Gabapentin weight loss
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Gabapentin and Weight Loss: Analyzing the Evidence
Gabapentin and Weight Changes: Overview
Gabapentin, a medication commonly used for seizure disorders and neuropathic pain, has been associated with various changes in body weight. The evidence from multiple studies indicates that weight gain is a more frequent outcome than weight loss among patients using gabapentin.
Weight Gain with Chronic Gabapentin Therapy
A study examining 44 patients treated with high-dose gabapentin for over 12 months found that weight gain was a common side effect. Specifically, 25 out of 44 patients experienced weight gain, with 10 patients gaining more than 10% of their baseline weight and 15 patients gaining between 5% to 10% of their baseline weight. Only 3 patients reported a weight loss of 5% to 10% of their initial weight1. This suggests that while weight loss can occur, it is relatively rare compared to weight gain.
Long-term Gabapentin Use and Weight Gain
In a study focusing on the long-term safety of a gastroretentive formulation of gabapentin (G-GR) in patients with postherpetic neuralgia, the mean weight change over a 24-week period was minimal, with an average increase of 0.76 kg. Weight gain was reported as an adverse event in only 2.5% of the patients2. This indicates that while some weight gain can occur, it is generally modest and not a significant concern for most patients.
Gabapentin Enacarbil and Weight Gain
Gabapentin enacarbil (GEn), a prodrug of gabapentin, was studied in patients with painful diabetic peripheral neuropathy. The study found that weight gain was dose-dependent, with higher doses leading to more significant weight increases. The mean weight gain at the end of the 12-week maintenance phase was 1.22 kg for the 1200 mg dose, 1.71 kg for the 2400 mg dose, and 1.85 kg for the 3600 mg dose. In comparison, patients on pregabalin experienced a mean weight gain of 2.65 kg, while those on placebo had a mean weight loss of 0.55 kg3 4. This suggests that while gabapentin enacarbil is associated with weight gain, it is generally less than that observed with pregabalin.
Conclusion
The evidence indicates that gabapentin is more likely to cause weight gain than weight loss. While some patients may experience minimal weight changes or even weight loss, the majority tend to gain weight, especially with higher doses and prolonged use. This information is crucial for healthcare providers when considering gabapentin for long-term therapy, particularly in patients where weight gain could be a concern.
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Most relevant research papers on this topic
Changes in body weight with chronic, high-dose gabapentin therapy.
Chronic, high-dose gabapentin therapy may cause weight gain in some patients, with weight stabilization after 6 to 9 months.
Observational Study
Highly CitedLong-term Safety of Gastroretentive Gabapentin in Postherpetic Neuralgia Patients
Long-term treatment with a gastroretentive formulation of gabapentin (G-GR) of 1800 mg is well tolerated and associated with little weight gain (1 kg) in postherpetic neuralgia patients.
RCTPeripheral Edema and Weight Gain in Adult Patients with Painful Diabetic Peripheral Neuropathy (DPN) Receiving Gabapentin Enacarbil (GEn) or Pregabalin Enrolled in a Randomized Phase 2 Trial (I6-1.004)
In a phase 2 study, GEn was associated with lower incidences of peripheral edema and weight gain than pregabalin, with weight gain in GEn-treated patients appearing to be dose-dependent.
RCT
Large Human Trial
Rigorous JournalPeripheral Edema and Weight Gain in Adult Patients with Painful Diabetic Peripheral Neuropathy (DPN) Receiving Gabapentin Enacarbil (GEn) or Pregabalin Enrolled in a Randomized Phase 2 Trial (I6-1.004)
In a phase 2 study, GEn was associated with lower incidences of peripheral edema and weight gain than pregabalin, with weight gain appearing dose-dependent.
RCTLarge Human TrialRigorous JournalGabapentin reduces alcohol consumption and craving: a randomized, double-blind, placebo-controlled trial.
Gabapentin effectively reduces alcohol consumption and cravings, potentially aiding patients in maintaining abstinence and supporting its potential use in alcohol withdrawal and dependence treatment.
RCTHighly CitedUse 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 CitedGabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group.
Gabapentin is not an effective adjunctive treatment for outpatients with bipolar disorder when administered as a 900-3,600 mg/day dose.
RCTHighly CitedA probable case of gabapentin-related reversible hearing loss in a patient with acute renal failure.
Gabapentin-related hearing loss, myoclonus, and confusion in a patient with acute renal failure rapidly improved after hemodialysis and discontinuing the medication.
Case ReportGabapentin before laparoscopic sleeve gastrectomy reduces postoperative oxycodone consumption in obese patients: a randomized double-blind placebo-controlled trial.
Preoperative gabapentin administration in obese patients reduces postoperative oxycodone consumption and delays pain onset, compared to placebo.
RCTGabapentin misuse, abuse and diversion: a systematic review.
Gabapentin misuse is prevalent globally, with substance abuse populations at a higher risk for misuse/abuse, primarily for recreational purposes and self-medication.
Systematic ReviewRigorous JournalHighly Cited