sleepy man

Q. I would like to know your feelings on the regular use of gabapentin for chronic insomnia. As a long time suffer of insomnia, my doctor has prescribed a myriad of drugs. Most recently upwards of 3600 mg of gabapentin at bedtime.

After more than 6 months of use I have noticed that gabapentin is taking a toll on my quality of life. Your thoughts please!

A. Gabapentin (Neurontin) was originally developed as an anti-seizure drug. It was approved by the FDA as an “add-on” treatment for patients with epilepsy in 1993. Although researchers do not completely understand how gabapentin works to control seizures, they think it affects production of a neurochemical in the brain called GABA (gamma-aminobutyric acid).

Pfizer, the manufacturer of the brand name Neurontin, got into major trouble when it marketed this drug for off-label uses. A company is not allowed to promote a medicine for things that the FDA has not approved. In Pfizer’s case, these unofficial uses for Neurontin included bipolar disorder, alcohol withdrawal, migraines and pain. The company eventually paid $430 million in penalties and admitted to fraudulent promotion.

We mention this because Neurontin is currently available generically as gabapentin. In addition to treating epilepsy, the drug now has official FDA approval for alleviating nerve pain caused by shingles (postherpetic neuralgia).

Even though gabapentin does not have the FDA’s blessing for treating other kinds of nerve pain (neuropathy), many doctors are using it for this purpose. Some physicians prescribe it to patients with fibromyalgia and migraines as well as to control hot flashes brought on by menopause, even though there is no official blessing from the FDA. This is not illegal. Doctors can prescribe any drug for any reason they see fit. That said, we could find little evidence to suggest that gabapentin would be helpful for insomnia. This is definitely an “off-label” use if ever there was one.

If there were few, if any, side effects associated with gabapentin we would not worry too much about the prescribing of this drug for so many off-label uses. But gabapentin has some potentially worrisome adverse effects. The FDA has issued this warning:

“Antiepileptic drugs (AEDs), including Neurontin [gabapentin], increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.”

The FDA also mentions an “unexpectedly high incidence of pancreatic acinar adenocarcinomas” [cancer] in male rats that received gabapentin. The agency adds the unhelpful caveat that the, “clinical significance of this finding is unknown.” In other words, no one knows whether this animal research means that men will be at higher risk for pancreatic cancer. This is not the sort of thing that the FDA requires drug companies to follow up on because the long-term research needed to detect a cancer signal can be quite challenging and expensive.

Gabapentin Side Effects:

  • Dizziness, vertigo
  • Fatigue and or tiredness
  • Unsteadiness or incoordination
  • Abnormal thinking, anxiety, hostility, confusion, amnesia,
  • Depression, suicidal thoughts, mood changes
  • Fluid accumulation in feet, edema of face or extremities
  • Digestive distress, indigestion, loss of appetite, gas, nausea, vomiting, diarrhea
  • Dry mouth, dental problems, gingivitis
  • Blurred vision, double vision, unusual eye movements (nystagmus)
  • Headache
  • Withdrawal seizures (never stop gabapentin suddenly!)
  • Blood disorders
  • Skin rash (alert your M.D. immediately if this occurs!)
  • Upper respiratory tract infections, fever
  • High blood pressure
  • Palpitations
  • Tremor, jerky movements
  • Joint pain, joint stiffness, arthritis

No one should ever discontinue gabapentin abruptly. Like so many medications that affect the central nervous system, sudden withdrawal may lead to unexpected side effects. Some that have been reported include anxiety, insomnia, nausea, pain, sweating and even seizures. Sadly, though, the FDA gives very little guidance to prescribers about how to gradually taper patients off gabapentin.

Bottom line: Gabapentin is an effective treatment for epilepsy and the excruciating pain that sometimes lingers after an attack of shingles. Although it is quite frequently prescribed for off-label uses, the benefit/risk ratio is not clear. The drug has many potentially serious side effects. We are surprised that your doctor prescribed such a heavy-duty drug for insomnia, especially at such a high dose. The “normal” dose of gabapentin for treating epilepsy or shingles pain would be up to 1800 mg daily. Although 3600 mg is sometimes prescribed, it would have to be considered a high dose, especially for an unapproved use.

