Gabapentin side effects in men

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Gabapentin Side Effects in Men

Introduction to Gabapentin

Gabapentin is a medication commonly prescribed for various conditions, including epilepsy, neuropathic pain, and hot flushes in menopausal women. Despite its therapeutic benefits, gabapentin is associated with several side effects, some of which are particularly relevant to men. This article synthesizes research findings on the side effects of gabapentin in men, focusing on respiratory issues, misuse potential, and other adverse effects.

Respiratory Issues: Apnea-Hypopnea Index

Increased Apnea-Hypopnea Index

One significant side effect of gabapentin in men is its impact on sleep breathing. A study conducted on older men without sleep apnea found that gabapentin acutely increased the apnea-hypopnea index (AHI), which measures the severity of sleep apnea. The study revealed that the AHI was significantly higher in the gabapentin group compared to the placebo group (22.4 ± 6.1 vs. 12.2 ± 4.3, P ≤ 0.05) . This indicates that gabapentin can worsen sleep breathing, particularly during non-rapid eye movement (NREM) sleep and in the supine position.

Oxygen Desaturation

In addition to increasing the AHI, gabapentin also elevated the oxygen desaturation index (ODI), which measures drops in blood oxygen levels during sleep. The ODI was higher in the gabapentin group (20.6 ± 5.8 vs. 10.8 ± 3.9, P ≤ 0.05) . These findings suggest that gabapentin can lead to significant respiratory issues during sleep in older men.

Misuse and Interactions

Potential for Misuse

Gabapentin has been identified as having a potential for misuse. The drug is sometimes used recreationally to achieve a high, alleviate opioid withdrawal symptoms, or potentiate the effects of methadone . This misuse is concerning given the increasing number of prescriptions and related fatalities.

Drug Interactions

Gabapentin interacts with several other substances, including morphine, caffeine, losartan, ethacrynic acid, phenytoin, mefloquine, and magnesium oxide . These interactions can exacerbate side effects or reduce the efficacy of either gabapentin or the interacting drug.

Other Adverse Effects

Central Nervous System Effects

Gabapentin can cause several central nervous system (CNS) side effects, including somnolence, dizziness, ataxia, nystagmus, and fatigue . These effects can impair daily functioning and increase the risk of accidents, particularly in activities requiring alertness, such as driving.

Sedation and Dizziness

A meta-analysis on the use of gabapentin for perioperative pain control found that the drug was associated with a significant increase in dizziness (relative risk [RR] 1.40) and a borderline significant increase in sedation (RR 1.65) . These side effects can be particularly troublesome for men who need to maintain high levels of alertness and cognitive function.

Conclusion

Gabapentin, while effective for various medical conditions, has several side effects that are particularly relevant to men. These include increased apnea-hypopnea and oxygen desaturation indices, potential for misuse, and CNS-related side effects such as dizziness and sedation. Men prescribed gabapentin should be closely monitored for these adverse effects, and healthcare providers should consider these risks when prescribing the medication. Further research is needed to fully understand the long-term implications of these side effects and to develop strategies for mitigating them.

Sources and full results

Most relevant research papers on this topic

Gabapentin acutely increases the apnea–hypopnea index in older men: data from a randomized, double‐blind, placebo‐controlled study

Gabapentin acutely worsens sleep breathing in older men without sleep apnea, but long-term safety and effectiveness of GABAergic agents remain unclear.

RCTRigorous Journal

2017·

33citations

·R. Piovezan et al.

Gabapentin for the treatment of hot flushes in menopause: a meta-analysis.

Gabapentin effectively reduces menopausal hot flushes in postmenopausal women with contraindications to hormonal therapy, but future studies should investigate the lowest effective dose to minimize adverse effects.

Meta-AnalysisVery Rigorous Journal

2020·

17citations

·S. Yoon et al.

Review about gabapentin misuse, interactions, contraindications and side effects

Gabapentin is a potential drug of abuse for recreational use, opioid withdrawal, and methadone effects, with potential interactions and side effects.

Systematic ReviewRigorous JournalHighly Cited

2017·

80citations

·Gabriel C Quintero

Prevalence of gabapentin in impaired driving cases in Washington State in 2003-2007.

Gabapentin is a common drug found in impaired driving cases in Washington State, with only 7% positive for it alone, and most cases indicate polydrug use.

Observational Study

2009·

22citations

·Brianna L Peterson

Use of gabapentin for perioperative pain control -- a meta-analysis.

Gabapentin improves analgesic efficacy and reduces opioid consumption in postoperative patients, but is associated with increased sedation and dizziness.

Meta-AnalysisHighly Cited

2007·

188citations

·P. Peng et al.

Gabapentin: a pooled analysis of adverse events from three clinical trials in patients with postherpetic neuralgia.

Increasing doses of gabapentin in postherpetic neuralgia patients may increase the risk of peripheral edema, but not dizziness or somnolence.

Meta-Analysis

2004·

56citations

·B. Parsons et al.

Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study.

Gabapentin may be effective for treating restless legs syndrome, but its use may increase the risk of serious side-effects like malaise.

RCTHighly Cited

2003·

203citations

·B. Burchell

How addictive are gabapentin and pregabalin? A systematic review

Gabapentinoids show limited addictive power, with pregabalin being more addictive, and should be avoided or administered with caution in patients with substance use disorders.

Systematic ReviewHighly Cited

2017·

211citations

·U. Bonnet et al.

Placebo-controlled study of gabapentin treatment of panic disorder.

Gabapentin may have anxiolytic effects in more severely ill patients with panic disorder, but overall results were similar to placebo.

RCTHighly Cited

2000·

260citations

·A. Pande et al.

A randomized study of the effects of single-dose gabapentin versus placebo on postoperative pain and morphine consumption after mastectomy.

A single dose of 1,200 mg oral gabapentin significantly reduced postoperative morphine consumption and movement-related pain after radical mastectomy without significant side effects.

RCTHighly Cited

2002·

377citations

·J. Dirks et al.

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