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Gabapentin, sold under the brand name Neurontin among others, is a structural analog and derivative of GABA. Specifically a synthetic analog, meaning it was designed to mimic the structure and effects of the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Primarily used to treat neuropathic pain and also for partial seizures of epilepsy. It is a commonly used medication for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central pain. It is moderately effective: about 30–40% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a meaningful benefit.. Gabapentin is commonly prescribed off-label as a Anxiolytic or anti-anxiety medication, although not as effective as Pregabalin in this regard, especially for Generalized Anxiety Disorder (GAD), as gabapentin is more effective for Social Anxiety Disorder (SAD).
Gabapentin, like other gabapentinoid drugs, acts by decreasing activity of the α2δ-1 protein, coded by the CACNA2D1 gene, first known as an auxiliary subunit of voltage-gated calcium channels. However, see Pharmacodynamics, below. By binding to α2δ-1, gabapentin reduces the release of excitatory (primarily Glutamic acid) and as a result, reduces excess excitation of neuronal networks in the spinal cord and brain. Sleepiness and dizziness are the most common . Serious side effects include respiratory depression and allergy. As with all other antiepileptic drugs approved by the FDA, gabapentin is labeled for an increased risk of suicide. Lower doses are recommended in those with kidney disease.
Gabapentin was first approved for use in the United Kingdom in 1993. It has been available as a generic medication in the United States since 2004. It is the first of several other drugs that are similar in structure and mechanism, called . In 2023, it was the ninth most commonly prescribed medication in the United States, with more than 45million prescriptions. During the 1990s, Parke-Davis, a subsidiary of Pfizer, used several illegal techniques to encourage in the United States to prescribe gabapentin for off-label uses. They have paid out millions of dollars to settle lawsuits regarding these activities.
Regarding the specific diagnoses, a systematic review has found evidence for gabapentin to provide pain relief for some people with postherpetic neuralgia and diabetic neuropathy. Gabapentin is approved for the former indication in the US. In addition to these two neuropathies, European Federation of Neurological Societies guideline notes gabapentin effectiveness for central pain. A combination of gabapentin with an opioid or nortriptyline may work better than either drug alone.
Gabapentin shows substantial benefit (at least 50% pain relief or a patient's global impression of change (PGIC) "very much improved") for neuropathic pain (postherpetic neuralgia or peripheral diabetic neuropathy) in 30–40% of subjects treated as compared to those treated with placebo.
Evidence finds little or no benefit and significant risk in those with chronic low back pain or sciatica. Gabapentin is not effective in HIV-associated sensory neuropathy and neuropathic pain due to cancer.
Gabapentin is effective for the long-term treatment of social anxiety disorder and in reducing preoperative anxiety.
In a controlled trial of breast cancer survivors with anxiety, and a trial for social phobia, gabapentin significantly reduced anxiety levels.
For panic disorder, gabapentin has produced mixed results.
Gabapentin enhances slow-wave sleep in people with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal.
Gabapentin is ineffective in cocaine dependence and methamphetamine use, and it does not increase the rate of smoking cessation. While some studies indicate that gabapentin does not significantly reduce the symptoms of opiate withdrawal, there is increasing evidence that gabapentinoids are effective in controlling some of the symptoms during opiate detoxification. A clinical study in Iran, where heroin dependence is a significant social and public health problem, showed gabapentin produced positive results during an inpatient therapy program, particularly by reducing opioid-induced hyperalgesia and drug craving. There is insufficient evidence for its use in cannabis dependence.
Gabapentin decreases the frequency of in both menopausal women and people with breast cancer. However, antidepressants have similar efficacy, and treatment with estrogen more effectively prevents hot flashes.
Gabapentin reduces spasticity in multiple sclerosis and is prescribed as one of the first-line options. It is an established treatment of restless legs syndrome. Gabapentin alleviates itching in kidney failure (uremic pruritus) and itching of other causes. It may be an option in essential tremor or orthostatic tremor.
Gabapentin does not appear to provide benefit for bipolar disorder, complex regional pain syndrome, post-surgical pain, or tinnitus, or prevent episodic migraine in adults.