Since you report that gabapentin is affecting the quality of your life in a negative way, perhaps it is time to talk to your doctor about reconsidering this drug and discussing a gradual withdrawal process. You may need to consult a sleep specialist to help you deal with your chronic insomnia in a more integrative manner.

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  1. Diana
    Sound beach N.Y

    I’m going bald. Anyone else experiencing this also

  2. Linda
    Spokane wa

    Due to incompetent doctors, I was forced to suffer severe pain from a herniated disk in my neck. Rather than fix me, I finally submitted to the drug, gabapentin.

    I hated the drug. I was a depressed zombie with big swollen ankles after the first dose. After a month on the drug, my legs felt heavy. I had hard painful lumps in my thigh muscles. I could no longer use my treadmill. A few months later! I could barely walk. Using the stairs was an ordeal.

    Getting off my toilet was a major undertaking. I could hardly walk any length without such pain. My hip joint began stabbing me no matter where or how I sat. I had MRIs on my spine. No one knew what was causing my disability. I read some forums and saw that others had mentioned leg weakness and heaviness.

    I weaned off the medication after finally getting neck surgery and had immediate relief overnight. Nerve pain continued so I began taking Lyrica. Within a month I had leg pain again. However! That drug was very wicked to get off. It took a year to wean off 300 mg. My legs were in terrible condition.

    At the end of the taper, my body ached something terrible for weeks. My legs had huge muscle knots and my hips hurt so bad that I used the maximum oxycodone. That barely touched the muscle misery. My doctor informed me that the muscle damage could be permanent. I was horrified.

    It’s been 8 weeks and I still need oxycodone to bury the pain. But I believe my muscles are beginning to heal with massage, time, and CoQ10. Both drugs were horrible for me. While helping with nerve pain, the stiffened my muscles so bad that they became hard to the touch and I felt as though I would break when I moved.

    Beware. Many doctors like these drugs because they are not opiates. But the withdrawal (which some refuse to acknowledge) are terrible and last for months—such as benzodiazepines. Terrible.

  3. Jonanne

    I had been on gabapentin for about 2 years for nerve damage from gallbladder surgery, I was on 300mg 3 times a day. These tabs were a wonder drug and took my pain away almost immediatel. I also suffer from deppresion and was not sleeping very well and found gabapentin was helping these symptoms.

    Now 2 years later I returned to the doctor and told her I would like to come off this medication as I feel its time. So for the last few weeks she weened me off them with a withdrawal chart, which I followed till the last tablet. Just 2 days after being completely off gabapentin the side effects have hit me: dizziness, headaches, nausea, and I actually fainted which I have never done before in my life.

    The doctor told me I had come off them to quick and to start taking a lower dosage and weaning off gradually again, which I have done but still the same symtoms. Have not taken any now for 5 days and the dizziness headaches are back and I am not sleeping, I am also having hot sweats in the night and feeling very low in mood. I am no way going back on them, I am going to persevere with symptoms and hope I can cope. I feel like I am going around the bend and will never get better. I advice anyone thinking of taking these tablets to think again and DONT do it 😥😥😥

  4. Bonnie (pain in the Knee)

    I suffered for 3 years with extreme pain after a total knee replacement. On October 12, 2015 a new doctor prescribed Gabapentin 100 mg twice a day. NO MORE PAIN!!! However, on Dec 1, 2015 I developed a rash of tiny blisters on the knee where I had the replacement. After a week this area looked like I had shingles, so I went to my family doctor. He diagnosed the rash as a bacterial infection. As of Jan. 13, 2016, I still have this rash (not as severe). After 1 & 1/2 months of taking 200mg per day of Gabapentin, did I develop a reaction to it? Skin rash is listed as a side effect of Gabapentin. Doctor says no.

  5. Robert

    I have suffered with chronic pain for 15 years . My M.D. prescribed me Neurontin for pain , and said it was used to treat diabetic leg pain. I asked him , if it was an anti-psychotic drug , as I am not able to tolerate the side effects of these types of drugs. He assured me , it was NOT ,an anti-psychotic drug. Following his dosage recommendation , I found the drug helped me to sleep @ the 400mg. dose. However , after I was on the drug for a week , I sank into a state of uncontrollable depression. The thoughts of suicide ,were so intense , I scrambled to find a psychologist. Being unable to find ,anyone , I tried talking to anyone who would listen. That night I looked up the side effects of Neurontin , and low and behold ,there was the data , crystal clear. Further research , led me to believe , that this drug was killing people. I am NOT very happy with what my physician did ,and what he had told me. I’d like to do something about doctors prescribing this drug for off use purposes ,as Pfizer has paid billions in lawsuits due to this practice.

