Gabapentin for Alcohol Withdrawal: Uses, Risks, and More

Though normally prescribed as a pain medication, gabapentin is sometimes used off-label for alcohol withdrawal and in alcohol use disorder (AUD) treatment to reduce cravings and symptoms of anxiety and insomnia.

In this article, you will learn:

How gabapentin relieves AUD symptoms
Efficacy in treatment of AUD
Who gabapentin can benefit
Risks and limitations
Use as an adjunct to FDA-approved AUD medications

Nearby Alcohol Rehab Centers

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Key Facts

Gabapentin calms the nervous system, reducing symptoms like anxiety and insomnia.
Gabapentin can reduce the need for benzothiazines, which is especially helpful for patients who do not tolerate benzodiazepines well.
Gabapentin use is contraindicated for people with a history of severe withdrawal symptoms or seizures, for the elderly and pregnant women.
After detox, gabapentin can be replaced with other drugs that are FDA-approved for alcohol use disorder.

Gabapentin 101

What is Gabapentin and its FDA-approved uses?

Gabapentin is FDA-approved as an anti-convulsant medication and as a neuropathic pain medication used to treat symptoms caused by nerve damage.

It is not FDA-approved for alcohol withdrawal treatment, but is sometimes prescribed off-label because it calms the nervous system and reduces withdrawal and early recovery symptoms like cravings, anxiety, and insomnia.

When used to treat alcohol use disorder, gabapentin requires clinical oversight and screening to check for co-occurring disorders or medication interactions.

How it Works & Why Clinicians Consider It

A doctor writing a prescription for gabapentin

During alcohol withdrawal, a rebound effect occurs in the brain as it rebalances the neurotransmitter chemicals GABA and glutamate.

Gabapentin helps return GABA and glutamate to their normal concentrations by increasing the available amount of GABA and reducing the amount of glutamate in the brain. This calms the nervous system and reduces cravings, anxiety, and insomnia.

Gabapentin is not a benzodiazepine medication, so it avoids the cross-tolerance risk associated with benzodiazepines and alcohol. It also has fewer side effects than benzodiazepines.

Does Gabapentin Help with Alcohol Withdrawal?

Evidence for Use in Mild-Moderate Withdrawal

Studies have shown that gabapentin can reduce CIWA-Ar scores. Clinical Institute Withdrawal Assessment for Alcohol-Revised scores quantify the severity of alcohol withdrawal symptoms and complications. Lowering scores indicates success in addressing symptoms.

Gabapentin is suited for withdrawal management care in inpatient treatment settings as well as outpatient treatment settings with clinical monitoring.

Because gabapentin has similar effects to benzodiazepines, its use can lower the need for benzodiazepines to treat cravings, anxiety or sleep problems. Used as short-term treatment during early recovery, following detox, gabapentin can help maintain abstinence.

Risks and Limitations of Gabapentin in Severe or Complicated Cases

Gabapentin is not adequate for use as the only medication prescribed for high CIWA-Ar scoring patients with more severe symptoms and/or complications. It is also not adequate for patients with prior seizures or risk for DTs.

Red flags include:

Uncontrolled vital signs (temperature, pulse, respiratory rate, blood pressure)
Confusion
Hallucinations
Severe electrolyte issues
Severe or complicated cases require moving to a higher level of treatment, using benzodiazepine-based therapy and inpatient management.

Where Gabapentin Fits vs. Benzodiazepines & Carbamazepine

Benzodiazepines are the first-choice option for moderate to severe alcohol withdrawal syndrome because they have been proven to be effective in treating severe complications.

Gabapentin is recommended for mild or moderate withdrawal when insomnia or anxiety exists or as an alternative or adjunct treatment when benzodiazepines are contraindicated.

Another anti-convulsant medication, carbamazepine, is also sometimes prescribed off label to treat AUD. Carbamazepine can be another alternative to benzodiazepines. It has less potential risk for dependence and respiratory depression than benzodiazepines, but has a greater risk for liver damage.