Dizziness and somnolence are the most frequent . Fatigue, ataxia, peripheral edema (swelling of extremities), and nystagmus are also common. A 2017 meta-analysis found that gabapentin also increased the risk of difficulties in mentation and visual disturbances as compared to a placebo. Gabapentin is associated with a weight gain of after 1.5 months of use. Case studies indicate that it may cause anorgasmia and erectile dysfunction, as well as myoclonus that disappear after discontinuing gabapentin or replacing it with other medication. Fever, swollen glands that do not go away, eyes or skin turning yellow, unusual bruises or bleeding, unexpected muscle pain or weakness, rash, long-lasting stomach pain which may indicate an pancreatitis, , anaphylaxis, respiratory depression, and increased suicidal ideation are rare but serious side effects.
On its own, gabapentin appears not to have a substantial addictive power. In human and animal experiments, it shows limited to no rewarding effects. The vast majority of people abusing gabapentin are current or former abusers of opioids or sedatives. In these persons, gabapentin can boost the opioid "high" as well as decrease commonly experienced opioid-withdrawal symptoms such as anxiety.
Large cohort studies and post-marketing surveillance indicate that neuropsychiatric symptoms—including confusion, depression, and behavioral disturbances—can occur in up to 29% of gabapentin users. Most reactions are mild to moderate and often dose-dependent. There is also evidence associating gabapentin with an increased risk of suicidal behavior, especially in younger patients, and rare reports of violent or aggressive behavior. Causality is difficult to establish, and such events remain uncommon.
Gabapentin has also been tested in a wide variety of animal models that are relevant for analgesic actions. Generally, gabapentin is not active to prevent pain-related behaviors in models of acute Nociceptive pain pain. It prevents pain-related behaviors when animals are made sensitive by prior peripheral inflammation or peripheral nerve damage (inflammatory or neuropathic conditions).
Gabapentin is not a direct calcium channel blocker: it exerts its actions by disrupting the regulatory function of α2δ and its interactions with other proteins. Gabapentin reduces delivery of intracellular calcium channels to the cell membrane, reduces the activation of the channels by the α2δ subunit, decreases signaling to lead to neurotransmitters release, and disrupts interactions of α2δ with voltage gated calcium channels but also with , , and thrombospondin. These proteins are found as mutually interacting parts of the presynaptic active zone, where numerous protein molecules interact with each other to enable and to regulate the release of from Synaptic vesicle into the synaptic space.
Out of the four known isoforms of α2δ protein, gabapentin binds with similar high affinity to two: α2δ-1 and α2δ-2. All of the pharmacological properties of gabapentin tested to date are explained by its binding to just one isoform – α2δ-1.
The endogenous α-amino acids L-leucine and L-isoleucine, which resemble gabapentin in chemical structure, bind α2δ with similar affinity to gabapentin and are present in human cerebrospinal fluid at micromolar concentrations. They may be the endogenous ligands of the α2δ subunit, and they competitively antagonize the effects of gabapentin. Accordingly, while gabapentin has nanomolar affinity for the α2δ subunit, its potency in vivo is in the low micromolar range, and competition for binding by endogenous L-amino acids is likely to be responsible for this discrepancy.
Gabapentin is a potent activator of voltage-gated potassium channels KCNQ3 and KCNQ5, even at low nanomolar concentrations. However, this activation is unlikely to be the dominant mechanism of gabapentin's therapeutic effects.
Gabapentin is structurally similar to the neurotransmitter glutamate and competitively inhibits branched-chain amino acid aminotransferase (BCAT), slowing down the synthesis of glutamate. In particular, it inhibits BCAT-1 at high concentrations (Ki = 1 mM), but not BCAT-2. At very high concentrations, gabapentin can suppress the growth of cancer cells, presumably by affecting mitochondrial catabolism; however, the precise mechanism remains elusive.
Even though gabapentin is a structural GABA analogue, and despite its name, it does not bind to the , does not convert into or another GABA receptor agonist in vivo, and does not modulate GABA transport or metabolism within the range of clinical dosing. In vitro gabapentin has been found to very weakly inhibit the GABA aminotransferase enzyme (Ki = 17–20 mM); however, this effect is so weak that it is not clinically relevant at prescribed doses.
The oral bioavailability of gabapentin is approximately 80% at 100 mg administered three times daily once every 8 hours, but decreases to 60% at 300 mg, 47% at 400 mg, 34% at 800 mg, 33% at 1,200 mg, and 27% at 1,600 mg, all with the same dosing schedule. Drugs that increase the transit time of gabapentin in the small intestine can increase its oral bioavailability; when gabapentin was co-administered with oral morphine, the oral bioavailability of a 600 mg dose of gabapentin increased by 50%.
