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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.
How Gabapentin Compares to Other Alcohol Withdrawal Medications
| Medication | Primary Use in Alcohol Care | Typical Course | Common Side Effects |
|---|---|---|---|
| Librium (chlordiazepoxide) | First-line treatment for moderate-to-severe withdrawal; prevents seizures and delirium tremens | 3 to 7 days, tapered | Drowsiness, dizziness, coordination issues |
| Gabapentin | Mild-to-moderate withdrawal; reduces anxiety and cravings | 5 to 7 days, tapered | Dizziness, fatigue, swelling |
| Clonidine | Adjunct medication for high blood pressure, sweating, and anxiety; does not prevent seizures | 3 to 5 days | Low blood pressure, dry mouth, drowsiness |
| Naltrexone (oral or Vivitrol injection) | Post-detox craving and reward reduction | Daily oral or monthly injection; often long-term | Nausea, headache, fatigue |
| Thiamine (Vitamin B1) | Prevents Wernicke-Korsakoff syndrome; routinely given during alcohol detox | Daily during detox, often parenteral | Generally well tolerated |
For reference only. Medication decisions belong with a licensed clinician.
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
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| Name / Address / Rating | Description | Treatments / Payments / Programs | Review / Contact | Images | |
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Avenues Recovery Center at ClarksvilleAd 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  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  Alcoholism Mental Health And Substance Abuse Drug Addiction Opioid Addiction Substance Abuse Dual DiagnosisMental Health  Adult Program Young Adult Program LGBTQ Program Military Program  Private Insurance Self-Pay Options Medicaid Military Insurance | View Website (930) 203-1947 | 
Avenues Recovery center is a very good place love the staff love the facilitators love the case managers there’s a lot of good help here I am still involved with the alumi meetings I just love how were family love you avenues recovery center
Joshua Levi Johnson
1 day ago
Avenue staff was exceptionally considerate to all of my needs. Highly recommend if your truly searching for recovery.
Janezee Leezy
1 day ago
Really good place to go to
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9.67 / 10 Claimed | All In Solutions Wellness Center is a treatment facility located in West Palm Beach, Florida. This facility specializes in treating adults who are struggling with co-occurring disorders and addiction. The levels of care offered here are detox, residential, and aftercare programs. As one of the best-rated detox centers in Florida, All In Solutions | Treatments Programs Payment Options AlcoholismDrug AddictionMental Health And Substance AbuseOpioid AddictionSubstance AbuseDual Diagnosis Adult Program Program For Men Program For WomenYoung Adult Program Private InsuranceSelf-Pay Options | 
My experience at All In Solutions exceeded my expectations. I was treated with respect, honor and dignity. I was kept comfortable while detoxing.
Timothy Snow
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My wife completed residential treatment here for alcohol addiction and the change has been remarkable. Family therapy sessions helped all of us understand how to support her moving forward.
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Attentive medical staff during detox, comfortable rooms, board-certified providers who explain everything clearly.
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5 5 
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Top 10 Rehab in TN
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9.64 / 10 | Recovery Unplugged Nashville Drug & Alcohol Rehab is a private luxury addiction treatment center located just south of Nashville, in Brentwood, Tennessee. They offer several levels of care, including medication assisted treatment (MAT), residential treatment and behavioral telehealth. Adults with dual diagnoses and substance use disorders are welco | Treatments Programs Payment Options Substance AbuseAlcoholismDrug AddictionDual Diagnosis Adult Program Private InsuranceSelf-Pay Options MedicareMedicaidMilitary Insurance | 
This place helped me save my own life. I couldn’t recommend a company more.. especially in a dire situation. They are family.
Michelle Aspen
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Help my family out wonders!
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9.61 / 10 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 | 
This facility has been amazing. The staff is great and the program is also great
Michael Miller
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Awesome staff and great facilities. All my needs were met and they got me on the road to recovery.
Brian Mckinney
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Everything here was really great. The stars and medical team was very helpful. I left here with a new life
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5 5 
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Avenues Recovery Center at Lake ArielAd This is an ad and Avenues Recovery Center at Lake Ariel 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 Lake Ariel, PA Claimed | Clients seeking treatment for alcohol addiction may be required to undergo detox first. As one of the best detox facilities in Pennsylvania, the process at Avenues Recovery Center 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 | Treatments Programs Payment Options Substance AbuseAlcoholismDrug AddictionMental Health And Substance AbuseDual Diagnosis Adult Program Private InsuranceSelf-Pay OptionsMilitary Insurance | View Website (570) 354-6060 | 
Amazing place! Totally worth it!
Megann
1 week ago
Excellent facility fabulous staff!
amy knorr
1 week ago
This is truly an amazing facility! Every single person I’ve encountered is absolutely wonderful. The staff are incredibly kind, caring, and knowledgeable, groups are fun & informative, and the housing and food are excellent. There’s an amazing sense of community and I 1000% recommend.
