Using Gabapentin for Opiate Withdrawal: Will it Work?
Designed to be prescribed as a medication to treat nerve pain and as an anticonvulsant, gabapentin, or Neurontin in brand-name form, can also be helpful for managing some of the symptoms of opioid withdrawal. Gabapentin is commonly used off-label, that is for symptoms it is not specifically FDA-approved to treat, during opioid detox.
The Journal of Clinical Psychopharmacology publishes that when used as an adjunctive medication, gabapentin does help to relieve some of the physical side effects of opiate withdrawal. The key word here is adjunctive, which means in addition to and as a method of complementing other medications and treatments.
Gabapentin can be a helpful tool used during medical detox to reduce some of the specific side effects of opiate withdrawal, but it is not used as a primary method of treatment.
Managing Opiate Withdrawal with Medications like Gabapentin
Opioid withdrawal can be significant once a person has developed physical dependence on an opiate, such as heroin or a prescription painkiller like OxyContin (oxycodone) or Vicodin (hydrocodone/acetaminophen). Opiates change the way some chemical messengers are made and used throughout the central nervous system.
With regular use of a mind-altering opioid drug, the brain may not send its signals the same way, and brain chemistry can become out of balance. If a person then stops taking opiates, the brain can struggle to restore balance without the drugs, and it can take some time for chemical equilibrium to be restored. During this time, levels of some of the neurotransmitters that are impacted by opioid use, like dopamine, may drop significantly, resulting in difficult withdrawal symptoms.
Opioid drugs also act on the central nervous system as depressants, slowing down some of its normal functions, which help to regulate body temperature, heart rate, and blood pressure. When someone takes an opiate regularly and then stops taking it, the central nervous system can become somewhat hyperactive as it is no longer being suppressed by the drugs.
This is where gabapentin comes in. As an antiepileptic drug, gabapentin works within the nervous system as well. It may increase the workings or levels of GABA (an inhibitory neurotransmitter) in the brain, which can help with some of the autonomic nervous system functions that can be overactive during opiate withdrawal.
Gabapentin may specifically help with the following side effects of opiate withdrawal:
- Muscle tension
- Chills and feelings of being cold
- Dysphoria (a general feeling of unease and unhappiness)
- Restless leg syndrome
Physical flu-like symptoms and emotional lows are common during opiate withdrawal, and individuals are advised to not stop taking these drugs suddenly. Instead, a medical detox program that uses medications like gabapentin to manage withdrawal symptoms can be helpful. Typically, methadone or buprenorphine is used during opiate detox as they are long-acting opioid agonists that can be given in lower doses and then weaned off slowly to keep cravings and withdrawal symptoms to a minimum.
Other medications may be helpful during detox as well to act on certain withdrawal symptoms. The Pakistani Journal of Pharmacology reports that when used during detox along with other medications, such as methadone, gabapentin can alleviate some of the specific withdrawal symptoms impacting the nervous system that are caused by opioid drug dependence.
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