Neurontin side effects
Pro Research Analysisby 
Searched over 200M research papers
Neurontin (Gabapentin) Side Effects
Common Side Effects of Neurontin
Gabapentin, marketed under the brand name Neurontin, is widely prescribed for conditions such as epilepsy, neuropathic pain, anxiety, insomnia, bipolar disorder, and restless leg syndrome2. Despite its broad usage, gabapentin is associated with several side effects. The most frequently reported side effects include somnolence (drowsiness), dizziness, fatigue, ataxia (lack of muscle coordination), and nystagmus (involuntary eye movement)1 2 3. These side effects are generally mild but can significantly impact the quality of life, especially during chronic use2.
Neurological and Psychophysical Effects
Gabapentin's neurological side effects, such as dizziness and ataxia, are linked to its action on the central nervous system. It acts as an inhibitor of the α2δ subunit-containing voltage-dependent calcium channels (VDCCs), which are involved in neurotransmitter release2. Additionally, gabapentin has been shown to interact with δGABA-A receptors, contributing to its anxiolytic and motor side effects2. These interactions can lead to psychophysical indicators of central nervous system depression, such as poor performance on standardized field sobriety tests and horizontal gaze nystagmus1.
Impact on Driving and Impairment
Gabapentin has been implicated in impaired driving cases. A study reviewing cases in Washington State found that gabapentin concentrations in blood from impaired drivers ranged from <2.0 to 24.7 mg/L, with a mean of 8.4 mg/L1. In these cases, subjects exhibited clinical indicators such as dilated pupils, low body temperature, and elevated pulse and blood pressure, which are not typically consistent with central nervous system depressants1. This suggests that gabapentin can impair psychomotor functions, posing risks for activities requiring full cognitive and motor abilities, such as driving.
Serious Adverse Events and Fatalities
While serious adverse events are rare, they can occur. A case report detailed a fatality associated with an acute gabapentin overdose, where a 47-year-old female was found with elevated postmortem gabapentin concentrations4. This underscores the potential for severe outcomes in cases of intentional or accidental overdose, although such instances are uncommon.
Conclusion
Gabapentin (Neurontin) is an effective medication for various conditions but comes with a range of side effects, primarily affecting the central nervous system. Common side effects include somnolence, dizziness, fatigue, ataxia, and nystagmus, which can impair daily activities and quality of life. More severe outcomes, such as impaired driving and rare fatalities, highlight the importance of cautious use and monitoring, especially in individuals with a history of substance use or those engaging in activities requiring full cognitive and motor function.
Sources and full results
Most relevant research papers on this topic
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 StudyAn enigmatic role of tonic inhibition in gabapentin therapy
Gabapentin's effectiveness in treating chronic pain may be influenced by its ability to inhibit GABA-A receptors, which may contribute to its side effects.
Rigorous JournalGabapentin (Neurontin) as Add‐on Therapy in Patients with Partial Seizures: A Double‐Blind, Placebo‐Controlled Study
Gabapentin (Neurontin) is a safe and effective add-on therapy for some patients with refractory partial seizures, with the most common adverse events being somnolence, dizziness, and fatigue.
RCT
Highly CitedAn acute gabapentin fatality: a case report with postmortem concentrations
Acute gabapentin ingestion can cause fatalities, with postmortem concentrations showing elevated levels in the body.
Case ReportThe antiepileptic agent gabapentin (Neurontin) possesses anxiolytic-like and antinociceptive actions that are reversed byd-serine
Gabapentin may be a novel anxiolytic and analgesic agent, with its anxiolytic-like effects reversed by d-serine, suggesting it may be a novel type of analgesic agent.
Non-RCT
Animal StudyHighly CitedSide Effects of Antiepileptics— A Review
Newer generation antiepileptic drugs have better tolerability and lower drug interactions, but new side effects like weight gain, metabolic acidosis, and nephrolithiasis have been reported.
Literature ReviewHighly CitedOpen label gabapentin treatment for pain in multiple sclerosis
Gabapentin provides excellent to moderate pain relief in multiple sclerosis patients, with throbbing, pins and needles, and cramping pains responding best, but mild to moderate side effects.
Non-RCTHighly CitedSwitchability of Gabapentin Formulations: A Randomized Trial to Assess Bioequivalence Between Neurontin and Gabasandoz on the Individual Subject Level
Substitution of gabapentin 800 mg tablets between Neurontin and Gabasandoz is possible without affecting clinical outcomes.
RCTRigorous JournalAbuse and diversion of gabapentin among nonmedical prescription opioid users in Appalachian Kentucky.
Nonmedical prescription opioid users in Appalachian Kentucky are abusing and diversion gabapentin, potentially substituting it for other licit and illicit drugs.
Highly CitedThe Neurontin legacy--marketing through misinformation and manipulation.
Neurontin's lawsuits have exposed the structure and function of pharmaceutical marketing, potentially leading to action against misleading and manipulative practices.
Highly Cited