Gabapentin and Alcohol Addiction: Can it Reduce Cravings?

Gabapentin can reduce alcohol cravings by decreasing anxiety
Photo by Levi Bare for Unsplash

Many people don’t know that there are medications for alcohol addiction, but they are often more effective than abstinence-based programs. One of these medications is gabapentin.

Whether you want to stop drinking completely, cut down, or need something to help with withdrawal symptoms, this medication may help.

In this post, we’ll discuss gabapentin’s effectiveness in treating alcohol use disorder.

What is Alcohol Addiction?

Alcohol addiction—also known as alcoholism or alcohol use disorder—is a disease in which people rely on drinking to feel normal. People suffering from alcohol addiction typically find it difficult to stay sober for a long duration of time. How often a person with alcohol use disorder drinks can vary. One person may drink all day, every day, while another may go through binge drinking periods.

One in eight Americans has alcohol use disorder, according to a 2017 study. Over the decade analyzed by researchers, the number of people with the disease increased by about 49%. If you’re not sure whether your drinking is considered normal, take our Alcohol Use Survey to find out.

What is Gabapentin?

Gabapentin is most commonly known as an anticonvulsant and antiepileptic drug, sold under the brand names Neurontin, Gralise, and Horizant, among others. It’s prescribed to control seizures and to relieve nerve pain after shingles. Lesser known is that it can also help curb alcohol cravings.

How does it work? By decreasing anxiety. Since people with AUD are twice as likely to have anxiety, many have speculated that either the anxiety drives the drinking, or the drinking drives the anxiety. But treating one problem usually helps to treat the other, which is why gabapentin is effective at reducing alcohol consumption in some people.

Why not just use another anxiety medication? The problem is that some of the most effective medications come with a lot of baggage: benzodiazepines like Valium and Xanax can produce dependence and have significant withdrawal symptoms. SSRI’s (selective serotonin reuptake inhibitors) like Prozac and Zoloft can produce weight gain and, curiously, have not been shown to be useful in alcohol-dependent anxious patients.

Gabapentin, on the other hand, is a safe option for most people. One study found that it had no serious adverse effects. Another study echoed these findings. But patience is key: Gabapentin works by remodeling your neurons’ synapses, which takes time. Dr. John Mendelson, Chief Medical Officer of Ria Health, says that he typically waits at least one month before determining the drug’s effectiveness.

Gabapentin and Alcohol Addiction

In terms of alcohol dependence, gabapentin can be used to help you reduce your drinking or abstain from it completely. Gabapentin can also treat withdrawal symptoms that can cause relapse—such as insomnia, craving and dysphoria (unhappiness or dissatisfaction).

To analyze its effectiveness, one study compared gabapentin to a placebo. Patients who received a placebo had an abstinence rate of 4%, compared to 17% for those that took 1800 mg of gabapentin. The “no heavy drinking” rate for those that took a placebo was 22% and double (45%) for those that took the real medication.

2007 study also found that, compared to a placebo group, those who took gabapentin significantly reduced their heavy drinking and number of drinks per day. They also increased their number of alcohol-free days.

People who haven’t reduced drinking while taking naltrexone may respond better to gabapentin. Your doctor may also recommend a combination of the two. If you’re experiencing some side effects from naltrexone, such as insomnia and mood problems, gabapentin may help counteract them.

2012 study compared those who took naltrexone alone to those that took a naltrexone-gabapentin combination. Researchers found that the combination was more effective in helping delay heavy drinking, reduce heavy drinking days, and reduce the number of drinks.

Why Haven’t I Heard of Gabapentin?

The research on gabapentin shows that it can help people who have been unsuccessful at changing their drinking habits. So, why haven’t you heard of the medication? Unfortunately, medications approved for alcohol addiction are prescribed to fewer than 9% of those who could benefit from it. The author of a 2018 review of research urged more doctors to prescribe anti-craving drugs because they’re promising for those suffering from alcohol addiction.

Even though gabapentin isn’t well known as an anti-alcohol medication, the American Psychiatric Association (APA) recommends it for patients with moderate to severe alcohol use disorder. The guidelines state it can be used to either reduce alcohol consumption or for abstinence.

How Do You Take Gabapentin for Alcohol Use Disorder?

Gabapentin is typically taken in the form of an oral capsule or tablet. Doses can vary based on a patient’s needs.

When taking medication for alcohol dependence, it’s important to be under the supervision of a doctor who can monitor what works best for you.

Ria Health uses evidence-based treatments to help problem drinkers cut back. Along with providing medication, we develop personalized plans to help you reach your unique goals. Unlike other programs, ours is tailored for your needs.

Many Ria members say that anti-craving medication has improved their life and their relationship with alcohol. If you’re ready to try something different, join today.

Riannon Westall is a health writer based in Toronto, Canada. Her work has been featured in the Toronto Star, on CBC.ca and on various blogs. She writes articles and website copy that further her clients’ goal of helping people create healthier and more fulfilling lives.

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