigh the benefits I’ve experienced. I discussed my decision with my doctor and she agreed it was the best choice for me. You may have a different experience. Whatever you decide to do, make sure to involve your physician in the conversation.

Do you take this drug or another like it? Have you experienced any side effects? Does your physician monitor you for signs of depression or suicidal thoughts?

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Note: Fibromyalgia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Fibromyalgia News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to fibromyalgia.

27 comments

  1. Chris says:

    I am on what my doctor describes as the minimum dosage for adults: 300 mg once a day, at nighttime. With just that dosage, I’ve got the weight gain and swollen breasts. And my periods are now very painful (not sure if related). I am concerned that after only 4 months, my nighttime FM symptoms are returning, which seems to means my body adjusted to the 300 mg and now I need to take more. No thanks. At least not until I have proper support.

    I did have some depression and suicidal ideation creep in with just 300 mg. I asked my doctor about any therapists he could refer me to and he was unable to. Even after asking for a therapist, he ushered me out of his office and pat me on the back and said he was glad “everything was on the up and up.” He really didn’t hear me. He was just excited that the Gabapentin was affording me sleep.

    Enabling me to sleep is the greatest benefit for me with this drug. I hadn’t realized how bad my sleep was until I took it. For that, it’s worth it’s weight in gold. But I’m still reluctant to increase the dosage like my doctor wants me to do. Oh, and Inshould mention, after only 2 weeks on the drug, I was already addicted. Didn’t take it one night and woke up at 4am with withdrawals….cold sweats, intense nausea, dizziness. I took one of the pills and the symptoms went away after 30-45 minutes. That’s alarming. My doctor says not possible at such a low dose. Getting a new doctor. 🙂

    At the end of the day, I would like to find a natural remedy for sleep, but for now, I will stick with Gabapentin at the low dose. Thanks for the article!

    • Peter says:

      Chris, I’ve been using it the same way for a few years — 300mg before bed. I’ve experimented with more dosing (e.g. during the day) and less (say, every other night). But interdose withdrawal is a real issue, even leading to fairly severe brain zaps.

      Still, I’ve yet to meet a doctor who recognizes gabapentin’s potential for side effects. That seems to me the biggest problem. Docs just don’t believe patients that gabapentin is serious stuff. It probably has a role for some (it helps my sleep and RLS), but docs should not be so flippant about helping patients dose, withdraw, etc.

  2. Dianne Wilber says:

    Thank you for this article on Gabapentin . I need to get off of it ! Insomnia is a real problem now + I`ve never had it before . I`ve also gained weight . My doctor told me it was a lot of fluid + gave me a diuretic. It has helped my pain from Fibro , but I don`t think it`s worth the side affects . She told me the extra fluid is from the Gabapentin .

  3. Karen says:

    I do take gabapentin. One doctor wanted me to increase my dosage to 2700 mg per day. I gained more weight so went down to 1200 mg. I think it is safer than cymbalta. Nothing takes the pain away completely but I would hate to think how bad I feel without my medication.

    • Bobbie Cruzen says:

      Dear Karen: The amount you are taking, 1200 mg daily of Gabapantin, seems very high! I took a very low dose for 2 years and decided the side effects were worse than the pain so I got off of it. I personally believe that Gabapentin is not designed for long term use. My research, and personal experience, has convinced me that this true! I was offered Lyrica, to replace the Gabapantin, and decided against it. I’ve learned to deal with the pain which of course varies day-to-day. I take arthritis strength Tylenol when the pain is more noticeable, sometimes up to 3000-4000 mg daily, but only for 2 days at the most. I try to eat an anti-inflammatory diet and stay away from alcohol and sugars. I also have chiropractic treatment once a week and acupuncture every other week. For the past year I’ve been doing physical therapy twice a week along side of the other treatments. These combined activities plus diet and suppliments keep me at a minimum level of pain; I’m 65 and retired 5 years now. You know your own body and should decide what’s best for you! Bobbie

  4. I had a very brief experience with neurontin for nerve pain. I took the lowest dose at bedtime for 2 nights in a row. I woke up in such a stupor on the third day that I could barely function

  5. S.U. Narayanan says:

    Try alternative medications for FM like Homeopathy or Ayurveda. Though they act slow, the have significant long term positive impact with no side effects. My wife is going through FM and trying out Homeopathic medication. She is feeling that her symptoms are improving.

  6. Carolyn says:

    What you’re describing with the tongue sounds like it could be an early sign of tardive dyskinesia. I’m not an MD, but please make sure your doctor knows about that side effect.