Side effects that are common with gabapentin and carbamazepine include drowsiness, dizziness and gastrointestinal issues.

Who Is (and Isn’t) a Good Candidate for Gabapentin?

Good Fit for People Who Have:

Mild alcohol withdrawal syndrome
Stable housing and transport
Feasibility for daily outpatient check-ins
Co-occurring insomnia or anxiety
Plans to continue treatment for AUD symptom relief if beneficial
Liver disease, where the use of benzodiazepines raises a concern
Adequate kidney/renal function for dosing

Poor Fit and Red Flags:

History of severe AWS, seizures or DTs
Unstable medical or psychiatric status
Pregnancy/breastfeeding
Significant renal impairment
Older adults with fall risk
Concurrent opioid/CNS depressant use
History of gabapentin misuse or improper sharing

How Gabapentin is Used in Practice

Care setting & monitoring

Gabapentin is usually provided during outpatient treatment with structured CIWA-Aror SAWS (Short Alcohol Withdrawal Scale) tracking and monitoring.
Gabapentin use requires regular monitoring of vital signs and daily patient contact early on.
Emergency room treatment is indicated if irregular heartbeat, confusion or signs of psychosis (hallucinations, delusions or paranoia) occur.
A step-up in care from outpatient to inpatient is indicated if complications involving co-occurring conditions or symptoms of DTs arise.

Typical outpatient approach

A short course of gabapentin treatment is given, often followed by brief tapering (3–7 days) to gradually reduce the dosage and prevent rebound symptoms.
- Patients should not self-escalate the tapering schedule.
Gabapentin can provide adjunct treatment to symptom-triggered benzodiazepine treatment (where benzodiazepines are administered only when symptoms approach an increased level of intensity) or if breakthrough symptoms (re-emergence of previously controlled symptoms) occur.
When taking gabapentin, avoid driving or operating machinery until you know how the medication affects you, especially in relation to sedative effects.

Bridging from withdrawal to AUD treatment

After detox and withdrawal, gabapentin use may be replaced by other drugs that are FDA-approved for AUD. It may be continued short-term if it is helping with cravings or insomnia.
Counseling, often using cognitive behavioral therapy (CBT) that addresses negative thoughts and beliefs leading to self-destructive behavior and motivational enhancement therapy that increases motivation and a commitment to action, helping patients overcome triggers and stressors that lead to alcohol use.
12-step and other peer support groups provide companionship and encouragement.

FDA-approved AUD meds include naltrexone, Acamprosate and disulfiram.

Naltrexone reduces alcohol cravings and euphoria.
Acamprosate helps reduce cravings, anxiety and insomnia.
Disulfiram causes an adverse reaction to alcohol use and discourages drinking.

Safety & Legal Considerations

A doctor speaks with a patient during an appointment to discuss MAT for alcohol withdrawal

Common side effects & serious risks

Dizziness
Sleepiness
Loss of balance
Edema
GI upset
Increased fall risk
Respiratory depression when used with opioids, benzodiazepines and other sedatives

Gabapentin should be used with caution in elderly patients who have chronic obstructive pulmonary disease (COPD) or obstructive sleep apnea.

Renal function should be monitored and adjusted, when necessary, to avoid toxic levels of gabapentin accumulating in the kidneys.

When discontinuing gabapentin, a gradual tapering schedule is used to avoid rebound symptoms.

Misuse, diversion, and state monitoring of gabapentin

The potential for misuse of gabapentin is higher in users who have co-occurring opioid use disorder. Gabapentin may be misused to enhance the effects of opioids or to postpone withdrawal symptoms when opioids are not available.
Gabapentin users sometimes participate in drug diversion activity, where they transfer their prescription medication to another person for illicit use.
Some states track prescriptions of gabapentin using an electronic database system, orprescription drug monitoring program (PDMP).
It is important for gabapentin users to get their prescriptions from a single prescriber. They should use secure storage, like a locking medicine box. They should never share their gabapentin medication with others.

Gabapentin FAQs

Is Gabapentin FDA-Approved for Alcohol Withdrawal?

