Last Updated on September 16, 2026 by
Alternative to Meds Editorial Team
Medically Reviewed by ATMC Clinical Review Team
Table of Contents:
Often when an antipsychotic drug was prescribed, there was not sufficient time to become adequately informed. Once the mental health crisis has passed, it may be time to learn more that can be discussed for the best path forward on your treatment journey.
What is Gabapentin?
Gabapentin is an anti-epileptic, anticonvulsive drug that came to market in the early 90s. The brand name for the drug is Neurontin. The drug was found to modulate the body’s “voltage-gated calcium channels” which resulted in decreasing the output of excitatory neurochemicals.
While the drug’s effects have proved helpful in certain conditions, the risks of weight gain, obesity, suicidal ideation, and other side effects present concerns, especially over long-term use of gabapentin.
What is Gabapentin Used for?
Gabapentin has been FDA-approved for several clinical uses. There have also developed a number of off-label uses — most notably for the treatment of pain. The use of gabapentin in pain relief has grown significantly, perhaps as an answer to the overuse of opioids. However, clinical evidence to support its efficacy in pain management applications is weak, according to researchers.1-3
A controlled-release version of the drug, gabapentin enacarbil was also developed for its longer-lasting effects.
FDA-approved uses for gabapentin include:
- As an adjunctive therapy for partial onset seizures in adults and children age 3 and up with epilepsy
- Post-herpetic neuralgia (pain after herpes)
- (enacarbil controlled-release) Restless legs syndrome
Off-label uses for gabapentin are many, fors example:
Neuropathy in diabetic patients- Neuropathy related to spinal cord injury
- Pain relief in fibromyalgia
- Bipolar
- Anxiety disorders
- Treatment-resistive depression
- Mood disorders
- Irritable bowel syndrome
- Alcohol withdrawal
- Insomnia
- PTSD
Long-Term Use of Gabapentin Pros & Cons
Gabapentin has been used both short and long-term in alcohol withdrawal. Short term use was deemed safe in acute alcohol withdrawal. Gabapentin long-term was found superior to benzodiazepines for supporting continued abstinence after alcohol withdrawal. However, studies found gabapentin lacked efficacy for reducing cravings or for treating other types of substance dependence such as opioids.3
However, a massive study of gabapentin in persons with and without alcohol use disorder showed adverse effects including somnolence, falls and fractures, and altered mental states.11
In a 60-day trial on aged mice, authors reported gabapentin long-term effects under the category of cognitive decline, even though the trial was only 60 days in duration.4
One of the barriers to knowing more about long-term effects of gabapentin is that the studies published on off-label uses tend to be short, i.e. 4-6-8 weeks. However, used in pain management, prescriptions of gabapentin often extend into years of treatment, especially in the elderly population.
The British Journal of General Practice reported as far back as 2012 that gabapentin had become a mainstay in long-term pain management, which generally lasts for extended periods of time.
Is Gabapentin Addictive?
According to researchers in the UK, gabapentin developed an “exponential” statistical increase in both the numbers of prescriptions written from 1999 to 2011, and in the rise of numbers of persons who are addicted to gabapentin, along with a significant street presence of gabapentin.
Gabapentin’s side effects that accompany pain relief are similar to other drugs of abuse, including these examples:
- Euphoria
- Relaxation
- Sense of calm
- A marijuana-like high
- Somnolence
- Loss of muscle control and coordination
- Tremors
- Mood dysregulation
UK Police reports showed gabapentin has been commonly used as a cutting agent in street heroin. Like heroin, gabapentin overdose is fatal — but unlike heroin, there is no quick remedy for overdose such as naltrexone.5
In the Us, prescriptions for gabapentin doubled from 2009 to 2016 according to a massive review of insurance-based claims, and the trend has continued to rise.6
Dependence to gabapentin whether used for recreational, pain management, or other use can result in withdrawal symptoms shown below.
Gabapentin Withdrawal after Long-Term Use
Like any drug, after dependence or addiction develops, withdrawal can cause adverse effects. Some of gabapentin’s withdrawal effects can include seizures, mood disturbances, hallucinations and many others. Never abruptly stop taking a prescription of gabapentin as the withdrawals can be severe. Careful withdrawal management is recommended for the safety of the patient.
