Can You Overdose on Gabapentin?
In This Article
What is Gabapentin
Gabapentin or Neurontin is an anticonvulsant and anti-epileptic medication. It is available as an oral capsule or a solution and is not a federally controlled substance. Gabapentin usually doesn’t cause feelings of pleasure or euphoria, making it less likely to be misused.
Gabapentin treats various conditions, including:1
- Partial seizures
- Nerve pain caused by diabetes
- Postherpetic neuralgia (Gralise)
- Herpes
Can You Overdose on Gabapentin?
Although it’s possible to overdose on gabapentin, it’s relatively non-lethal. However, it can become dangerous when abused with other substances.2
Mixing gabapentin with other substances, like alcohol or opioids, can amplify their side effects. For example, gabapentin can increase the sedative effects of alcohol, which can lead to injury.4
Another concern is the rise of gabapentin misuse for suicidal reasons.5 There have been two reported deaths due to gabapentin misuse.2,3
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Signs & Symptoms of a Gabapentin Overdose
Gabapentin overdose symptoms include:
- Drowsiness
- Slurred speech
- Double vision
- Lethargy/exhaustion
- Diarrhea
- Nausea and vomiting
- Low blood pressure
- Rapid heart rate
- Labored breathing
- Marked sedation
- Blue-colored skin, lips, fingers, and toes
- Hypoactivity (inhibition of behavioral or locomotor activity)
- Coma (in kidney failure cases)
If you notice a combination of the above symptoms after taking gabapentin, seek immediate medical assistance. You can also call the Poison Helpline at 1-800-222-1222.
Common Side Effects of Gabapentin
Aside from having overdose side effects, gabapentin also has common side effects. These side effects include:
- Coordination problems
- Restlessness
- Slurred speech
- Panic attacks
- Jerky movements
- Temporary memory loss (amnesia)
- Unusual eye movement
- Mania (abnormal changes in mood and behavior)
- Sleepiness
- Unusual bruising
- Yellowing of skin or eyes
- Swollen glands
- Upper stomach pains
- Weight gain
- Worsening irritability or anxiety
- Depression
- Violent or angry behavior
Gabapentin use may cause more significant side effects, such as mood swings, behavioral abnormalities, and severe allergic reactions. Consult your doctor if you or a loved one experiences these adverse effects.
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How Much Gabapentin is Too Much?
Taking anything above the recommended dose of gabapentin can be considered too much. The maximum dosage depends on your condition and age:
| Children 3 to 11 years old | Up to 50 mg/kg daily |
| People 12 years and older | 300 to 600 mg thrice daily |
Although the lethal dosage of gabapentin is not yet known, researchers found that people who consumed 49 grams of Gabapentin experienced unpleasant symptoms.6
According to an FDA study, 8,000 milligrams per kilogram (mg/kg) of gabapentin did not harm mice. However, the mice experienced acute toxicity with drooping eyelids and labored breathing symptoms.6
What to Do if You Overdose on Gabapentin
If you or someone you know is experiencing an overdose or toxic reaction to gabapentin, seek immediate medical attention. Don’t administer any medications or drinks unless instructed by qualified medical professionals.
If you’re watching over someone who has overdosed, do the following as you wait for medical emergency services:
- Roll the person and make them lie on their side
- Bend the upper leg so that the hip and knee appear perpendicular (form a right angle)
- Tilt their head back to avoid oxygen deprivation
- Try to keep them calm and stay with them until help arrives
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How to Prevent a Gabapentin Overdose
While some adverse effects are minor, others, such as oxygen deprivation and seizures, may be deadly and cause irreversible damage.
Below are tips on how to prevent gabapentin overdose:
- Take only the recommended dose
- Only take gabapentin if a licensed medical professional prescribes it
- Do not take gabapentin with alcohol or other illicit substances
- If you realize you missed one dose, do not compensate by taking a higher dosage
- Do not increase your dose without first consulting your healthcare provider
- An adult must supervise the administration of gabapentin to children
- Store gabapentin away from children
- If you notice any signs of a gabapentin overdose, seek emergency care immediately
Gabapentin Overdose Risks
Gabapentin is not a commonly misused medication. For this reason, it often goes unnoticed as a cause for worry.
Nonetheless, some people misuse gabapentin to enhance the effects of other substances.7 When gabapentin is used with opiates or alcohol, it may cause overdose and even death.
When taken alone or combined with other medications, gabapentin may induce respiratory depression. Combining gabapentin with other respiratory depressants is dangerous.
Gabapentin Drug Interactions
Some medications that interact with gabapentin include:
- Antihistamines such as cold, cough, and allergy products
- Anxiety and sleep medications
- Depression medications such as sertraline, amitriptyline, and fluoxetine
- Certain stomach medications, such as aluminum and magnesium-containing antacids
- Narcotic pain relievers such as codeine, fentanyl, and hydrocodone
- General and local anesthetics
- Muscle relaxants that are given before surgery
Treatment for Gabapentin Overdose
Unfortunately, there is no well-known treatment for gabapentin overdose because gabapentin toxicity is rare. However, healthcare providers can treat overdoses through supportive care and detoxification measures.
Studies have shown that hemodialysis (kidney dialysis) can remove gabapentin from the system.8
Supportive care strategies for gabapentin overdose include:
- Airway management: If the patient is unable to breathe on their own, they will need airway management, supplemental oxygen, and ventilation assistance
- Use of activated charcoal or gastric lavage: This process flushes out any residual gabapentin from the gastrointestinal system
- Protection from self-injury: in case of lack of coordination or violent behavior
- Treatment for agitation or any other adverse symptoms
How to Stop Using Gabapentin
Abruptly discontinuing gabapentin may increase the risk of seizures. You can reduce the risk of adverse withdrawal symptoms by seeking a medical detoxification program.
A detox is often the first step in treating people struggling with gabapentin misuse. It involves the removal of the drug from the body in a controlled manner.
Treatment Options for Gabapentin Addiction
After detoxification, you may join an inpatient or outpatient recovery program to complete your addiction treatment. Below are some treatment options for gabapentin addiction:
- Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
- Outpatient treatment: A treatment program where patients are freely allowed to leave the rehab facility
- Support groups: Provides a much-needed community to help maintain sobriety after treatment
- 12-Step Programs: A support group that follows a 12 step program to help guide you through the recovery process and maintain sobriety
Summary
Gabapentin or Neurontin is an anticonvulsant and anti-epileptic medication. Healthcare providers often use it to treat partial seizures, postherpetic neuralgia (Gralise), and more.
A gabapentin overdose is rare, but it is possible. The likelihood of an overdose increases when you abuse gabapentin with other drugs like opioids and alcohol.
If you or someone you know is experiencing a gabapentin overdose, seek medical help immediately. Although there is no well-known treatment for a gabapentin overdose, there are ways to help get it out of your system.
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- “Gabapentin,” U.S. National Library of Medicine, 2022.
- “Suicide by gabapentin overdose,” National Center for Biotechnology Information (NCBI), 2011.
- “An acute gabapentin fatality: a case report with postmortem concentrations,” National Center for Biotechnology Information (NCBI), 2015.
- Rentsch et al. “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.
- “Trends in gabapentin and baclofen exposures reported to U.S. poison centers,” Journal of Clinical Toxicology, 2019.
- “Gabapentin,” US Food and Drug Administration (FDA)
- “Abuse of Opioid Alternative Gabapentin Is on the Rise,” The Pew Charitable Trusts, 2018.
