If you’ve ever experienced nerve pain, you know that typical pain meds like acetaminophen or ibuprofen, frankly, don’t do sh*t.
That’s because nerve pain—often described as a burning, prickling, or tingling pain—is totally different from, say, menstrual pain, which is considered visceral pain (pain in the organs), or muscle pain, which is considered somatic pain (when pain receptors in tissues are activated).
That’s why many people who suffer from neuropathy, a.k.a. nerve pain, turn to gabapentin, also sold under the brand name Neurontin.
“We use it a lot when there is any type of irritated nerve, most commonly lumbar radiculopathy—sciatica, in laymen’s terms. Or radiating neck pain that goes into the arms and hands,” says Kiran Patel, M.D., director of neurosurgical pain at Lenox Hill Hospital, in New York.
It’s also prescribed to treat pain linked to nerve damage from diabetes and chemotherapy, she says. Unlike other pain meds like opiods, which work by blocking feelings of pain, gabapentin changes the way the body senses pain.
The drug is often prescribed off-label, too, says Patel. (That means doctors prescribe it to help treat conditions the FDA hasn’t approved it for.) Case in point: Non-pain related conditions like anxiety and alcohol withdrawal can benefit from gabapentin, says Andrew Saxon, M.D., chair of the American Psychiatric Association’s Council on Addiction Psychiatry.
But, because gabapentin can work for multiple conditions, some doctors fear that it’s being over-prescribed. A 2017 report in the New England Journal of Medicine suggests gabapentin is being increasingly prescribed for almost any type of pain.
In 2016, it was the 10th most commonly prescribed medication in the United States with a total of 64 million prescriptions dispensed that year, up from 39 million prescriptions in 2012, according to the report.
On top of that, recent news reports suggest the drug has the potential for abuse and misuse. Officials in Kentucky and Ohio are reporting it’s shown up in people who’ve overdosed on opioids.
Though the drug isn’t believed to be the cause of the overdoses, which are linked to drugs such as heroin and fentanyl, it could be a contributing factor, says Patel explaining that it may be the result of “polypharmacy”—the use of multiple drugs at the same time to treat a condition. Gabapentin may also help enhance the euphoria caused by opioids.
According to Patel and Saxon, gabapentin is usually well-tolerated when taken as directed. Still, it’s important to be aware of these gabapentin side effects.
You always feel woozy and drowsy, even after a good night’s sleep.
The most common gabapentin side effect is drowsiness, says Saxon. That sleepy feeling may be more pronounced when you first start taking gabapentin and then slowly goes away as your body adjusts to the medication, according to the Mayo Clinic. Don’t get behind the wheel (golf carts and bikes included) if it makes you feel groggy. If the drowsiness doesn’t go away, check in with your doctor who can work with you on tweaking the dose, or may suggest weaning you off.
You’re having memory issues or trouble forming thoughts.
“I’ve seen some of my patients who don’t feel as sharp cognitively and have issues with memory,” says Patel. Talk with your doctor about this symptom before you stop taking the drug. Just don’t stop cold-turkey—you’ll likely have to taper off of the medicine, since suddenly stopping gabapentin can make you feel worse, says Patel.
You’re kind of wobbly too.
Balance problems may also be a side effect of taking gabapentin, along with uncoordinated movement, says Patel. Again, tell your doctor, who may want to adjust your dose or discuss other pain relief options.
You’re on other medications and start to feel worse after beginning a course of gabapentin.
Definitely do not mix gabapentin with opioids without consulting with your doctor first. Tell your doctor if you’re using herbal drugs, too, like ginkgo biloba, which can lessen then effects of gabapentin. Antacids can also reduce the effectiveness of the drug. But it’s okay to combine gabapentin with the (proper dosage) of over-the-counter pain relievers ibuprofen or acetaminphen, Patel says.
You’ve been feeling depressed lately.
Gabapentin side effects can also include an increased risk of suicidal thoughts and behaviors (the Food and Drug Administration issued a warning about this possible in 2008). Talk to a doctor or a mental health expert right away if you’re experiencing these thoughts or feelings.
You’re having difficulty breathing.
“Gabapentin should not be taken with other medicines that can cause sedation, including Benadryl, sleep aids, muscle relaxants — and most definitely not with alcohol — because of the potential risk of respiratory depression. Even cough syrup,” says Patel.
It should also be noted, that you should talk to your doctor if you’re taking gabapentin and are pregnant or are considering pregnancy; gabapentin’s side effects in pregnancy have not been well-researched.
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