Learn more about gabapentin withdrawal and the most effective recommendations for stopping the drug safely.
Gabapentin Side Effects Can Become Long-Term Effects
A prescription of gabapentin will commonly occur over an extended period of time. Side effects which persist over this time have been documented in clinical trials in both animals and humans.
According to the FDA, gabapentin prescriptions must include 2 mandatory high-level warnings of side effects. High-level warnings are safety signals, with a severity comparable to black box warnings on other prescription drugs.1,11
The high level warnings for gabapentin are:
- Fatal respiratory depression (stops breathing)
- Risk of suicidal thoughts and suicide attempts
Other known long-term effects of gabapentin include:
Developed dependence, addiction- Cognitive decline
- Sedation
- Weight gain
- Heart attack
- Stroke
- Unusual mood changes
- Worsened depression
- Falls
- Fractures
- Altered mental states
- Dizziness
- Fainting
- Kidney toxicity
for Help with Gabapentin Long-Term Effects
[ =” “]Gabapentin Long-Term Effects FAQs
Citations:
1. FDA label Neurontin (gabapentin) capsules for oral use approval 1993 [cited 2026 July 14]
2. Goodman C, et al., A Clinical Overview of Off-label Use of Gabapentinoid Drugs published march 25, 2019 JAMA [cited 2026 July 14]
3. Rama Yasaei, et al., Gabapentin: Treatment and Management published 2/21/2024 in Stat Pearls [cited 2026 July 14]
4. Suyun Xia, et al., Long-term gabapentin treatment impairs cognitive function in aged mice… published in Frontiers Journal pf Pharmacology, 2 Sept 2025 [cited 2026 July 14]
5. Smith B, et al., Substance misuse of gabapentin published in the British Journal of General Practice Vol 62 issue 601 August 2012 [cited 2026 July 14]
6. Pauly NJ, Delcher C, Slavova S, Lindahl E, Talbert J, Freeman PR. Trends in Gabapentin Prescribing in a Commercially Insured U.S. Adult Population, 2009-2016. J Manag Care Spec Pharm. 2020 Mar;26(3):246-252. doi: 10.18553/jmcp.2020.26.3.246. PMID: 32105169; PMCID: PMC7155217.[cited 2026 July 14]
7. Dutta D, Mohindra R, Kumar M, Banerjee M, Sharma M, Mukhopadhyay S. Cardiovascular safety of gabapentinoids gabapentin & pregabalin: A systematic review. Indian J Med Res. 2025 Apr;161(4):363-374. doi: 10.25259/IJMR_1990_2024. PMID: 40536375; PMCID: PMC12178190. [cited 2026 July 14]
8. Information for Adult Patients Prescribed Gabapentin for the Treatment of Pain published by the Faculty of Pain Medication, to be reviewed in 2023 [cited 2026 July 14]
9. Lennox R, Mangin D. Gabapentin misuse. CMAJ. 2019 Jan 14;191(2):E47. doi: 10.1503/cmaj.180599. PMID: 30642825; PMCID: PMC6333539. [cited 2026 July 14]
10. Barrueto F Jr, Green J, Howland MA, Hoffman RS, Nelson LS. Gabapentin withdrawal presenting as status epilepticus. J Toxicol Clin Toxicol. 2002;40(7):925-8. doi: 10.1081/clt-120016965. PMID: 12507063. [cited 2026 July 14]
11. Rentsch CT, Morford KL, Fiellin DA, Bryant KJ, Justice AC, Tate JP. Safety of Gabapentin Prescribed for Any Indication in a Large Clinical Cohort of 571,718 US Veterans with and without Alcohol Use Disorder. Alcohol Clin Exp Res. 2020 Sep;44(9):1807-1815. doi: 10.1111/acer.14408. Epub 2020 Jul 28. PMID: 32628784; PMCID: PMC7540277. [cited 2026 July 14]
Originally Published July 15, 2026 by Diane Ridaeus
ATMC Clinical Review Team
The ATMC Clinical Review Team includes licensed physicians and experienced healthcare professionals dedicated to ensuring the accuracy, quality, and integrity of our medical content. The team reviews articles for clinical accuracy, evidence-based guidance, and relevance while supporting Alternative to Meds Center’s whole-person approach to mental health, recovery, and long-term wellness.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.