    • Sandra

      Robert – this happened to me also and I agree with you. The drug seems to help some people but use of any drug that could cause depression and thoughts of suicide should be monitored closely by your doctor.

      For me the danger was high because I did not talk to anyone and my thinking was so distorted that I was unable to perceive that I had a problem or that I had changed.

      What I’ve come to realize is that no one warns the patient about the dangers of drugs. The pharmacist doesn’t, the doctor doesn’t, no one does. The medical community is controlled by the drug companies. And there is no one on our side.

      • icki

        You have to ask these questions

        • Sheila

          Robert did ask and it was still prescribed to him. THAT is just WRONG!!

  6. Arkemia

    It’s not even quite a month being on this neaurotin and I can’t remember anything it’s very frightening for my family to tell me that I left my front door open for 5hours, not remembering that I got up at 11pm at night to lock my daughter out. I need my mind thank you so I’ll rather deal with this chronic nerve pain.

    • ron

      @Arkemia. I’m glad I’m not the only one suffering from amnesia…I have the same problem. I can’t remember something I did 10 minutes before I did it. Very scary indeed! I know I had slight memory loss after 7 years of extreme benzo use, but nothing like this.

  7. John
    Milwaukee WI

    I have been on gabapentin for over 3 years. I have even used Gralise a 24 HR version. 3 900 mg a day. I have seen no help from it. If anything my problems have worsened. I have bad neuropathy in my legs feet, low back. It has since progressed to my arms and hands. I feel like my body is in a vice. I am now suffering from edema in my legs feet and face. I have to get off to see if my situation changes. My Dr says it will just be more pain, I can’t believe there would be.

    I am going to do it against his advice but need to know how to suffer the least amounted withdrawals. Just to preface this, the pain I was feeling when treatment was started was 1/10th of what it is now. That is also using the max amount of tramadal and tiazadine. I dont want to take opioids and can’t believe that this is what I am stuck with at 48 years of age

    • colleen

      I had the same issues and went off it on my own and suffered SEVERE nausea for month. Taper down very slowly or you can have the same side effects as bento withdrawal (that is what they compare it to) for months. All I know it is is severe when you go off it quickly.

  8. ron

    Doctor put me on gabapentin for benzodiazepine withdrawals. 300mg 3 times daily. I fainted head first onto the floor the other day, woke 2 hours later! I would rather deal with the benzo withdrawals than be on gaba. Worst medication I have ever taken.

  9. Nina

    I have Fibromyalgia and have been taking Gabapentin for 5 months. I am currently taking 1600 mg. Prior to starting Gabapentin I had a flare up that left me bedridden for two months. The Gabapentin was a life saver and controlled my pain enough that I could function semi normally and start scaling back on my pain meds. I have had and continue to have side effects from the beginning and for me it’s just weighing the positives versus the negatives. Positives: less pain, improving quality of life. Negatives: Being very ditzy (forgetful, losing things, having to focus more while driving), weight gain.
    While the side effects have lessened (the first month was bad! ) I still have them but I am much happier on it at this point.

  10. Portia Parker
    United States

    I have Neuropathy unrelated to Diabetes & I have been prescribed Gabapentin for approximately two years combined with chronic pain meds, meclizine, topomax, imitrex, mainly; which are most effective for me. Although the Gabapentin causes immediate urination & slight weight gain, it is practically immediately effective at ceasing my nerve ending pain; taking one 300mg capsule every six hours. It also helps with migraines; although initially skeptical, two nightly aids sleep.

  11. roxanna l.

    love gabapentin. found out I had sjogrens syndrome, a lot of joint pain, couldn’t function or get out of bed, now feel like a new person from this product. I take plaquenil also. So greatful for these meds, I feel so good. I still get sore here and there but for the most feel like a new women thank you.

