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Neurontin/Gabapentin for Alcohol Withdrawal

Alcohol withdrawal can be an uncomfortable, painful process that takes both time and tenacity to get through.

The physical cravings for alcohol – combined with its powerful psychological effects – often drive people right back to drinking.

Fortunately, some medications have demonstrated the ability to help make the alcohol withdrawal process more tolerable. Neurontin is an example one of these medications that may help.

What Is Neurontin?

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Neurontin is a brand name for the generic drug called gabapentin. Gabapentin is an anticonvulsant drug commonly used to treat seizure disorders and has also been used to manage the pain experienced after a person gets shingles (“postherpetic neuralgia”).1

Gabapentin may, however, also offer some treatment help for individuals who are suffering from alcohol withdrawal symptoms.

While not yet federally approved as a treatment for alcoholism, clinical studies using gabapentin are uncovering many potential benefits for treating the symptoms that occur during periods of withdrawal from alcohol.2

How Does Gabapentin Work?

The way that gabapentin works is not yet fully understood, but it was chemically designed to resemble γ-aminobutyric acid (GABA). While it does not appear to have a robust effect at GABA receptors, through other mechanisms of action, it is believed to cause increased production of GABA itself throughout the brain.

GABA is an amino acid that functions as an inhibitory neurotransmitter. It calms nervous activity in the brain by inhibiting nerve transmission.

Low GABA in Those Who Are Dependent on Alcohol

Those who are addicted to alcohol tend to have low levels of GABA in their system, and the craving for more alcohol may be, in part, due to the fact that alcohol intake boosts the brain’s GABA levels.3,4

After years of ongoing alcohol use, reaching for a drink when life gets stressful or overwhelming may seem like the most natural thing to do. One reason it may feel so natural is because of alcohol’s effect of increasing the body’s GABA levels – which can help soothe fear and stress.

After years of ongoing alcohol intake, the brain learns to rely on alcohol in order to cope with daily events. So in a sense, reaching for a drink becomes a “natural” behavior for increasing the amount of GABA in the system.

Gabapentin as an Alcohol Replacement

Part of the reason why researchers have taken an interest in gabapentin as an addiction treatment is due to the way it fights the cravings for alcohol by restoring the brain’s normal chemical functions. In effect, gabapentin helps malfunctioning brain cells produce the chemicals needed to handle everyday stressors without alcohol.

One study published in the Journal of Neuroscience demonstrated that gabapentin successfully reduced alcohol intake only in rats that were dependent on alcohol – unlike their non-alcohol-dependent counterparts.This finding may help affirm the theory that gabapentin reduces alcohol cravings by feeding the “hunger” of the GABA-deprived body.

Gabapentin’s Effects on Alcohol Withdrawal Symptoms

A closer look at some of alcohol’s withdrawal symptoms further highlights how gabapentin can help ease your alcohol withdrawal process.

Alcohol Withdrawal Symptoms

If you are dependent on alcohol, you may experience any of these common and less severe withdrawal symptoms as early as 6 hours after your last intake of alcohol6:
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  • Insomnia.
  • Anxiety.
  • Headache.
  • Gastrointestinal disturbances.
  • Palpitations (rapid, irregular heart beats).
  • Sweating.

Theoretically, gabapentin’s ability to increase GABA production may be responsible for producing a calming effect on a number of these alcohol withdrawal symptoms.

Research studies have added further insights as to how gabapentin succeeds in relieving a number of these symptoms.7

Insomnia Effects

If you’ve attempted to abstain from alcohol after a long history of drinking, you may have experienced bouts with insomnia on a regular basis. That’s because insomnia is one of the withdrawal effects brought on by alcohol deprivation.

Gabapentin has been demonstrated to be effective in treating sleep disorders in several different studies:

  • Gabapentin was shown to have greater effectiveness than both trazodone and lorazepam in treating insomnia among those withdrawing from alcohol. Moreover, participants who were given trazodone and lorazepam experienced grogginess during the daytime hours, while those receiving gabapentin did not.8
  • Sleep quality among 15 individuals withdrawing from alcohol was improved with a reported average dose of 953 mg/day.
  • Gabapentin was shown to be as effective as a benzodiazepine sedative for treating sleep disturbances in patients who had completed antidepressant therapy.9
  • Gabapentin has been recommended for treating chronic insomnia among women in menopause.10

One study of 21 individuals did report that gabapentin did not significantly improve sleep quality among those in alcohol withdrawal.8 However, this study involved a low number of subjects and should be taken in perspective alongside of the other gabapentin sleep studies.

Anxiety Effects

Social anxiety is a common ailment for those who struggle with alcohol as well as those who don’t. So it’s no surprise that alcoholic beverages are pretty much an “expected” menu item at most party events.

