Can You Overdose on Gabapentin?

Misusing gabapentin, like any other substance, can result in an overdose, which can sometimes be deadly. This medication, approved by the FDA, is primarily used to treat epilepsy but is also effective for nerve pain related to various conditions, including diabetes. Furthermore, it plays a role in managing withdrawal symptoms for those recovering from opioid and alcohol dependence, helping them transition to sobriety more safely. Gabapentin overdose typically occurs when it is mixed with other substances, especially central nervous system (CNS) depressants like opioids, which can significantly amplify its effects, leading to respiratory depression, a slowed heart rate, and potentially fatal outcomes.

Gabapentin can induce sensations of relaxation, tranquility, and euphoria. Some users have noted that snorting gabapentin can produce effects similar to stimulants and can enhance the euphoric effects of other drugs, like heroin and other opioids. The likelihood of an overdose from gabapentin increases when the medication is used this way. A study from the University of Kentucky, published in the National Library of Medicine, indicates that while gabapentin was once thought to have no potential for abuse, there has been a notable increase in its misuse, particularly among those with substance use disorders. People often misuse gabapentin for recreational reasons, self-medication, or even intentional self-harm, either on its own or in combination with other substances like benzodiazepines, opioids, and alcohol.

What Is a Toxic Level of Gabapentin?

Gabapentin, marketed under names like Neurontin and Gralise, has become a popular drug of abuse among those seeking a relaxing high similar to that of opioids. In the United States, there is growing concern about the potential for gabapentin misuse, mainly due to the risk of overdose, which can be life-threatening. Although overdosing on gabapentin is generally less fatal compared to other central nervous system depressants, combining it with alcohol or other drugs can lead to severe consequences. Gabapentin works by inhibiting nerve activity, which can slow down critical bodily functions when taken in excessive amounts or alongside other depressants. The threshold for an overdose varies based on an individual’s health, weight, and tolerance, but typically, a toxic dose is considered to be around 49 grams or more.

Research from Western Michigan University published in the National Library of Medicine dictates that the dosage of gabapentin can differ based on the condition being treated, usually falling between 300 to 500 mg per day. The therapeutic blood concentration is ideally between two to 20 μg/mL, with levels exceeding 25 μg/mL classified as toxic. However, it’s important to note that overdose risks can arise even at lower doses when gabapentin is mixed with other depressants or alcohol.

What Are the Side Effects of High Doses of Gabapentin?

Gabapentin binds to calcium channels in the brain, decreasing nerve excitability and promoting feelings of relaxation and euphoria. This mechanism makes it beneficial in treating a range of issues off-label, such as restless leg syndrome, insomnia, anxiety, and general pain. However, similar to other medications, gabapentin can have a range of physical and psychological side effects, including suicidal thoughts and behaviors. According to the Cleveland Clinic, some common side effects of gabapentin include:

• Dizziness
• Fatigue or drowsiness
• Headaches
• Nausea and vomiting
• Speech difficulties
• Memory issues
• Weight gain
• Frequent infections
• Movement disorders, including lack of coordination, tremors, and jerky motions
• Unusual eye movements and double vision
• Anxiety
• Irritability

High doses of gabapentin are associated with a twofold increase in adverse effects, including ataxia, nystagmus, tremors, and drowsiness. In toxic levels of gabapentin, a person may experience an overdose, which can include vomiting, low blood pressure, labored breathing, and coma. While most gabapentin overdoses are managed medically without significant complications, they can still pose serious risks, particularly for children, the elderly, and those with compromised kidney function. Additionally, combining moderate to high doses of gabapentin with opioids raises the risk of opioid-related death by 60% compared to using opioids alone.

Mixing gabapentin with other substances, especially central nervous system depressants, heightens the risk of fatal overdose. This combination can lead to respiratory depression or failure, and if the brain is deprived of oxygen for three to five minutes, it may suffer permanent damage, shortly followed by death. Many patients prescribed opioids are also given gabapentin, which can further increase the potential for misuse and overdose. Some people can become addicted to gabapentin with continued misuse and can experience withdrawal symptoms when they attempt to stop taking it.

What’s the Highest Amount of Gabapentin You Can Take at Once?

Maximum doses of gabapentin prescribed to adults are between 900 and 3,600 mg a day, split into three doses. Gabapentin abuse typically involves taking a higher dose in a single administration. The average dose for gabapentin abuse is 3600 mg and above, which is 3 times the maximum recommended single dose of 12 mg. Despite its therapeutic role in various health issues, gabapentin produces psychoactive effects, which can put them at risk of being abused. Individuals with current or previous opioid abuse, cocaine use, and/or concurrent use of benzodiazepines or cannabis are at higher risk for gabapentin abuse. 

It is also important to note that mixing gabapentin with other substances, including alcohol, can lower its maximum dose amount. Its sedative effects can be significantly intensified by alcohol and vice versa, including dizziness, confusion, drowsiness, impaired thinking, lowered inhibitions, and impaired motor skills and coordination. Mixing alcohol or other sedative substances can increase the chances of an overdose related to gabapentin.

Is Gabapentin a Very Strong Painkiller?

Gabapentin is a medication primarily used to treat seizures, but it also plays a significant role in alleviating nerve pain. Unlike traditional painkillers such as opioids, it offers a different approach to pain management. It can be particularly beneficial for individuals suffering from conditions like postherpetic neuralgia or peripheral diabetic neuropathy, providing moderate relief. However, it’s important to note that increasing the dosage or extending the treatment period does not enhance its pain-relieving effects. 

For those recovering from opioid addiction, gabapentin can help ease withdrawal symptoms, including muscle cramps, anxiety, depression, restlessness, agitation, irritability, and insomnia. While the exact mechanism of how it aids in opioid withdrawal remains unclear, it appears to soothe the brain’s response to pain. As a non-opioid alternative, it is frequently prescribed for individuals with opioid use disorders, but caution is advised due to its potential for misuse and addiction.

Contact WhiteSands Treatment If You Have Experienced a Gabapentin Overdose

Gabapentin carries a risk of misuse, particularly among those who abuse multiple substances. Although it is often viewed as a safer alternative to opioids, there are still significant risks involved, including the possibility of gabapentin overdose. If you or a loved one is facing challenges with gabapentin misuse or addiction, WhiteSands Treatment offers comprehensive programs designed to support long-term recovery. Experiencing any form of drug overdose, including accidental gabapentin intoxication, can be a sign of a substance use disorder, which is often difficult to tackle alone. Our treatment strategies incorporate evidence-based behavioral therapies alongside holistic methods to address each individual’s addiction and its underlying causes. Our compassionate clinical team collaborates to develop a tailored treatment plan focused on healing and equipping patients with essential coping skills for sustainable sobriety.

To find out more about our addiction treatment options, contact WhiteSands Treatment today at 877-855-3470.

 

External Sources

• National Library of Medicine – Gabapentin misuse, abuse, and diversion: A systematic review
• National Library of Medicine – Gabapentin in Mixed Drug Fatalities: Does this Frequent Analyte Deserve More Attention?
• Cleveland Clinic – Gabapentin

If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.