Tapering Off Gabapentin

Gabapentin pills spilled on a blue countertop

Doctors prescribe gabapentin for many different reasons. The two indications approved by the Food and Drug Administration (FDA) are for postherpetic neuralgia (pain after shingles) and seizure disorders.

Gabapentin has been around for so long that it has many off-label uses, which have not been approved by the FDA. Off-label uses range wildly and includes conditions like alcohol withdrawal, cough, fibromyalgia, hiccups, restless legs syndrome (RLS) and pruritis.

Off-label prescribing is generally considered safe, but this type of prescribing has exposed many people to gabapentin that may not have received it otherwise.

In recent years, studies have illuminated the addictive potential of gabapentin. Despite this new information, the Drug Enforcement Administration (DEA) has not relabeled gabapentin to reflect this. However, some states like Kentucky and Ohio and taken steps to control the substance on a state, rather than the federal level.

The addictive potential of gabapentin means that people experience gabapentin withdrawal symptoms when they try to stop taking it. Symptoms may include:

  • Abdominal cramps
  • Agitation
  • Anxiety
  • Chest pain
  • Confusion
  • Disorientation
  • Flu-like symptoms
  • Headaches
  • Hot flashes
  • Hypertension (high blood pressure)
  • Light sensitivity
  • Restlessness
  • Vertigo

To reduce the severity of these symptoms, a gabapentin taper may be recommended.

How To Taper Off Gabapentin

A taper is when the daily dose of a substance is slowly decreased to avoid uncomfortable withdrawal symptoms.

Regardless of whether someone is using gabapentin with a prescription or without, they will likely need to taper the medication to avoid withdrawal symptoms. The exception is if a person has been using gabapentin for less than one week or if their daily dose is less than 300 mg.

Stopping gabapentin use “cold turkey” can be uncomfortable. Withdrawal symptoms are a common reason that people continue using drugs — they want to keep those symptoms at bay. Gabapentin should be tapered for at least seven days.

As medical professionals learned more about gabapentin’s addictive potential, they’ve realized that it should be tapered on schedules similar to opioids or benzodiazepines, with a 10% to 25% reduction each week (or even longer for some people). Gabapentin affects brain cells like other addictive substances, so it should be tapered over long periods.

Gabapentin Taper Schedule

No one should try to taper gabapentin without the help of a medical professional. People taking it with a prescription should speak with their doctor about developing a taper schedule. People abusing gabapentin can turn to a detox facility for help.

Tapering schedules will be different based on the person needing to be tapered. Factors include why they are taking gabapentin, how long they have been taking it and what their daily dose is. Doses can range from 100 mg to 3600 mg per day and could be higher for people taking it without a prescription.

Some gabapentin tapering examples are provided below for illustration purposes only — each person’s taper will be different and should be constructed by a medical professional.

Assuming someone takes 2400 mg daily, this is a taper schedule based on gabapentin’s package insert:

  • Day 1: 2400 mg
  • Day 2: 1800 mg
  • Day 3: 1200 mg
  • Day 4: 900 mg
  • Day 5: 600 mg
  • Day 6: 300 mg
  • Day 7: 100 mg

A safer taper schedule may look something like:

  • Week 1: 2400 mg daily
  • Week 2: 2100 mg daily
  • Week 3: 1800 mg daily (25% reduction)
  • Week 4: 1500 mg daily
  • Week 5: 1200 mg daily (50% reduction)
  • Week 6: 900 mg daily
  • Week 7: 600 mg daily (75% reduction)
  • Week 8: 300 mg daily
  • Week 9: 100 mg daily

Gabapentin will be completely cleared from the body within 36 hours after the last dose, based on its half-life of 5 to 7 hours.

Medically-Assisted Gabapentin Detox

Medical detox is the best way to stop consuming gabapentin safely.

Many people report uncomfortable symptoms like light sensitivity, headaches, and flu-like symptoms while detoxing from gabapentin. More serious risks of gabapentin detox include abdominal cramps, dehydration, and seizures. By utilizing medical detox, people are ensuring that a medical expert is available to assist them, should any of these symptoms become severe.

Contact The Recovery Village Ridgefield if you or a loved one are ready to address a substance use disorder. Call to speak with a representative to learn how professional treatment can address a substance use disorder and any co-occurring mental health disorders. Don’t let gabapentin addiction control your life, take the first step toward a healthier future by calling today.

Hellwig, Thaddaus; et al. “Withdrawal Symptoms after Gabapentin Discontinuation.” American Journal of Health-System Pharmacy, 2010. Accessed September 23, 2019.

Mersfelder, Tracey L; William H Nichols. “Gabapentin: Abuse, Dependence, and Withdrawal.” The Annals of Pharmacotherapy, 2016. Accessed September 23, 2019.

National Health Service. “Protocol for the Management of Pregabalin and Gabapentin Use in HMP Lewes.” Aug. 2016. Accessed September 23, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.