  7. PAMELA BERGMANN-KNEBEL says:

    Good article; I’ve been on Gabapentin for about 4 years and gained 50 pounds in about 4 months and am now treated for high blood pressure which I never had a problem with prior. I have terrible insomnia as well. I am taking 900 mg a day, increased at one point because my symptoms were so bad. I am going to discuss this with my doctor and see about getting off this drug. I am been thinking about this for awhile and this article has helped. I will need to find another alternative for fibro symptoms, if anyone has ideas, would welcome suggestions.

    • Robin says:

      Kratom has helped many people with fibromyalgia get off all their pain killers and gaba , minimizes withdrawal and helps considerably better for the pain than the narcotics and gaba !

  8. Linda Whitton says:

    I was prescribed Gabapentin and found the side effects, non of which matched the list here on the e-article, horrendous. I could not function properly at all. Couldn’t think straight, string a sentence together, and as for answering a question, I could not formulate the words I wanted to say and was literally tearing my hair out in frustration dur9ng a medical interview. As for the headaches!!!!!!!!!!! My doctor suggested I persevere, absolutely NoT.

  9. J. Reynolds says:

    I am on 600 twice a day, plus a muscle relaxant at night. It has truly given me my life back. I have had a hysterectomy, so no worries about pregnancy, and I have low BP, so I am at a good starting point for that at least.
    CONS: I have experienced the weight gain and occasional blurred vision.
    Overall, this med is worth the side effects to me. I am only three months in, so I cautiously optimistic that I have found my management med.

  10. Lori Galpeer says:

    I am sorry that you had such a bad experience with gabapentin. For me, it has been a life saver in terms of getting sleep at night (unless bad flair or a headache) and when get burning pain or escalation from a flair. In addition to mentioning the pros and cons, it might have been helpful to note that some of the side effects you mentioned (ex. weight gain, insomnia) are not very common and that the rolling of eyes is an effect that is to be alerted to your dr. if this occurs. It is interesting that you didn’t feel the eye or facial movements; glad that someone brought it to your attention for it sounds like this medication is defintely making your sicker and of little benefit. Hope you were able to convince your boss that you weren’t making fun of him. Hope you feel much better when you are fully off the medicine and that a replacement drug will helpful! take care 🙂

  11. Chris says:

    A small correction to my earlier post. I meant to say I was already dependent on the medication, not addicted. There is a difference.

  12. Judy Hummel says:

    I have been on Gabapentin for years. I take 400mg in the morning and 1200mg at night. It was not given to me for my fibromyalgia. It was prescribed by my psychiatrist for my anxiety and panic attacks that went along with my PSTD and bipolar. I haven’t had any side effects. But I’m on several meds that cause fatigue. And each visit he asks if I have any of the side effects associated with the drug. I involuntary movements, etc.

  13. Colette says:

    16 months after having used it for only a short while? It firstly did nothing for me other than make me gain *a lot* of weight – it turned me into a frightening insomniac and once I stopped, I still have so much Tardive Diskenisia that I can see people stare at me as if I was born with some or other facial tic syndrome. It seems that all this drug was good for was to take a normal, quiet, calm face and turn it into a permanently grimaced one! 🙁 Stay as far away from this medicine as possible!

  14. Gail Wilson Webb says:

    I was prescribed gabapentin by my pain doc as an alternative to opioids. I didn’t last 3 weeks before the side effects became too much. The one that bothered me the most was the loosening of all my ligaments and tendons. They went back to normal after discontinuation of the gabapentin.

  15. Kathy says:

    Okay so I just started taking Gabapentin 300 mg (1st pill last night) and I must say that I think it’s going to work for me and I’m excited about that. Someone mentioned a side effect of facial expressions person your lips to connect your tongue I rolling and I would just like to say that I honestly believe that is a side effect of fibromyalgia not Gabapentin because I used to do that a lot it drove my husband insane. I don’t know if it was cuz of my conscious decision to constantly be aware and to stop doing it or if it was the venlafaxine that I started taking that corrected that problem. As far as weight gain I gained weight I have gone from 1:35 – 150 from 2010 until now and I hate it it has nothing to do with medicine it has something to do with the fact that when everything hurts you’re in constant pain and you get depressed many of us turn to food food makes my mouth happy so they’re least something’s happy the other reason I’m gaining weight is because it hurts to move it hurts not to move it hurts to exercise you get the picture so I’m going to make a conscious decision to exercise even if it’s five minutes of walking around my house a day anything is better than nothing that’s just my take on gabapentin I’m going to give it a try and I’m not going to increase my dosage of the 300 mg works for me then that’s fine I don’t need more I take enough other pills you know what I mean…?

  16. Kathy says:

    I need corrections made towards the top of that comment, it should say: pursing your lips sticking out your tongue & eye rolling….

