Like other psychotropic drugs, you should ease off gabapentin gradually. There are some known withdrawal symptoms. This mostly comes from people who take high doses of the drug and suddenly stop. You should only abruptly discontinue this drug because of a serious side effect, and even then, it should be done with your doctor’s supervision and direction.
Gabapentin Dosage and Administration
Typically, your doctor will prescribe 300 mg once a day, usually in the evening, to start. The dose will then be increased every three to five days. Some people will take 600 mg/day, others will increase to 3,600 mg/day—the maximum dose approved by the FDA.
If used as a mood stabilizer or anti-depressant, the dose is usually between 900 and 2,000 mg a day. But, it may also be increased for better results. Some people see improvement in their symptoms about a week after starting treatment. Others need about a month before they see significant improvement.
Gabapentin has a half-life of about six hours, so it must be taken three to four times a day.
Gabapentin Overdose and Toxicity
It’s possible to fatally overdose on gabapentin. Reports of gabapentin being abused alone, and with opioids, prompted the FDA to release a warning statement (in December 2019) about the fatal risk of respiratory depression. Signs of overdose include:
- Ataxia (decreased muscle coordination)
- Drooping eyelid
- Drowsiness and lethargy
- Double vision
- Labored breathing
- Marked sedation
- Slurred speech
If you suspect an overdose, you need immediate medical treatment. The only way to remove the drug is through kidney dialysis in the emergency room.
Gabapentin and Alcohol Use Disorder
Gabapentin may be helpful in treating alcohol use disorder and withdrawal. Between 2004 and 2010, The Veterans Affairs Department conducted a double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women over 18, struggling with alcohol dependence.3 The results of the study showed that gabapentin (particularly the 1800 mg dosage) was effective in safely treating alcohol dependence and relapse-related symptoms including insomnia, dysphoria, and cravings.