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

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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

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

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

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Avenues Recovery Center at Clarksville Ad This is an ad and Avenues Recovery Center at Clarksville is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Clarksville, IN 4.8 (409 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	View Website (930) 203-1947	Absolutely outstanding place for detoxing and wanting to restructure your life..If your haveing mixed emotions on where you might want to get help this is forsure the best place to do so. Matt Harris 1 week ago I love all the BHTs they walked me through some things, let me vent and helped me process and all the facilitators as well especially Chris and gonzo Brittany Hon 1 week ago Avenues is a very good program James Turner 1 week ago	4
Soberman’s Estate Cave Creek, AZ 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	Soberman’s Estate was everything I needed for my recovery. The staff, the program, physical activity and culinary experience were top notch and essential. The program is well designed and worked better than I expected. The staff is remarkable – professional, considerate and genuinely caring. My time there and being removed from alcohol for five weeks was everything I needed to remove my craving for alcohol. Soberman has changed my life in ways I never could have imagined. I feel confident, secure and grateful for my new life. I have reconnected with my family and friends. Thank you Soberman. George B. 2 months ago Yes, very professional staff, treatment, therapist, chefs were good! even the home cook did the best she could, and loved the horses of Course! Saturday morning hiking was fun to explore the trails of the nearby mountain area! John E Williams 2 months ago I had a great experience overall and would recommend it to anyone wanted to jump start their sobriety!! Kevin Crawford 2 months ago	5 5
All In Solutions Detox 1 Top 10 Rehab in CA Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.81 / 10 4.9 (536 reviews) Claimed	All In Solutions Detox in Simi Valley is one of the best ranked inpatient detox facilities in California providing safe, medically supervised care for individuals beginning their recovery from drug or alcohol addiction. As part of the All In Solutions Behavioral Health network, this facility serves as the first step in a full continuum of care. Cli	Treatments Programs Payment Options AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Private InsuranceSelf-Pay Options	The staff here is amazing and so helpful Misty Rahe 5 days ago Excellent staff and service. Very comfortable experience. Highly recommend. The support here is amazing. Cody Knight 3 weeks ago Great staff every one is nice and treats everyone with respect great environment and energy Ramon Ruiz 3 weeks ago	5 5
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Boca Recovery Center – Bloomington Alcohol & Drug Rehab Ad This is an ad and Boca Recovery Center – Bloomington Alcohol & Drug Rehab is a paid advertiser. Paid advertisers may be listed first in search results. This ad may contain content provided by the advertiser. Rehab.com does not verify ad content or any reviews that are displayed. Learn More Bloomington, IN 4.9 (209 reviews)	The Boca Recovery Center is a luxury alcohol and drug rehab center for adults in Bloomington, Indiana. They specialize in cutting edge addiction treatment provided in a residential setting. One unique part of this alcohol and drug rehab in Indiana is the peaceful, secluded setting. If recovering in a clinical hospital setting doesn’t sound very a	Treatments Programs Payment Options Drug AddictionAlcoholismOpioid AddictionDual DiagnosisMental Health and Substance AbuseSubstance Abuse Adult ProgramYoung Adult ProgramSeniors ProgramLGBTQ ProgramMilitary Program Private InsuranceSelf-Pay OptionsMilitary InsuranceFinancial Aid	View Website (930) 203-1400	This facility was great to my process of developing into a responsible adult and also putting my future in my hands other than others. Many Thanks to all staff for their efforts. The BOCA thorn in their side has left the building!!! Josh Fannin 1 week ago good support when you’re in need of it. bcrescent 2 weeks ago Its a great place Andrea Youngblood 1 month ago	6 6
All In Solutions Counseling Center 1 Top 10 Rehab in FL Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.80 / 10 4.9 (287 reviews) Claimed	All In Solutions Counseling Center is a mental health center and addiction treatment program in Boynton Beach, Florida. They provide a partial hospitalization program, an intensive outpatient program (IOP), an outpatient program, medication-assisted treatment, and mental health care for adults with substance use disorder. All In Solutions Counseli	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual DiagnosisMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Self-Pay OptionsPrivate insurance	Ms Karen from the Cherry Hill, NJ locations was just awesome. She called me every week to give me updates concerning my husband. She has been so helpful to keep me grounded and encouraged that I’m sure she did the same for her clients. I have to say she was the best, thank you Miss Karen for all you do and may God continue blessing you always.. Sandra Cornish 1 week ago All in was a great program! The staff was amazing. Very helpful in my recovery! They were very attentive. Mike Garcia 2 weeks ago This place helped me when I felt like no one could, 5 stars to the techs, 5 to the therapists, and 5 to case management will love you guys for ever. kyle Buchmaier 3 weeks ago	4