  12. Marie

    I have been taking it for probably about 9 months on and off, so 9 months total. I noticed that I get horrible memory loss on it. Ironically, instead of improving my illness, it seems to have caused more mental symptoms. I lost my job because I couldn’t even remember to sign in and out of the log book. I wasn’t like that before the Gabapentin. I also got myoclonic jerks from being on it. I hope that they eventually go away. Gabapentin slows my thinking and makes me feel like a zombie. I would rather deal with my illness and feel more alive and able to converse than the way I feel on Gabapentin. On the other hand, when I experience terrible insomnia, it is one of the only drugs that will help me get to sleep without building a tolerance. Sometimes I sleep OK though. So I think that I will get off the Gabapentin again.

  13. Gary

    This is a very valuable site.

  14. Gary

    I have been taking gabapentin for abut ten months. I have developed extreme and prolonged numbness and lack of feeling in my lower extremities and anal area. I have diabetic neuropathy, which is why I was prescribed gabapentin….and pain has occurred less frequently. I also have developed prolonged sense of tinniness in my hearing, especially my own voice which is closest to my ears; but, all sounds, especially loud ones, are tinny. The numbness may be due to neuropathy becoming worse but no other thoughts on ‘tin ear.’

    • Rachel

      Gary, you report altered sensation in the anal area and lower body, this is a red flag symptom for cauda equina, if you have had lower back issues, I’d suggest you make an appt swiftly to get this ruled out. Cauda equina if left untreated can result in permanent disability.

      • dando

        I thought caudal equina was a lack of control of urine and bowell movements… Not the actual numbness. I had numbness too but the surgery seems to have alleviated much of the numbness in that area.. still have it in the feet and legs however.

  15. Ally

    Before anyone goes on this medication, PLEASE double check every fact your doctor, pharmacist and other sources give you. And, I apologize if this is hard to follow, but writing anything is so hard. My thoughts do not align.

    I have been taking this medication for seizures for 11 months with a significant increase in dose for pain. I have been on narcotics off and on, and had a drastic spinal surgery. I was willing to try anything to address the pain.

    I was also experiencing severe hot flashes with perimenopause. (I am 42)
    I had been diagnosed with pmdd, a severe pms which I was told is attributed to hormonal imbalance., and I was put on celexa for this. The neurontin was supposed to help with this also, as it is now being used to treat bipolar depression. Although, I didn’t have an official diagnosis for bipolar, my early onset menopause gave me what I perceived to be very similar symptoms.
    You can imagine, this was a wonder drug. Many little pill. And, I wish I had never started on it.

    I loved that I got energy from this, mood lift, and sometimes a blissful sleep that came to me after some sort of doctor approved euphoria at times. I always reasoned through sadness, to be clear, but the hormonal drop off gave me a huge looming sense of despair. AND, it also prevented me from having ANY opiate withdrawal after I was yanked off my pain meds because I was released too early from the neurosurgeon. Was so willing to go through that now that I have this hell.


    BRAIN GONE! Focus shattered. Had to stop driving.
    I had to drop out of school where I was pursuing a chemistry degree. I was losing my mind. I was not able to focus, and my ability to even remember things I knew how to do well were slipping. I felt like I had some kind of horror beginning like alzheimers. I knew it had to do with this medication. My goals were gone. My dreams didn’t even belong to me anymore. I started researching.

    INTENSE HUNGER PANGS, severe weight gain.
    I discovered the weight gain WAS from this drug. I gained 35 pounds in 11 months. I was hungry all the time, and it was painful. I honestly felt like the switch in your brain that tells you that you ate enough, was broken. There was no joy in eating. Except I had eaten a ton of food and it could be anything, so long as that terrible pain didn’t come back.
    MANIA and debilitating depression that kept me in my bed for almost 8 months.
    Nightmares. No f’n thank you.

    By month 11 now, I have gone off this stuff. I started a new job. I wasn’t able to go to my purse and take pills every 3 hours. The withdrawal started immediately, but I only realized this in retrospect. Dissiness, vertigo, ear pain, flu symptoms, eyes wouldn’t stop darting all over the place, insomnia, and the most intense pain of my life. Burning cuts.
    Lymphatic vessels and ducts filled with fluid, pain from that was excruciating. You have hundreds of lymph nodes all over your body to carry fluid which contains new white blood cells, and destroys old cells, in addition to getting rid of toxins. On any given day here off this stuff, had at least 25 harden like rocks as other filled up and I couldn’t stand anything to touch me.