Gabapentin at a low dose of 100 mg has a Tmax (time to peak levels) of approximately 1.7 hours, while the Tmax increases to 3 to 4 hours at higher doses. Food does not significantly affect the Tmax of gabapentin and increases the Cmax and area-under-curve levels of gabapentin by approximately 10%.
Gabapentin can cross the blood–brain barrier and enter the central nervous system. Gabapentin concentration in cerebrospinal fluid is approximately 9–14% of its blood plasma concentration. Due to its low lipophilicity, gabapentin requires active transport across the blood–brain barrier. The LAT1 is highly expressed at the blood–brain barrier and transports gabapentin across into the brain. As with intestinal absorption mediated by an amino acid transporter, the transport of gabapentin across the blood–brain barrier by LAT1 is saturable. Gabapentin does not bind to other drug transporters such as P-glycoprotein (ABCB1) or OCTN2 (SLC22A5). It is not significantly bound to plasma proteins (<1%).
Gabapentin undergoes little or no metabolism.
Gabapentin is generally safe in people with liver cirrhosis.
Gabapentin is eliminated in the urine. It has a relatively short elimination half-life, with the reported average value of 5 to 7 hours. Because of its short elimination half-life, gabapentin must be administered 3 to 4 times per day to maintain therapeutic levels. Gabapentin XR (brand name Gralise) is taken once a day.
Although it has been known for some time that gabapentin must bind to the α2δ-1 protein in order to act pharmacologically (see Pharmacodynamics), the three-dimensional structure of the α2δ-1 protein with gabapentin bound (or alternatively, the native amino acid, L-Isoleucine bound) has only recently been obtained by cryo-electron microscopy. A figure of this drug-bound structure is shown in the Chemistry section of the entry on gabapentinoid drugs. This study confirms other findings to show that both compounds alternatively can bind at a single extracellular site (somewhat distant from the calcium conducting pore of the voltage gated calcium channel α1 subunit) on the calcium channel and chemotaxis (Cache domain1) domain of α2δ-1.
The first pharmacology findings published were sedating properties and prevention of Epilepsy in mice evoked by the GABA antagonist, thiosemicarbazide. Shortly after, gabapentin was shown in vitro to reduce the release of the neurotransmitter dopamine from slices of rat caudate nucleus (striatum). This study provided evidence that the action of gabapentin, unlike baclofen, did not arise from the GABAB receptor.
Initial utilizing small numbers of subjects were for treatment of spasticity and migraine but neither study had statistical power to allow conclusions. In 1987, the first positive results with gabapentin were obtained in a clinical trial using three dose groups versus pre-treatment seizure frequency for 75 days, as add-on treatment in patients who still had seizures despite taking other medications. This study did not show statistically significant results. It did show a strong dose-related trend to decreased frequency of seizures.
Under the brand name Neurontin, it was first approved in the United Kingdom in May 1993, for the treatment of refractory epilepsy. Approval by the U.S. Food and Drug Administration followed in December 1993, also for use as an adjuvant (effective when added to other antiseizure drugs) medication to control partial seizures in adults; that indication was extended to children in 2000. Subsequently, gabapentin was approved in the United States for the treatment of pain from postherpetic neuralgia in 2002. A generic version of gabapentin first became available in the United States in 2004. An extended-release formulation of gabapentin for once-daily administration, under the brand name Gralise, was approved in the United States for the treatment of postherpetic neuralgia in January 2011.
In recent years, gabapentin has been prescribed for an increasing range of disorders and is one of the more common medications used, particularly in elderly people.
While off-label prescriptions are common for many drugs, marketing of off-label uses of a drug is not. In 2004, Warner-Lambert (which subsequently was acquired by Pfizer) agreed to plead guilty for activities of its Parke-Davis subsidiary, and to pay $430 million in fines to settle civil and criminal charges regarding the marketing of Neurontin for off-label purposes. The 2004 settlement was one of the largest in U.S. history up to that point, and the first off-label promotion case brought successfully under the False Claims Act.