Boca Recovery Center – New Jersey Drug & Alcohol Rehab 1 Top 10 Rehab in NJ Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.79 / 10 4.9 (447 reviews) Claimed	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	I would highly recommend Boca Recovery Center to anyone struggling with an illness. They do an amazing job and will change your life for the better. The staff makes you feel comfortable while stretching your boundaries and understanding. One of the strongest parts of the program is their follow up after treatment, specifically the Alumni Coordinator. Greg D 1 week ago Amazing staff great program was life changing so glad I made that call I like to commend Jon Ashley Kevin and Mike I wish I remember the night shift names that’s an amazing staff and the cooks that was good food Monica Garcia 2 weeks ago Staff a Boca rehab are very caring to your needs my experience was amazing through out my recovery Wal Williams 3 weeks ago	7 7
S2L Recovery (Spring2Life): Christian Rehab Center 1 Top 10 Rehab in TN Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.77 / 10 4.9 (111 reviews)	If you’re looking for a Christian-based men’s drug rehab center, S2L Recovery in Woodbury, Tennessee, might be the place for you or your loved one. Located at the top of Short Mountain, and overlooking the green hills of Middle Tennessee, this residential and detox clinic boasts a one-to-one staff/patient ratio so there’ll always be someone t	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance AbuseDual Diagnosis Adult ProgramYoung Adult ProgramProgram For Men Private InsuranceSelf-Pay Options	Coming from Canada, I was hesitant. But God knew that S2L was exactly where I needed to be. At 64 years of age, I was able to discover my true identity, purpose, and mission in Christ. They help you in trying to get clean and sober for sure. But what S2L and the staff are all about is the Gospel of Jesus Christ. That’s why it is so successful. TIM TANNER 2 months ago I’ve had the privilege of seeing the life-changing impact this ministry has on countless men & I can’t recommend it highly enough! God has His Hand on this ministry & I’m honored to see the Lord work in these men! Hunter Stanfield 2 months ago Come here with a open mind and heart. It can and WILL change your life in all ways. Trust the process and trust God! Could go on and on about how amazing this place, I’ll forever be grateful! Trevor Woodard 2 months ago	6 6
Steps to Recovery 1 Top 10 Rehab in PA Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.76 / 10 4.8 (299 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	Good place, great housing Nicole Rivera 1 month ago Amazing support network and great staff lovely time with my stay at STR buck William Perry 2 months ago My experience at Steps to Recovery has been great for the most part, the people and the environment are very welcoming and comforting. I have had some issues that have come up, but they usually get resolved. My only main gripe is with some of the other clients at the community living house fail to clean up after themselves, and some do not know self control. But, the staff here is very professional and easy to talk to. I find that the opportunities here for my recovery journey are pretty good, although I’d like access to more holistic therapy resources. I’ve actually personally facilitated a Dharma meeting and will facilitate more in the future. I appreciate my time here at STR and am excited for the future with them. Jerry Davis 2 months ago	6 6
Elevate Addiction Services 2 Top 10 Rehab in CA Rehab Score Our Rehab Score is designed to make it easier for you to find the best treatment centers. We combine overall ratings with recent feedback to create a score that reflects a center’s quality right now. 8.76 / 10 4.8 (317 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. One of the best ranked Outpatient treatment centers in California, Elevate Addiction Services provides a wide continuum	Treatments Programs Payment Options AlcoholismDrug AddictionOpioid AddictionSubstance Abuse Adult ProgramYoung Adult ProgramLGBTQ Program Self-Pay OptionsPrivate insuranceMilitary InsurancePrivate InsuranceFinancing	Great place. The staff super nice amd very knowedgable about addictions. Its a very special place. Better than all others ive gone to. Definate thumbs up Tyler Kerney 1 week ago Our experience with Elevate Addiction Services has been truly life-changing. From the very beginning, the director, family liaisons, counselors, therapists, continuing care coordinators, house dad’s – we felt genuine compassion and care from everyone we had the pleasure of interacting with. We were kept informed of how our son was doing every step of the way. It never felt like we were alone in this. Everyone at Elevate was fighting for our son right alongside of us. The love and compassion shown to our son meant everything. Today, he is living clean & sober, feeling confident in the tools and foundation Elevate equipped him with. Elevate welcomed him with open arms. Watching him complete the program and graduate has been one of the proudest moments of our lives. We are so deeply grateful for Elevate and the loving and compassionate professionals who work there. Without hesitation, we would highly recommend Elevate Addiction Services to anyone seeking help for themselves or a loved one. They helped our son find his way back.❤️ Kenny & Shelly Wright 2 weeks ago Highly worth putting in the effort and money. One of the best decisions of my life was to enroll in the program at Elevate. Jack Downer 2 weeks ago	5 5

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