Neurontin/Gabapentin for Alcohol Treatment
Alcohol use disorders are complex — their diversity is reflected in their varied presentations, as well as the many ways they impact those who suffer from them. Still, the exact mechanisms underlying the development of alcohol use disorders are not yet fully understood.
While the Food and Drug Administration (FDA) has approved some medicines for treatment of alcohol use disorders, these are not fully effective among all people who are prescribed, so research into more effective medicines continues.1
Neurontin – also known as the generic gabapentin – is one of the drugs currently in research as a possible treatment for addictive disorders, and so far, the outlook is promising.2 While it may not be a one-size-fits-all medicine for alcohol addiction, Neurontin does offer an alternate or adjunct option for treatment, which offers hope to many.
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Current wisdom suggests that alcohol use disorders are bio-psycho-social in nature, and research has helped provide a better understanding of the biological underpinnings of the condition.
Various biological factors, such as genes, neurotransmitters, neural pathways and specific regions of the brain have been implicated in the development of alcohol use disorders.3 Knowing this has helped point scientists in the right direction in terms of finding appropriate medications.
The brain’s cells (or neurons) regulate brain functions by releasing different types of neurotransmitter chemicals. Over time, the effects of alcoholism can cause certain brain cell areas to malfunction, which affects the amount of neurotransmitter chemicals they can release at a time.
Though commonly used to treat seizure disorders and neuropathic pain, Neurontin’s effects makes it a potentially compatible treatment for alcohol and drug dependence disorders too.4
Neurontin’s chemical composition closely resembles gamma-aminobutyric acid (GABA), which is one of the brain’s main neurotransmitter chemicals that is affected by ongoing alcohol abuse. And while gabapentin may molecularly resemble the GABA molecule, it is not via direct interaction with GABA receptors that it is thought to achieve its effects. Through not-altogether well-understood mechanisms, gabapentin raises GABA neurotransmission, restoring some balance to certain brain chemicals and systems, which may thereby reduce or eliminate the contribution that the faulty systems may have had toward alcohol addiction.4
Off-Label Uses for Neurontin or Gabapentin
While Neurontin’s FDA approval only covers the treatment of seizure disorders and neuropathic pain, doctors at times will prescribe the drug for other conditions in cases they deem necessary. Some of the conditions for which off-label use of Neurontin has been reported include the following: 5
- Pain syndromes
- Bipolar disorder
- Attention deficit disorder
- Peripheral neuropathy
- Diabetic neuropathy
- Complex regional pain syndrome
- Restless legs syndrome
- Trigeminal neuralgia
- Periodic limb movement disorder of sleep
- Migraine headaches
Clinical Studies: Neurontin’s Effects on the Brain’s Addiction Cycle
Clinical studies among those diagnosed with mood disorders and seizure disorders have reported improvement in mood and sleep with Neurontin.6When tested on alcohol-dependent men, similar results were found with subjects reporting reduced alcohol cravings and improved sleep.7,8A 2014 double-blind placebo-controlled trial reported that Neurontin was effective in treating alcohol dependence and relapse-related symptoms of insomnia, dysphoria and craving.7,9 However, certain concerns have been expressed about the methodological issues related to these studies, so further research is needed.
As one of the main neurotransmitter chemicals, GABA secretions affect a wide range of chemical interactions in the brain. So a person’s reaction to Neurontin – given its effects on GABA activity – will be influenced by his or her specific body and brain chemical makeup. Some of the most common effects observed include:10
- Loss of voluntary muscle control.
Other, more uncommon, side effects may include: 10
- Double vision.
- Involuntary eye movement.
- Decreased vision in one or both eyes.
- Difficult or unclear speech.
- Dry mouth.
- Increased appetite.
- Reduction of white blood cells.
- Back pain.
- Muscle pain.
- Muscle spasms.
- Swelling of the limbs.
While helpful in treating some symptoms of addiction, Neurontin is known for producing certain withdrawal effects when a person stops taking the drug all at once following chronic use. These symptoms tend to develop 1-2 days after the abrupt discontinuation and share some clinical features of alcohol and benzodiazepine withdrawal. Some reported effects include:10
- Problems falling asleep.
It is far safer to slowly wean off Neurontin under a qualified medical professional’s supervision. Any reputable alcohol and drug treatment center is staffed with trained medical professionals to aid you this process.
- Food and Drug Administration. (2015). Alcoholism: Developing Drugs for Treatment: Guidance for Industry.
- Mason, B.J., Quello, S., Goodell, V., Shadan, F., Kyle, M., Begovic, A. (2014). Gabapentin Treatment for Alcohol Dependence: A Randomized Clinical Trial. JAMA Internal Medicine, 174(1), 70-77.
- National Institute on Alcohol Abuse and Alcoholism. (2004). Alcoholism and the Brain: An Overview.
- Koob, G.F. (2010). The Potential of Neuroscience to Inform Treatment. Alcohol Research Current Reviews, 33(1-2), 144-151.
- Fukada, C., Kohler, J.C., Boon, H., Austin, Z., Krahn, M. (2012). Prescribing gabapentin off label: Perspectives from psychiatry, pain and neurology specialists. Canadian Pharmacists Journal, 145(6), 280-284.
- Ghaemi, S.N., Katzow, J.J., Desai, S.P., Goodwin, F.K. (1998). Gabapentin treatment of mood disorders: a preliminary study. Journal of Clinical Psychiatry, 59(8), 426-429.
- Mason, B.J., Light, J.M., Williams, L.D., Drobes, D.J. (2009). Proof-of-concept human laboratory study for protracted abstinence in alcohol dependence: effects of gabapentin. Addiction Biology, 14(1), 73-83.
- Furieri, F.A., Nakamura-Palacios, E.M. (2007). Gabapentin reduces alcohol consumption and craving: a randomized, double-blind, placebo-controlled trial. Journal of Clinical Psychiatry, 68(11), 1691-1700.
- Karam-Hage, M., Brower, K.J. (2000). Gabapentin treatment for insomnia associated with alcohol dependence. American Journal of Psychiatry, 157(1), 151.
- Medline Plus. (2016). Gabapentin.