Kaiser Foundation Hospitals and Kaiser Foundation Health Plan sued Pfizer Inc., alleging that the pharmaceutical company had misled Kaiser by recommending Neurontin as an off-label treatment for certain conditions (including bipolar disorder, migraines, and neuropathic pain). In 2010, a federal jury in Massachusetts ruled in Kaiser's favor, finding that Pfizer violated the federal Racketeer Influenced and Corrupt Organizations (RICO) Act and was liable for in damages, which was Treble damages to just under $142.1 million. Aetna, Inc. and a group of employer health plans prevailed in their similar Neurontin-related claims against Pfizer. Pfizer appealed, but the U.S. Court of Appeals for the First Circuit upheld the verdict, and in 2013, the US Supreme Court declined to hear the case.
In a November 2005 article entitled "Curb Your Cravings For This Stock", Barrons wrote: "If the venture works out for patients and the investing public, it'll be a rare success for Peizer, who's promoted a series of disappointing small-cap medical or technology stocks ... since his days at Drexel". 60 Minutes, NBC News, and The Dallas Morning News criticized Peizer after the company bypassed clinical studies and government approval when bringing to market Prometa; the addiction drug proved to be completely ineffective. CBS News journalist Scott Pelley said to Peizer in 2007: "Depending on who you talk to, you're either a revolutionary or a snake oil salesman." Journalist Adam Feuerstein opined: "most of what Peizer says is dubious-sounding hype".
In November 2011, the results of a double-blind, placebo-controlled study (financed by Hythiam and carried out at UCLA) were published in the peer-reviewed journal Addiction. It concluded that Gabasync is ineffective: "The PROMETA protocol, consisting of flumazenil, gabapentin, and hydroxyzine, appears to be no more effective than placebo in reducing methamphetamine use, retaining patients in treatment, or reducing methamphetamine craving."
In the US, Neurontin is marketed by Viatris after Upjohn was spun off from Pfizer.
After Kentucky implemented stricter legislation regarding opioid prescriptions in 2012, there was an increase in gabapentin-only and multi-drug use from 2012 to 2015. The majority of these cases were from overdose in suspected suicide attempts. Increases in abuse and recreational use accompanied these rates.
Withdrawal symptoms, often resembling those of benzodiazepine withdrawal, play a role in the physical dependence some users experience. Its misuse predominantly coincides with the usage of other CNS depressant drugs, namely opioids, benzodiazepines, and alcohol.
Veterinarians may prescribe gabapentin as an anticonvulsant and pain reliever in dogs. It has beneficial effects for treating epilepsy, different kinds of pain (Chronic pain, Neuropathic pain, and post-operative pain), and anxiety, lip-licking behavior, storm phobia, fear-based aggression.
It is also used to treat chronic pain-associated nerve inflammation in horses and dogs. Side effects include tiredness and loss of coordination, but these effects generally resolve within 24 hours of starting the medication.
Anxiety
There is a small amount of research on the use of gabapentin for the treatment of anxiety disorders.
Sleep
Gabapentin is effective in treating sleep disorders such as insomnia and restless legs syndrome that are the result of an underlying illness, but comes with some risk of discontinuation and Drug withdrawal after prolonged use at higher doses.
Drug dependence
Gabapentin is moderately effective in reducing the symptoms of alcohol withdrawal and associated craving. The evidence in favor of gabapentin is weak in the treatment of alcoholism: it does not contribute to the achievement of abstinence, and the data on the relapse of heavy drinking and percent of days abstinent do not robustly favor gabapentin; it only decreases the percent days of heavy drinking.
Other
Gabapentin is recommended as a first-line treatment of the acquired pendular nystagmus, torsional nystagmus, and infantile nystagmus; however, it does not work in periodic alternating nystagmus.
Contraindications
Gabapentin should be used carefully and at lower doses in people with Renal failure due to possible accumulation and toxicity. It is unclear if it is safe during pregnancy or breastfeeding.
Side effects
In a systematic review analysing data from 5 cohort studies having 10,85,488 patients, use of gabapentinoids (gabapentin and pregabalin) was associated with an increased risk of thrombotic events (deep venous thrombosis and pulmonary thrombo-embolism) as early as three months of use, and with increased risk of cardiovascular events on prolonged use of more than a year duration. Heart failure was not increased with the use of gabapentinoids.