If you experience mild or moderate anxiety at work or around friends or family, these events can easily trigger the urge to drink. Gabapentin – and more specifically, the brand formulation Neurontin – has been found to help alleviate anxiety triggers for people going through alcohol withdrawal.11

Other Treatments for Alcohol Withdrawal

Medications that are currently FDA-approved for treating alcohol withdrawal symptoms tend to address isolated components of the withdrawal symptoms rather than the entire range of symptoms brought on by abstinence. Some of the FDA-approved medications currently used include12,13:

  • Benzodiazepines: may help alleviate seizures, anxiety and agitation.
  • Antidepressants: may help relieve depression and insomnia symptoms.
  • Low-dose tricyclic antidepressants: may help relieve insomnia symptoms.
  • Selective serotonin reuptake inhibitors or SSRIs: may help reduce anxiety and depression symptoms.

Compared to these medications currently FDA-approved for treating alcohol withdrawal, gabapentin holds unique promise in its ability to treat a broader range of withdrawal symptoms.

Alcohol Addiction Treatment Facility Types

When you are ready to pursue alcohol addiction treatment, you will find there are a few different facility types you will encounter:
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  • Luxury rehab facilities offer 24/7 residential addiction treatment alongside a wide array of plush, resort-like amenities to make your recovery process as comfortable as possible.
  • Executive rehab facilities offer the same residential treatment and high-end amenities as luxury programs – only they also provide the resources and program structure that allows busy professionals to maintain an active involvement in the workplace throughout treatment.
  • Standard rehab programs are conducted at both residential (“inpatient”) and non-residential (“outpatient”) addiction treatment settings. Most standard residential facilities do not offer the same range of extra amenities offered by luxury and executive programs. However, they offer treatment at a lower, more affordable price for those with more limited budgets.

Learn More and Find an Alcohol Addiction Treatment Facility

Perhaps you are ready for taking the next step in exploring the treatment options for your alcohol addiction. Or perhaps you are not quite ready – but would like to just learn more. Call us today at 1-888-744-0789, and we will be happy to listen to your concerns and walk you through your the recovery options that would best meet your unique needs and circumstances.

Sources

  1. Gabapentin (oral route). Mayo Clinic.
  2. Mason, B. J., Quello, S., Goodell, V., Shadan, F., Kyle, M., Begovic, A. (2014). Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med., 174(1), 70-77.
  3. Petty, F., Fulton, M., Moeller, F. G., Kramer, G., Wilson, L., Fraser, K., et al. (1993). Plasma gamma-aminobutyric acid (GABA) is low in alcoholics. Psychopharmacol Bull., 29(2), 277-81.
  4. The effects of alcohol on the brain. (2002). The Scripps Research Institute.
  5. Roberto, M., Gilpin, N. W., O’Dell, L. E., Cruz, M. T., Morse, A. C., Siggins, G. R., et al. (2008). Cellular and behavioral interactions of gabapentin with alcohol dependence. The Journal of Neuroscience, 28(22), 5762-71.
  6. Etherington, J. M. (1996). Emergency management of acute alcohol problems. Part 1: uncomplicated withdrawal. Can Fam Physician, 42: 2186.
  7. Myrick, H., Malcolm, R., Randall, P. K., Boyle, E., Anton, R. F., Becker, H. C. (2009). A double-blind trial of gabapentin vs. lorazepam in the treatment of alcohol withdrawal. Alcohol Clin Res., 33(9), 1582-88.
  8. Haq, A. (2010). Evidence-based pharmacotherapy of insomnia and anxiety in patients with chronic alcohol use disorders. Primary Psychiatry.
  9. Mowla, A., Ahmadzadeh, L., Razeghian Jahromi, L., Dastgheib, S. A. (2015). Comparing gabapentin with clonazepam for residual sleeping problems following antidepressant therapy in patients with major depressive disorder: a randomized clinical trial. Clin Drug Investig., 35(8), 513-7.
  10. Attarian, H., Hachul, H., Guttuso, T., Phillips, B. (2015). Treatment of chronic insomnia disorder in menopause: evaluation of literature. Menopause, 22(6), 674-84.
  11. Bystritsky, A., Khalsa, S. S., Cameron, M. E., Schiffman, J. (2013). Current diagnosis and treatment of anxiety disorders. P T., 38(1), 30-8, 41-4, 57.
  12. Jaffe, A. (2012). Treating alcohol withdrawal with benzodiazepines – safe if mindful. Psychology Today.
  13. Arnedt, J. T., Conroy, D. A., Brower, K. J. (2007). Treatment options for sleep disturbances during alcohol recovery. J Addict Dis, 26(4), 41-54.