    I have had a week long hell of feeling poisoned or had the worst hangover of my life, but I know this is gabapentin because this is twice now I had these exact symptoms.. and I don’t even drink!
    Migraine, nausea, vomiting, the worst runs of my life. And, restless everything. I had a close call with my breathing. I felt like my heart was slowing to dangerous bpm. (It was 45) Felt like I was suffocating. I had to throw on winter clothes and go walking down the street because I didn’t know how to get the heart rate up. My dr just says, go back on your dose… and that all goes away. WHAT? Trade withdrawal for being a vegetable the rest of my life?
    THIS IS A HIGHLY ADDICTIVE MEDICATION DESPITE IT”S CLASSIFICATION!!!! If your brain doesn’t shut down on it, you are lucky, but many people have similar problems to mine, just don’t take it.
    I have refills, and I can’t imagine going back on it. The only reason I would take any more is because the mental part is so horrible, and the probability of a seizure. (I am on another seizure medication) If I can be rid of it forever, this is the goal. I think I might have to take a night time dose for the next few weeks because I can’t work.

    CRUCIAL: taper, taper, taper!!!!
    Tell your doc you know there is something not right.
    Please let my suffering be your warning.

    • Ardith

      oh my Dear Lady.. you have just said everything I fear for my husband.. prayers so much love and prayers .. ardy

  16. Sarah

    I see that there are hundreds of comments, and I don’t know if anyone will read mine but I do want to say a couple of things for anyone newly on this med and considering going off or anyone considering taking this med. I want to share my story:

    I was prescribed Gabapentin for chronic pain and took it for about 6 months before trying to stop. Here I am more than a year after that, and I’m still not off of it completely due to how difficult this medication has been to get off. It is not just like having flu-like symptoms with other drugs. Getting off of this medication is serious. It’s psychological, and it’s nearly illogical. There were no hot flashes or runny noses or rotten bottom. It was all brain related.

    The side effects that I experienced on Gabapentin were rage and lethargy. I lost all motivation to do anything, to eat right, take care of myself, to continue physical therapy. I also became angry so easily, at the drop of the hat. You’re supposed to go onto Gabapentin gradually, so about six months into upping the dose, I found myself with so much rage that I knew I had to get off of this medication ASAP. So I immediately dropped down from 1200 mg to 600mg spread out through the day. I thought that since I had only recently gone up to 1200 mg that it would not be a big deal, I really don’t think it had been more than a few weeks.

    Huge mistake, I became suicidal for almost 2 months, but with the help of my family I made it through. Here I am now over a year later, and I still have not been able to get off of that 600 mg of Gabapentin. I am down to 100 mg capsule a day that I cut in half. I had originally just dropped one 100 mg capsule in the evening but the side effects I experienced were insane. I figured dropping from such a low dose wouldn’t be such a big deal at this point, but I could not have been more wrong. I started having anxiety, dizzy spells, confusion and a horribly itching spine.

    It’s been about two months that I’ve been splitting the dose in half and my back is still itching but the other effects finally calmed down. Through my research I found that if you have trouble getting off of Gabapentin it is very dangerous to just drop doses and go off so suddenly. The safest thing to do is to drop only 10% per month, so at that rate I’m still going to be on Gabapentin for at least another six months, making it a almost two years to get off of.

    My advice to anyone taking this off label is: don’t do it, it’s not worth it. If you ever decide that you want to get off of it, life is going to be a living hell. It’s not just drug withdrawals like you get from opioids such as like flu-like symptoms for a week. It’s serious neurological and psychological stuff.

    This is a crazy drug that is so dangerous that I can’t believe it exists. If I had been alone when I was trying to get off of this medication, I really don’t think that I would’ve made it. I think that I would have ended my life. When they say that it may cause suicidal thoughts, they were not kidding, and I have never been through that in my life. But I found myself lying in bed for hours plotting how I was going to do it.