Suicide
As with all antiepileptic drugs approved in the US, gabapentin label contains a warning of an increased risk of suicidal thoughts and behaviors. This warning is based on a meta-analysis of all approved antiepileptic drugs in 2008, and not with gabapentin alone. According to an experimental meta-analysis of insurance claims databases, gabapentin use is associated with an approximately 40% increased risk of suicide, suicide attempt, and violent death as compared with a reference anticonvulsant drug topiramate. The risk is increased for people with bipolar disorder or epilepsy. Another study has shown an approximately doubled rate of suicide attempts and
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Respiratory depression
Serious breathing suppression, potentially fatal, may occur when gabapentin is taken together with , , or other , or by people with underlying lung problems such as COPD. Gabapentin and opioids are commonly prescribed or abused together, and research indicates that the breathing suppression they cause is additive. For example, gabapentin use before joint replacement or laparoscopic surgery increased the risk of respiratory depression by 30–60%. A Canadian study showed that use of gabapentin and other gabapentinoids, whether for epilepsy, neuropathic pain or other chronic pain was associated with a 35–58% increased risk for severe exacerbation of pre-existing chronic obstructive pulmonary disease.
Withdrawal and dependence
Withdrawal symptoms typically occur 1–2 days after abruptly stopping gabapentin (almost unambiguously due to extended use and during a very short-term Rebound effect phenomenon) similar to, albeit less intense than most benzodiazepines. Agitation, confusion and disorientation are the most frequently reported, followed by gastrointestinal complaints and sweating, and more rare tremor, tachycardia, hypertension and insomnia. In some cases, users experience withdrawal seizures after chronic or semi-chronic use in the absence of periodic cycles or breaks during repeating and consecutive use. All these symptoms subside when gabapentin is re-instated or tapered off gradually at an appropriate rate.
Psychiatric and behavioral adverse effects
Gabapentin is increasingly recognized to cause a range of psychiatric and behavioral adverse effects that extend beyond its more common neurological side effects. Systematic reviews have documented atypical manifestations such as aggression, agitation, irritability, mood instability, and suicidal ideation, with some cases noting the emergence of mania, , and psychosis, particularly in pediatric populations and individuals with preexisting psychiatric conditions.
Overdose
Through excessive ingestion, accidental or otherwise, persons may experience overdose symptoms including drowsiness, sedation, blurred vision, slurred speech, somnolence, uncontrollable jerking motions, and anxiety. A very high amount taken is associated with breathing suppression, coma, and possibly death, particularly if combined with alcohol or .R.C. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 677–8. .
Pharmacology
Animal Models
Gabapentin prevents in a dose-related manner in several laboratory animal models. These models include spinal extensor seizures from low-intensity electroshock to the forebrain in mice, maximal electroshock in rats, spinal extensor seizures in DBA/2 mice with a genetic sensitivity to seizures induced by loud noise, and in rats "kindled" to produce by repeated prior electrical stimulation of the hippocampus. Gabapentin slightly increased spontaneous Absence seizure-like seizures in a genetically susceptible strain recorded with electroencephalography. All of these effects of gabapentin were seen at dosages at or below the Threshold dose for producing ataxia.
Pharmacodynamics
Gabapentin is a ligand of the α2δ calcium channel subunit. The α2δ-1 protein is coded by the CACNA2D1 gene. α2δ was first described as an auxiliary protein connected to the main α1 subunit (the channel-forming protein) of high voltage activated voltage-dependent calcium channels (L-type, N-type, P/Q type, and R-type). The same α2δ protein has more recently been shown to interact directly with some NMDA receptor and AMPA receptor Glutamic acid receptors at presynaptic sites and also with thrombospondin (an extracellular matrix protein secreted by Astrocyte).
Pharmacokinetics
Gabapentin is absorbed from the by an active transport process mediated via an amino acid transporter, presumably, LAT2. As a result, the pharmacokinetics of gabapentin is dose-dependent, with diminished bioavailability and delayed peak levels at higher doses.
Chemistry
Gabapentin is a 3,3-disubstituent derivative of GABA. Therefore, it is a GABA analogue, as well as a amino acid. It is similar to several other compounds that collectively are called . Specifically, it is a derivative of GABA with a pentyl disubstitution at 3 position, hence, the name - gaba pentin, in such a way as to form a six-membered ring. After the formation of the ring, the amine and carboxylic groups are not in the same relative positions as they are in the GABA; they are more conformationally constrained.