No. When gabapentin is used for alcohol withdrawal, it is prescribed off-label.

For severe or complicated alcohol withdrawal syndrome, benzodiazepine-based protocols are still recommended.

Can I Take Gabapentin With Naltrexone or Acamprosate?

Gabapentin is generally compatible with naltrexone and acamprosate. A medical professional should coordinate the dosing and monitor you for additive sedation.

For best outcomes, gabapentin use should be accompanied by therapy and peer support.

Is It Safe to Combine Gabapentin With Alcohol, Sleep Meds, or Opioids?

Avoid mixing gabapentin with alcohol, opioids or sleep meds like benzodiazepines that also cause sedation, as risks for dangerous respiratory depression will increase.

Any combined use should only occur while under direct medical supervision.

How Long Do People Stay On Gabapentin After Detox— and Do I Need to Taper?

Gabapentin use during withdrawal typically lasts for several days to a few weeks. Following detox, it may be continued short-term to treat insomnia and cravings during early recovery.

Gabapentin is often tapered gradually, using clinician guidance, to reduce rebound insomnia or anxiety.

Find Treatment Near You

Use the Rehab.com directory to find facilities that provide treatment for alcohol withdrawal syndrome. You can filter by location, level of treatment (outpatient or inpatient), special programs offered, or insurance accepted. Or call to speak to someone for more help.

Not sure where to start? Call today to talk to someone about your treatment options and see if your insurance will cover rehab.