    • Ardith

      Hi a wife and caregiver here.. my Ed has been on this since Sept of 2015.. just not the same man anymore.. he just is not happy with anything. and has gone back to comics and music that has to scream all day… his headaches are worse his moods swings just terrible and I have to be so careful with anything and every thing I say.. he has fallen twice in the last 3 weeks from his working chair in the computer room .. I believe he is having blackouts.. prayers to so many.. for even if this drug helps several it is going to harm so many more..

  17. Beth

    I was on Gabapentin for only 9 days. I was on several pain relievers and stopped everything because my hair was falling out at an alarming rate. I couldn’t get any of the Dr.’s from the VA to call me back (shocker, I know), so I took my pile of pills to the Walgreens pharmacist who informed me it was the Gabapentin. It was not in the information I got with the prescription, but looking into it online, it is very common. I also gained 12 lbs in that 9 days, though I thought at first it was the steroid injection. I also had severe agitation and hostility. This was such an easy drug for the VA Urgent Care Clinic to hand me for nerve pain due to a herniates disk. I am shocked it is even on the market! With the terrible side effects I had, am still dealing with, that my Dr. wasn’t even aware of, I think it should be used much less if at all. I felt after I saw this blip on here that it wouldn’t be right if I didn’t say anything. I can’t find anywhere that anyone has actually stated that their hair has made a full recovery, only that after months and years they now have short hair and some are looking at wigs. I am frightened at this point.
    Please be careful if you are on this medication. If you are considering it, I hope you read this in time.

    • leanne

      @ BETH, I’m about to start this drug tomorrow actually. When did you hair start falling out and how do you know it was the drug causing it? This is really frightening and it’s making me think twice about it. I don’t like taking drugs in the first place, I’d rather smoke pot or something more natural. I have a lot of nerve damage in my ankle/leg from a crush injury. If you could respond back to me, I’d really really appreciate it. I’m pretty nervous for this now!

    • Heath

      Hello Beth. I am curious what your experience has been since November. My wife took only 2 or 3 of the generic 600mg gabapentin in August 2015. She didnt need it anymore, so she discontinued it. A week later the hair loss started. She has since developed alopecia universalis.

    • JoF

      I, too, took Gabapentin and have experienced many of the same side effects that others have experienced in this forum. The worst ones for me have been the hair loss, the pain in my joints, the rash, and the depression.

      I called my doctor about all of them, and he said I shouldn’t worry because my dosage was so low (I have sensitivity to any kind of pain medication). He also told me that a rash and hair loss are not side effects to Gabapentin.

      After having been on the medication for less than 1 month, handfuls of my hair were coming out every time I washed it or brushed it. After 4 months, I had lost 3/4 of the thickness of my hair. This was traumatic to me (adding to my depressed feelings). After much thought, I decided on my own to go off of the Gabapentin.

      After I consulted with a dermatologist (to make sure it wasn’t alopecia), she told me that it wasn’t a disease, but it was the medicine. She also told me I may not see any improvement in my symptoms until at least January of this year if I went off the Gabapentin in October. It is February, and I am finally seeing small growths in my hair (about 1-1 1/2″ in length).

      It’s going to be a long haul, but I think my hair will return over time. It’s pretty ugly right now, but I’m glad it’s coming back. The pain in my joints continues, but I have hopes that it will also go away over time. I’m sorry others have had this problem, but I am glad that I am not alone.

  18. John chancy

    It gives alot of energy and helps me sleep. I feel no pain but I also can’t feel myself scratch an itch. I have headaches and it does make me sleepy some.

    • Gary

      Since taking gabapentin for ten months, I feel numb and my ears experience a rasping and tinny sound, especially from my own voice, which is nearest my ears.

  19. Scotty

    Was placed on Gabapentin, 300mg Q6H for Type 2 diabetic neuropathy. I had been thru the gantlet of drugs to address this including Tramadol and Methocarbinal. Nothing was effective and I refuse to use narcotic Meds.

    Since starting the Gabapentin my pain level has gone from a 8-9 to a 1-2. I have a small bit of constipation but address it with a stool softener BID. No weight gain and a decrease in appetite. No other side effects noted so far.

    What a real difference this med has made for me. I have even noted a increase in motivation which I attribute to the decrease in pain. This is the ONLY medication that has worked so far and all I can say is, IT’S ABOUT TIME !!!

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