Synthesis
A process for chemical synthesis and isolation of gabapentin with high yield and purity starts with conversion of 1,1-cyclohexanediacetic anhydride to 1,1-cyclohexanediacetic acid monoamide and is followed by a 'Hofmann' rearrangement in an aqueous solution of sodium hypobromite prepared in situ.
History
GABA is the principal inhibitory neurotransmitter in mammalian brains. By the early 1970s, it was appreciated that there are two main classes of , GABAA receptor and GABAB receptor and also that baclofen was an agonist of GABAB receptors. Gabapentin was designed, synthesized, and tested in mice by researchers at the pharmaceutical company Goedecke AG in Freiburg, Germany (a subsidiary of Parke-Davis). It was meant to be an analogue of the neurotransmitter GABA that could more easily cross the blood–brain barrier. It was first synthesized in 1974/75 and described in 1975 by Satzinger and Hartenstein.
Society and culture
Legal status
United Kingdom
Effective April 2019, the United Kingdom reclassified the drug as a class C controlled substance.
United States
Gabapentin is not a controlled substance under the federal Controlled Substances Act. Effective 1 July 2017, Kentucky classified gabapentin as a Schedule V controlled substance statewide. Gabapentin is a schedule V drug in other states such as West Virginia, Tennessee, Alabama, Utah, and Virginia.
Off-label promotion
Although some small, non-controlled studies in the 1990s—mostly sponsored by gabapentin's manufacturer—suggested that treatment for bipolar disorder with gabapentin may be promising, the preponderance of evidence suggests that it is not effective.
Franklin v. Parke-Davis case
After the corporate acquisition of the original patent holder, the pharmaceutical company Pfizer admitted that there had been violations of FDA guidelines regarding the promotion of unproven off-label uses for gabapentin in the Franklin v. Parke-Davis case.
Gabasync
Gabasync, a treatment consisting of a combination of gabapentin and two other medications (flumazenil and hydroxyzine) as well as therapy, is an ineffective treatment promoted for methamphetamine addiction. It had also been claimed to be effective for dependence on alcohol or cocaine. It was marketed as PROMETA. While the FDA has approved individual drugs, they have not approved their off-label use for addiction treatment. Gabasync was marketed by Hythiam, Inc., which is owned by Terren Peizer, a former junk bond salesman who has since been convicted of securities fraud relative to another company.Dave Michaels (21 June 2024). "Jury Convicts Milken Protégé Terren Peizer of Insider Trading," The Wall Street Journal. Hythiam charges up to $15,000 per patient to license its use (of which half goes to the prescribing physician, and half to Hythiam).
Usage trends
The consumption of gabapentinoids rose significantly between 2008 and 2018. A study published in Nature Communications in 2023 highlights this trend, demonstrating a notable escalation in sales of gabapentinoids. The study, which analyzed healthcare data across 65 countries/ regions, found that the consumption rate of gabapentinoids had doubled over the decade, driven by their use in a wide range of indications.
Brand names
Gabapentin was originally marketed under the brand name Neurontin. Since it became generic, it has been marketed worldwide using over 300 different brand names. An extended-release formulation of gabapentin for once-daily administration was introduced in 2011 for postherpetic neuralgia under the brand name Gralise.
Related drugs
Parke-Davis developed a drug called pregabalin, which is related in structure to gabapentin, as a successor to gabapentin. Another similar drug atagabalin has been unsuccessfully tried by Pfizer as a treatment for insomnia. A prodrug form (gabapentin enacarbil) was approved by the U.S. Food and Drug Administration (FDA).
Recreational use
When taken in excess, gabapentin can induce euphoria, a sense of calm, improved sociability, and reduced alcohol or cocaine cravings. Also known on the streets as "Gabbies", (2015). 9780199360574, Oxford University Press. ISBN 9780199360574 gabapentin was reported in 2017 to be increasingly abused and misused for these euphoric effects. About 1 percent of the responders to an Internet poll and 22 percent of those attending addiction facilities had a history of abuse of gabapentin. Gabapentin misuse, toxicity, and use in suicide attempts among adults in the US increased from 2013 to 2017.
Veterinary use
In cats, gabapentin can be used as an analgesic in multi-modal pain management, anxiety medication to reduce stress during travel or vet visits, and anticonvulsant.
See also
External links
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