Some experts say that gabapentin may have a role to play in reducing symptoms of alcohol withdrawal syndrome and promoting abstinence. However, this is an off-label use of the drug.

Gabapentin is an anticonvulsant that helps to control and reduce severe epileptic seizures. According to a 2020 study, people who took gabapentin for alcohol withdrawal tolerated it well.

Generally, people should not mix alcohol and gabapentin. The drug can cause various side effects, including dizziness and drowsiness. Since alcohol also produces these two effects, taking the substances together can worsen side effects.

This article discusses the role that gabapentin can play in alcohol withdrawal syndrome treatment. It also examines what can occur when alcohol and gabapentin mix.

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Gabapentin is a drug with anticonvulsant and pain-relieving properties, but researchers do not know exactly how it works. The Food and Drug Administration (FDA) has approved the uses of the drug in the treatment of the following conditions:

  • post-herpetic neuralgia, a painful condition that lingers after recovery from shingles
  • adjunctive treatment of partial seizures, which is an add-on treatment for seizures that affect a single area of the brain
  • moderate to severe restless leg syndrome, a condition involving an uncontrollable urge to move the legs

It also has off-label uses, which refer to conditions for which the FDA has not approved the drug. These include, but are not limited, to the following:

While there is not enough data to support the use of gabapentin alone for alcohol withdrawal syndrome, some research indicates that it could have an effect when combined with other medications.

The syndrome’s effects are detailed below.

What is alcohol withdrawal syndrome?

Approximately 14% of adults in the United States have AUD, resulting in serious health and social consequences.

Alcohol withdrawal syndrome occurs when a person with long-term AUD suddenly stops drinking or significantly decreases their alcohol intake.

The effects may include:

  • mild symptoms, such as:
  • moderate symptoms, such as seizures and hallucinations
  • severe symptoms, such as:

For some, withdrawal symptoms can be fatal if an individual does not receive treatment.

How gabapentin can help

Gabapentin can help with alcohol withdrawal by counteracting the physiological effects of the syndrome.

Evidence indicates that symptoms of alcohol withdrawal syndrome stem from reduced gamma-aminobutyric acid (GABA) activity and enhanced glutamate. GABA is an amino acid with an inhibitory effect in the brain, and glutamate is a key excitatory chemical in the brain.

Gabapentin increases GABA concentrations, which counters the reduced GABA activity. According to research findings, it also decreases the release of glutamate, which counters the enhanced glutamate.

Consequently, gabapentin decreases symptoms of alcohol withdrawal syndrome. These include:

Gabapentin can also promote abstinence and is effective in preventing relapses to heavy drinking, adds a 2020 clinical trial study.

The standard treatment for alcohol withdrawal is a class of medications called benzodiazepines. These drugs have sedating properties and can cause psychomotor impairments. Psychomotor impairments refer to interruptions in connections between muscle and mental functions, possibly affecting how people move and talk.

Additionally, benzodiazepines can lead to addiction, so doctors limit their use to the treatment of acute alcohol withdrawal. Typically, it would involve only short-term use.

Research compared the effects of the standard benzodiazepine treatment with gabapentin for inpatients and outpatients. While it found no advantages of gabapentin for inpatient (or hospital) treatment, it found benefits associated with it for outpatient treatment. One key benefit is that gabapentin can promote a smoother transition into early abstinence.

The FDA reports that gabapentin can cause drowsiness and dizziness. Because alcohol also has these side effects, drinking alcohol while taking gabapentin can intensify them.

Also, mixing alcohol with gabapentin can lead to fatigue, anxiety, and confusion.

Generally, it is not advisable to mix both. A person should talk with their doctor if they have alcohol use disorder or any other concerns before taking the drug.

Gabapentin can potentially cause an extensive spectrum of side effects, some of which are serious. Examples of the more common ones include:

  • dizziness
  • tiredness
  • somnolence, or drowsiness
  • ataxia, or issues with coordination
  • fever

Some of the most serious side effects include:

  • suicidal ideation
  • anaphylaxis, a life threatening allergic reaction
  • depression
  • angioedema, which is swelling under the skin due to an allergic reaction
  • withdrawal seizures if discontinued abruptly

Help is available

Seeking help for addiction may feel daunting or even scary, but several organizations can provide support.

If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice:

Gabapentin is an anticonvulsant and pain-relieving medication with several off-label uses, including treating alcohol withdrawal syndrome. It helps reduce symptoms, such as insomnia, cravings, and anxiety. Also, the drug can help promote abstinence and prevent relapses to heavy drinking.

Both gabapentin and alcohol produce dizziness and drowsiness, so a person should not take them together without talking with a doctor, advises the FDA.

Gabapentin on its own has the potential to cause many side effects, some of which are serious, such as depression and suicide. Someone who takes gabapentin should not exceed the prescribed dosage and should report any troubling symptoms to a doctor.