Gabapentin and Alcohol Withdrawal: How to Use It

In this article, you’re going to learn about gabapentin and alcohol withdrawal. Over the past few years, a growing number of people have successfully used gabapentin for alcohol withdrawal. Gabapentin is an anticonvulsant medication that is available only by prescription.

Gabapentin is very similar in structure to GABA, which is a brain chemical associated with feelings of calm and mental stability. Many of the symptoms of alcohol withdrawal are caused by low levels of GABA.

Gabapentin is a generic drug, and the most common brand name is called Neurontin. An extended-release version of gabapentin is prescribed under the brand Horizant. Gabapentin has been traditionally prescribed to treat:

• Epilepsy
• Nerve pain
• Restless leg syndrome
• Seizures

Gabapentin has also recently been used to treat anxiety disorder, panic disorder, and a range of chemical addictions including cocaine, opiates, and alcohol.

Gabapentin And Alcohol: Overview of Gabapentin

Gabapentin has shown to be effective at alleviating or preventing the following symptoms:

• Anxiety
• Insomnia
• Nausea
• Headache
• Heart Palpitations
• Panic attacks
• Sweating

Gabapentin works by increasing the production of GABA in the brain, essentially aiding brain cells that are too damaged to perform this crucial function.

It does this by modulating the action of two enzymes – one involved in the production of GABA, and the other involved in the production of glutamate, which is a stress chemical.

To understand the science behind using gabapentin for alcohol withdrawal, we will briefly review the causes of alcohol withdrawal symptoms.

Alcohol is a depressant that mimics GABA, and alcohol addiction causes the brain to decrease its long-term GABA production because it has learned to rely on alcohol for the same effect.

Because alcohol suppresses glutamate (the aforementioned stress chemical and “excitatory” neurotransmitter), the alcoholic brain ramps up its production of glutamate. In the absence of alcohol to calm down the brain, the alcoholic feels hyperactive, hypersensitive, and panicked.

When an alcoholic stops drinking suddenly, two important things happen:

• Glutamate rebounds to high levels within 3-8 hours
• GABA does not return to normal levels (this can take weeks)

Many of the symptoms of alcohol withdrawal are caused by a lack of GABA and an excess of glutamate.

While some people have used gabapentin for alcohol withdrawal and then tapered off, others have taken long-term gabapentin for alcohol cravings.

Continuing to use gabapentin after alcohol detox has helped many alcoholics reduce the chance of relapse. The trade-off is that long-term use of gabapentin can cause dependence.

Gabapentin And Alcohol: Gabapentin Dosage Information

The following dosage information may be useful if you are considering taking gabapentin for alcohol withdrawal:

• Since gabapentin is a generic drug, dosage amount may vary depending on the brand and different brand name tablets are not interchangeable.
• 600-1800 mg per day of gabapentin for alcohol withdrawal is typically effective to mitigate symptoms.
• Studies of gabapentin for alcohol withdrawal have used 1200 mg tapering to 800 mg or 900 mg tapering to 600 mg. (source)
• Larger doses of gabapentin for alcohol withdrawal (over 900 mg) are typically divided throughout the day.
• To avoid dependence, only take gabapentin for alcohol withdrawal as long as it is needed to manage symptoms – typically less than a week.
• There is no standard dosage of gabapentin for alcohol withdrawal; only a doctor can determine this depending on your situation.
• Only take gabapentin under the supervision of a doctor.

Before taking gabapentin for alcohol withdrawal, make sure to review the following:

• Overview
• Side effects
• Interactions

Research Studies

While gabapentin is not yet an FDA-approved treatment for alcoholism, a number of studies support the use of gabapentin for alcohol withdrawal and cravings:

• In a 12-day study of alcoholics detoxifying with either gabapentin or lorazepam (a benzodiazepine prescribed with the brand name Ativan), the gabapentin group was less likely to drink – and had less craving, anxiety, and sedation (source)
• In a 12-week study of 150 alcoholics receiving either gabapentin or a placebo, the gabapentin group had significantly less insomnia, dysphoria, and alcohol craving (source)
• Gabapentin reduced alcohol intake for alcoholic rats but not for non-alcoholic rats, demonstrating its effectiveness for alcohol cravings by acting as a substitute source of GABA (source)
• Gabapentin is comparable to clonazepam in its effectiveness for treating insomnia in depressed patients (source)

Alternatives To Gabapentin

Not everyone can obtain gabapentin, since it must be prescribed by a doctor. It can sometimes be difficult to find a doctor who is open to prescribing gabapentin for alcohol withdrawal.

Besides benzodiazepines, which are the most commonly prescribed drugs for alcohol detox, there is an alternative to gabapentin for alcohol withdrawal known as baclofen.

Baclofen

Baclofen is another prescription drug that is structurally similar to GABA. Like gabapentin, baclofen can be used to manage alcohol withdrawal symptoms.

Long-term, high-dose baclofen has also been used by a growing number of people to achieve a state of indifference toward alcohol. To learn more, check out this article on the interesting baclofen alcohol relationship.

Gabapentin And Alcohol: Conclusion

Gabapentin for alcohol withdrawal is a little-known but highly effective treatment that our medical establishment has all but hidden from patients. While not everyone responds well to gabapentin, a greater awareness of the use of gabapentin for alcohol withdrawal can improve recovery odds for many people.

There is no one-size-fits-all approach for alcohol detox and recovery. Most people who quit drinking are not enlightened about nutrient repair, other pharmacological options, or holistic strategies for improving quality of life.

Check Fit Recovery’s list of supplements that work best for supporting the brain-body system through alcohol recovery.

If you have any questions about gabapentin and alcohol withdrawal, please post them in the comment box below.

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Dr. Ken Starr is board certified in both Addiction Medicine and Emergency Medicine, and diplomate of the American Board of Addiction Medicine. In addition to his work as the Addiction Medicine Director for Fit Recovery, he operates Ken Starr MD Wellness Group in Arroyo Grande, CA. His clinic offers advanced drug and alcohol detox methods, long term recovery facilitation, and IV nutritional programs including NAD+ therapy.

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