  17. Diana Du De Voire says:

    I only took this drug for two weeks. It was prescribed for anxiety. I just stopped it cold turkey, as I didn’t care what would happen and I wasn’t on it that long. What happened to me was I had absolutely no control over my bowels. I could never make it to the bathroom on time, never. I was constantly shitting in my pants and it was always diarrhea. Do you think that was enough to cause anxiety? Especially in public? It even happened in my car when I was driving. Now I have fibromyalgia and two different drs. want to put me on it. Both times a reverberating NO! I will never take that drug again. Bad stuff. Oh, and it didn’t do anything or the anxiety.

  18. Kathy says:

    I took it for years. It did stop the neuropathy, but it also cause weight gain, dizziness and the last straw was losing words. I quit cold and didn’t have any problems, but that is me. I now have words back and will just live with the peripheral neuropathy. I have refused the fibro drugs for the same reason.No cymbalta or Lyrica. Does the same thing to me. We just need for someone to cure this debilitating disease!

  19. Cindy says:

    Several years ago I was put on gabapentin for fibromyalgia. The first tier level helped my pain tremendously yet when I started to go up to the second tier level, I developed suicidal ideation. I called the VA hospital immediately and was told by their pharmacy that suicidal ideation is a common side effect… I was given directions on how to decrease the dosage in order to get off of it. When I was tapering off, I found the Stanford Research study which raised the hairs on my neck. After reading that I was grateful I had the side effect I did and couldn’t continue taking it. I consider what happened a blessing in disguise. Thank you for writing this article so that more people are aware of its effects.

  20. Mrs s wright says:

    I take 1500 a day ,I do have a lot of problems with it ,my memory is bad and I get slurred speech ,I hate it when I’m talking to other people and I stop in mid sentence And I can’t remember what I was say ,my ligaments and muscles ach when I do repetitive things for a minute or so I get very bad pain in my tendons and muscles ,I got restless leg ,weight gain ,I have very dry eyes I can’t see out of them some times ,mouth nose and skin are dry and itchy ,I have lost my get up and go and meny more ,the doctor said he can not change it because I’m im on lots of other meds,,my illments are SNP ,fibromalger ,hypothyroidism ,heart problems ,,gastro refluxes ,I have lots of side affects from most of my meds ,but I find with Gabapentin it can stop working, so it get put up some more ,it gets me through my day and I am quite happy on it .

  21. Teresa says:

    I have not read the Stanford article but intend to do so right way. My neurosurgeon prescribed Neurontin for nerve damage following back surgery. I tried taking it a couple different times. The first, I took just 200mg at night. I was told it would help me sleep. It did nothing for my nerve pain. The next time, he told me to continue increasing the dosage until I got results. So we were attending an event for the 4th of July and I decided to take 600mg. It was amazing I could actually walk again- without a limp. I thought, this is great. I continued taking about 600 – 1,000mg /day. I started gaining weight immediately. About 10lbs the first month and I was craving food. Then a couple weeks later, I was driving home after running errands and kept falling asleep at the wheel. This was serious bc I had enormous difficulty keeping my eyes open. I decided I would not take the medication before driving. Just at night. Then I realized I couldn’t go to asleep until sometimes 4 am. I have insomnia due to the Cymbalta I’m taking but not as bad as this. I’ve been on Ambien for many years and never had problems with sleeping. After reading some of the comments from others I realized that there were actually more side effects than what I thought – like swelling of breasts, word loss, sweating and suicidal thoughts. Yes. It does help reduce the nerve pain in my leg but I found I kept needing to increase the dosage for it to be effective. I decided after reading this article to go cold turkey. That was two days ago. I no longer trust my doctors to know more about my body than I do. I don’t think I’ve had withdrawal symptoms. My appetite has decreased and the insomnia is a little better. I’ve been taking Cymbalta for more than 10 years and it seems to work just fine for my fibromyalgia. I experience occasional flares and amplified pain with surgery and try to push through it. I’ve been taking dilaudid periodically to reduce the post surgery pain. Frankly, the opioids are more effective for my sciatic nerve pain and I have fewer side effects. Im seeking another opinion for the post surgical back and leg pain. Hope this helps someone.

    • Karen says:

      Teresa… Cymbalta did seem to help me with pain but I did not like the brain zaps & horrible sweating. I went off of Cymbalta. I have many of the symptoms you mentioned but not the sleep problem. I am afraid of the pain I might have if I go off of gabapentin. I am going to try a cleanse to see if that might help me.

      Fibromyalgia is such a nasty disease. Some days are worse than others.

  22. Vee says:

    I’ve been on Neurontin for years, but recently cut my dose, due to memory, migraines, not sleeping issues. I just can’t seem to think straight anymore. Countless copays to different docs who say keep taking it. My tongue stings at times. Does anyone else have this problem Just tired of not remembering, itching, pain.

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