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Name / Address / Rating	Description	Treatments / Payments / Programs	Review / Contact	Images
Avenues Recovery Center at Clarksville 1 Top 10 in Alcoholism 4.8 (388 reviews) Claimed	Avenues Recovery Center in Clarksville, Indiana, is an inpatient drug and alcohol detox and rehab center. They strive to provide individuals receiving treatment with a loving environment and attentive medical care. You’ll be away from toxic environments and triggers and have the opportunity to focus on developing life skills that will support you	Treatments Programs Payment Options AlcoholismMental Health And Substance AbuseDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health Adult ProgramYoung Adult ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsMedicaidMilitary Insurance	Great groups and staff very good people here Bryan Johnson 1 week ago They helped me immensely. Learned a lot about myself. Charles Meadows 1 week ago So grateful for avenues clarksville, they helped me start a journey that.i couldn’t have been more grateful, they saved my life. Shout out to all the staff. 😍 Brandon Terry 1 week ago	4
Soberman’s Estate 1 Top 10 in Alcoholism 5.0 (16 reviews)	Soberman’s Estate, located in Cave Creek, Arizona, is an alcohol and drug rehab center that provides addiction treatment services to adult men, professionals, and public figures. They are a discrete, luxury rehab for individuals aged 30 to 80 years old. This location caps their treatment center at ten men at a time. Soberman’s Estate focuses on	Treatments Programs Payment Options Mental HealthSubstance AbuseAlcoholismOpioid AddictionMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For Men Private InsuranceSelf-Pay OptionsFinancial AidSliding Scale Payment AssistanceMedicaidMedicare	I had a great experience overall and would recommend it to anyone wanted to jump start their sobriety!! Kevin Crawford 1 month ago Very professional, great counselors, and a very good learning experience. Gave me structure and coping skills. Additionally, the psychiatric counseling was top notch. Gregory Gheen 4 months ago When it came to the realization I needed help to overcome my addiction, I ended up choosing to go to Sobermans. I couldn’t have been more grateful for this choice and the experience. I can’t say enough about the accommodations, setting, and food. However those things mean nothing without the proper staff. The best thing about Sobermans is their people. The care I received from each and every member of staff there was overwhelming. I’ve since returned for some aftercare and Alumni events, and upon my return, it feels like home. I would highly recommend Sobermans for any man that needs help with addiction or getting your mind cleared. I promise, if you put in the effort that their staff does, you will leave different person! backfortyhunter Rose 5 months ago	5 5
Symetria — Hurst Outpatient Rehab & Suboxone Clinic 1 Top 10 in Alcoholism 5.0 (64 reviews)	Symetria – Hurst Outpatient Rehab and Suboxone Clinic in Hurst, Texas, is a private drug rehabilitation clinic for adults. The CARF accredited clinic offers various withdrawal medications to help clients get started with their recovery journey. You’ll also have access to treatments such as the intensive outpatient program (IOP), one on one	Treatments Programs Payment Options Substance AbuseAlcoholismOpioid Addiction Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsMedicareMilitary Insurance	BEST PLACE EVER. I have tried various other doctors/clinics and none of them even begin to compare to this one. The staff here is absolutely amazing. I can’t even make a single complaint. Dr Son is the best as well. He explains everything and you truly feel like he understands you. I can proudly say this, this place saved my life. If you or someone you know needs help getting off opiates do it right the first time and come here. You won’t be disappointed. If you are specifically struggling with fentanyl please don’t waste your time with other ways. I have tried 6 other methods from lazer therapy to having the earpiece to suboxone. Methadone is the key to our current fentanyl crisis. This clinic makes recovery possible again! Mason 1 month ago Entire staff was friendly, helpful and supportive throughout the whole process from reception to nurses to counselors William Maddux 2 months ago The nurses at the hurst location and also Samantha the receptionist are all so kind and compassionate!! They all go above and beyond the call of duty. They should all be praised for their hard work and their kindness to their patients!! Debbie Tyler 2 months ago	5 5
Steps to Recovery 1 Top 10 in Alcoholism 4.8 (298 reviews)	The Steps To Recovery addiction treatment center is situated in Levittown, Pennsylvania. At this drug rehab center, patients can expect to engage in a unique treatment approach that focuses on helping individuals recover through authenticity, intimacy, community connection, and transparency. Steps to Recovery offers a serene and private environ	Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionMental Health Adult ProgramLGBTQ ProgramYoung Adult ProgramMilitary Program Self-Pay OptionsMonthlyPrivate Insurance	Great experience, professional staff, and flexibility of program was perfect for me! Feel like a new person. Thank you! Doug Bradley 1 month ago Steps to recovery was a great program. The bhts were great and understood what I was going through with a lot of them being in recovery as well. As well as the therapists being well trained and met my needs. Overall a wonderful program that I would return to. Omi Floyd 1 month ago My treatment here was absolutely a success. I came here highly depressed with a negative outlook on life with zero hope. In combination with group therapy and individual therapy, my whole perspective was changed. I’m leaving here refreshed and ready for what life has in store for me. Would absolutely recommend to anyone who is struggling with substances and or their mental health. Abronah Chandler 1 month ago	6 6
