Risks And Side Effects Of Mixing Gabapentin And Alcohol

Gabapentin is a prescription drug widely used for its anticonvulsant properties. While it may seem harmless to have a drink or two when taking this medication, many might not realise that its interaction with alcohol may lead to potentially dangerous health risks. 

This article explores the serious health risks of combining alcohol with gabapentin treatment, emphasising how its interaction can impact your overall health. 

Is Gabapentin A Prescribed Medicine?

Gabapentin is a prescription medication, meaning it is only dispensed by chemists when you have a prescription from your doctor. It is an anticonvulsant drug that is used to treat seizure disorders and nerve pain. It is also utilised in the management of anxiety disorders owing to its anti-anxiety properties. On top of its utilisation for these conditions, gabapentin has also been proposed as a novel treatment for alcohol use disorders (AUD). Gabapentin reduces excitement in the brain via multiple pathways, calming overactive nerve activity and ultimately leading to its therapeutic effects.

Why Do Individuals Take Gabapentin?

Gabapentin is primarily prescribed because of its anticonvulsant properties and its ability to reduce nerve pain effectively. This is the reason why it is useful for individuals with partial seizure disorder; for this condition, it is approved for use in adults and pediatric patients three years old and above. This medication is the treatment of choice for all types of nerve pain, including pain in diabetic neuropathy, a complication resulting from type 2 diabetes.

On top of its utilisation in the conditions as mentioned earlier, it also has various off-label uses. Your doctor may prescribe this medication if you have moderate-to-severe restless leg syndrome. In addition to this, it can also be prescribed to individuals with mood disorders, generalised anxiety disorders, bipolar disorders, social phobia, insomnia and post-traumatic stress disorder (PTSD).

Gabapentin may also be considered an alternative treatment in patients with AUD who have experienced severe, unwanted side effects of benzodiazepines in their alcohol withdrawal treatment protocol. 

The Side Effects Of Gabapentin

As with any other medication, Gabapentin has the potential for several expected side effects. These include dizziness, drowsiness or sedation, nausea, vomiting, fatigue, and issues with coordination, especially when the medication is initially introduced. Minimal cognitive changes can also occur, although they are uncommon. These cognitive side effects include memory problems, mood swings, depression and suicidal thoughts. 

Taking it with alcohol doesn’t come without risks, as both substances depress the central nervous system, affecting a majority of crucial functions of the brain.  These side effects are often amplified and could lead to potentially life-threatening conditions such as:

• Severe dizziness: This could increase the risk of accidents/falls.
• Extreme sedation: Asbrain activity slows down,  this leads to reduced alertness.
• Aggravated cognitive impairment: The interaction between alcohol and gabapentin can intensify cognitive side effects such as memory lapses and confusion.
• Respiratory depression: In more severe cases, extremely slow breathing could lead to unconsciousness, which can be fatal.
• Worsened suicidality and depression: The combination can heighten the feelings of depression and suicidal ideation. 

Drinking Alcohol While Taking Gabapentin

In general, alcohol consumption is not advisable when you’re on any medication; this includes gabapentin. Although alcohol may not directly affect the efficacy of gabapentin and how it is absorbed and metabolised by the body, it may intensify the sedative effects of the medication because it also depresses the central nervous system. Moreover, other sources would even emphasise that alcohol enhances the side effects of gabapentin, such as slurred speech, dizziness, and loss of consciousness. 

Half-Life

Gabapentin is cleared exclusively by the kidneys, and its half-life is approximately seven hours. Half-life is the amount of time it takes for half of a substance, like a medicine, to be cleared or broken down by the body. As aforementioned, Gabapentin is usually cleared from the body in approximately seven hours in people with normal kidney function. However, the half-life can increase to ten to twenty times the normal rate in individuals with impaired kidney function. This prolonged half-life increases the risk of toxicity such that the drug can stay in the body for up to 140 hours. Gabapentin toxicity can occur in these cases, which can manifest as tremors, altered mental status, and, in some cases, respiratory depression, which can be fatal. 

Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms (AWS) can be quite challenging to manage. However, for mild cases, Gabapentin may be considered as pharmacotherapy.  AWS symptoms may include mild symptoms such as elevated blood pressure, insomnia, tremors, anxiety, stomach upset, headache, and palpitations, but they can progress to hallucinations and alcohol withdrawal seizures that can occur 12 to 24 hours after stopping alcohol consumption. 

In more severe cases, delirium tremens can occur, which is the most severe form of alcohol withdrawal.  Signs and symptoms include visual hallucinations, rapid heart rate, elevated blood pressure, fever, agitation, and increased sweating. In these more severe cases, gabapentin is not considered as part of the pharmacologic therapy due to its high risk of seizures. 

Potential Overdose

Combining gabapentin with other central nervous system depressants, like opioids, can have serious consequences. Gabapentin misuse increases the risk of overdose and can cause respiratory depression, a dangerous condition where breathing becomes slow and ineffective, potentially leading to death. However, the risk of misuse is low when gabapentin is taken as prescribed by patients who do not have a history of opioid abuse.

Should I Be Concerned About Mixing Gabapentin And Alcohol?

The combination of gabapentin and alcohol can be risky and can lead to potentially life-threatening consequences. Both substances depress the central nervous system, and their combination can lead to increased drowsiness, dizziness, and difficulty breathing. Your reflexes may also be slowed, and you may have impaired coordination and judgement, which makes you vulnerable to accidents while driving, walking down the stairs or operating heavy machinery.  If you’re unsure, it’s best to consult your doctor for personalised advice.

Treatment For Alcohol Use Disorder 

Gabapentin is a viable and safe alternative to benzodiazepines for alcohol withdrawal syndrome. Despite being the first-line medication for the treatment of symptoms of alcohol withdrawal, benzodiazepines can cause uncomfortable side effects such as extreme sedation. Moreover, the propensity for addiction also increases, especially for long-term use.For this reason, gabapentin can be a safer alternative.

Another benefit for people with an alcohol withdrawal history treated with gabapentin is that it helps to lessen anxiety and cravings, which contributes to long-term rehabilitation and recovery. Gabapentin also lends itself well to the management of insomnia related to alcohol withdrawal, a symptom that can be very distressing. If not treated, this insomnia increases the risk of relapse.

Gabapentin is widely used in the outpatient setting, which makes it a more accessible option for those who do not have severe alcohol withdrawal syndrome and, hence, do not need close medical supervision. 

Getting Help for Gabapentin Misuse or AUD

The challenges of dependence on substances can be overwhelming, and you don’t have to be alone facing them. Remember that support is available through various channels. This may be a family member, a loved one, a friend or a community member. Helplines are also available online, including support groups from rehab communities. 

At Sierra Recovery, we provide you with a safe space where you can find help for addiction and start your recovery. Our compassionate and dedicated team will support you every step of the way. It is never too late to get help.