Boca Recovery Center – New Jersey Drug & Alcohol Rehab 1 Top 10 in Alcoholism 4.9 (436 reviews)	Boca Recovery Center – Galloway is a drug and alcohol rehab in Galloway, NJ. They provide inpatient addiction treatment and medical detox. Boca Recovery’s New Jersey Drug & Alcohol Rehab, located in Galloway, New Jersey offers residential addiction treatment, medical detox, and medication-assisted treatment in an immersive treatment s	Treatments Programs Payment Options Mental Health and Substance AbuseDrug AddictionAlcoholismOpioid AddictionDual DiagnosisSubstance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For WomenSeniors ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsMilitary InsuranceFinancial Aid	It was a fine everyone was helpful and nice food was good too Eric Kantor 1 day ago Had a great experience at Boca recovery everyone was so helpful thanks to all staff members and clinical members Harripersaud Subick 2 days ago Boca Detox saved my life quite literally. I recommend if you are struggling that you reach out to these people. Sissy is my favorite person here so shout out to her..but honestly all the staff are great and they care about saving lives Richard Forguson 2 days ago	7 7
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Elevate Addiction Services 1 Top 10 in Alcoholism 4.8 (309 reviews) Claimed	Located in Watsonville, California, Elevate Addiction Services provides alcohol and drug rehab services to men and women suffering from addiction. Their levels of care include detox, inpatient treatment, and outpatient treatment. Elevate Addiction Services provides a wide continuum of care that meets each person where they are in their recovery pro	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ Program Self-Pay OptionsPrivate insuranceMilitary InsurancePrivate InsuranceFinancing	I recently completed the 30 day Core Peogram at Elevate Addiction Services in Watsonville. After two relapses following decades of previous sobriety, I knew I could benefit from an intensive inpatient residential program to set me bsck on the right path again. I’m so grateful I found Elevate right away. The 12 Steps originally got me sober, and I have no issues with AA/NA, but Elevate is based on SMART Recovery, which is built on a different foundation from the 12 Step program. I gained new insights through the intensive workbooking and structured group sessions, as well as my time spent with my on-site therapist. There’s a big emphasis on Mindfulness at Elevate, so be prepared to meditate and practice breathwork frequently. The rural location is serene, with spectacular views of the Pajaro Valley, and the wildlife is abundant. If you enjoy nature, this is a wonderful, peaceful location. The ranch-style property doesn’t look or feel institutional at all. The facilities are a bit worn (it was originally built 50+ years ago as a retirement home for nuns), so if you’re looking for a luxury rehab, this probably isn’t the place for you. But if you could benefit from delicious meals, CrossFit and yoga, volleyball and pickleball and a well-stocked game, book and DVD library, look no further! Every single employee has gone through the program themselves, so they really understand what you’re going through. Many people opt to stay on past their 60-90 day programs to train as staff members. The facilitators are caring, kind and helpful. The folks in the detox center are supportive and gentle. The security staff are strict but reasonable. Monday-Saturday, the schedule is very structured, with plenty of breaks and evening free time, and Sundays are completely free all day and night. You will be expected to do chores and follow rules. After an initial 7 day “blackout” period, clients have access during free time to shared cell phones in a common room, and once a week you have an opportunity to use your personal cell phone/laptop in a more private space. Visits from friends/family are limited, subject to pre-approval and only take place on Fridays from 3-6pm. The structure and rules are in place to help keep you focused on what you came there to do in the first place: get clean and sober! Overall, Elevate offers clients the opportunity to hit “pause” on the chaos of using and drinking, the tools to gain clarity and insight, and the strength and will to go back to living a clean and sober, productive life. N. D. 1 week ago Elevate was such a great program, it’s really changed my way of thinking for a positive Thank you Elevate!!! michael gonzales 2 weeks ago It was the best program I could ever ask for going in at 18 I wasn’t courted to do anything the work is straight forward and really helped me to grow and mature thank you so much elevate you made me feel welcomed comforted and made me want to stay Jayden Evans 2 weeks ago	5 5
Avenues Recovery Center at Lake Ariel 2 Top 10 in Alcoholism 4.8 (323 reviews) Claimed	Clients seeking treatment for alcohol addiction may be required to undergo detox first. The detox process ensures any abused substances are out of a client’s system and that they are in a healthy frame of mind when they enter residential treatment. Detox is overseen and closely monitored by medical staff. The residential program takes clients	Treatments Programs Payment Options Substance AbuseAlcoholismDrug AddictionMental Health And Substance AbuseDual Diagnosis Adult Program Private InsuranceSelf-Pay OptionsMilitary Insurance	Going to avenues was the absolute best move I could have made..First thing I noticed was alot of people actually cared not gonna lie it was a struggle I wanted to leave more than once but I was always talked down from the caring staff that was around..There isn’t a better place the food is good, played a ton of basketball and threw the football around the fires and speakers at nite very cool only thing that was hard was the gender ban but it was that way for a reason.. Today im over a year clean and doing great in life and I can’t thank avenues enough..Its a great place but you have to give it a chance its not easy have to be ready to just give in and learn a new way of life! sean hunter 1 week ago Staff was friendly and seemed to really care, the day was broken up well, food was acceptable. Overall a positive experience as far as rehabilitation can go… Conor Smith 1 week ago The staff was always great! They helped me through many situations while I was in treatment. They game me the upmost care! They helped me find my way home. Dark 1 week ago	5 5
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