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Top 10 Rehab in VA
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9.45 / 10 | Recovery Unplugged offers a full suite of outpatient substance use recovery for adults and adolescents in the DC Metro area of Annandale, Virginia. They offer general outpatient and top-rated intensive outpatient care (IOP) alongside partial hospitalization programs (PHP). Each of these levels of care may incorporate medication-assisted treatment ( | Treatments Programs Payment Options Substance AbuseAlcoholismDrug AddictionDual Diagnosis Adult ProgramYoung Adult ProgramLGBTQ Program Teen Program Private InsuranceSelf-Pay OptionsMedicareMedicaid | 
I have been in and out of treatment for 15 years, and this is by far the best recovery center I have ever been to. The staff genuinely care about every client and their well-being. They aren’t just out for money or treating people like another number—they truly want to see you heal, grow, and succeed. I have felt supported, understood, and cared for throughout my time here. Recovery is not easy, but this center has given me hope and the tools I need to build a better life. I’m incredibly grateful for this place and would recommend it to anyone who is ready to make a change.
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I would not be where I am today without the help of Recovery Unplugged. I had two 30 day visits with them back in 2019 before moving on to a 90 program in Arizona. Everyone was friendly and you felt like you actually mattered. The musical component of it all was life changing and is still a huge support in my life today. It’s outside of the box recovery and if you are looking for a place to start, this is it. I’m coming on six years of sustained recovery and now hold a masters in divinity while thriving in Tucson. AZ. None of this would have been possible without Recovery Unplugged and I could not be more grateful for all they provided in early recovery.
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9.41 / 10 Claimed | All In Solutions Counseling Center is a mental health and addiction clinic in Cherry Hill, New Jersey. They provide outpatient addiction treatment and mental health care. They offer options like an intensive outpatient program, a partial hospitalization program, and medication-assisted treatment. All In Solutions Cherry Hill Drug & Alcohol Reha | Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisOpioid AddictionSubstance AbuseMental Health And Substance Abuse Adult ProgramYoung Adult ProgramProgram For MenProgram For Women Private insuranceSelf-Pay Options | 
The clinical building being separate from the housing is a detail that sounds small but makes a big practical difference. You go there to work, and you come back to somewhere calmer when the day is done. That separation gave the whole experience a clearer shape.
Brian Saunders
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Friday afternoons they bring in alumni speakers. Sitting in a room listening to someone who’s been through it and come out the other side is different from any group session with a counselor. It was one of the parts of the week I genuinely looked forward to.
Thomas Navarro
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The weekly family group, held online so family can join from wherever, is something I wasn’t expecting. My family had been through a lot and being able to include them in the process, even from a distance, changed how I felt about what I was doing here. Recovery doesn’t happen in a bubble and a program that actually acknowledges that is worth noting.
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Top 10 Rehab in TX
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9.39 / 10 | Symetria – Hurst Outpatient Rehab and Suboxone Clinic in Hurst, Texas, is a private drug rehabilitation clinic for adults. One of the best outpatient rehab centers in Texas, Symetria offers various withdrawal medications to help clients get started with their recovery journey. You’ll also have access to treatments such as the intensive outp | Treatments Programs Payment Options Substance AbuseAlcoholismOpioid Addiction Adult ProgramYoung Adult Program Private InsuranceSelf-Pay OptionsMedicareMilitary Insurance | 
Symetria is like a second family for me now and Mrs. Debrah , who runs the center is always awesome and also Mrs. Callie is my counselor and a great one at that! Come to Symetria if you need help you’re not alone they will treat you like your one of them. And the front desk lady Michelle is so sweet that she won’t let you miss a does so she calls every patient everyday in case you forgot so u don’t suffer!
Krystina Hubbell
2 weeks ago
I have been in the DARKEST place for so long. Symetria was my saving grace. My counselor Callie (my saving grace) showed me that I actually really do matter and gave me a sense of belonging for the FIRST time in my life! She truly cares and has helped me in so many ways that I can’t thank her enough. If it weren’t for her, I’m not sure where I’d be in life right now without her. Ms Callie, if you see this, thank you again. To all of the concerned mothers/fathers out there, I promise you, this is the best methadone clinic in the United States. Thank you for taking the time to read my comment, I promise I wouldn’t steer you the wrong direction. <3 Please take into consideration coming to Symetria. I finally have hope.
Madi Murphy
1 month ago
This place is great. The entire staff had always been excellent
bryan harris
2 months ago
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5 5 
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1
Top 10 Rehab in NY
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9.39 / 10 | This facility offers leading outpatient addiction treatment, recovery coaching, and medication-assisted treatment for adults. Through an intensive outpatient program or an outpatient program, participants engage in individual and group therapy that helps get to the root of addiction and relapse prevention skills. Outpatient support groups allow you | Treatments Programs Payment Options AlcoholismDrug AddictionSubstance AbuseOpioid Addiction Adult ProgramYoung Adult ProgramLGBTQ ProgramTeen Program Private InsuranceSelf-Pay Options Sliding Scale Payment Assistance Financing | 
As a family member, I cannot say enough wonderful things about Mountainside Treatment Center in Huntington. From the very beginning, the staff treated both our loved one and our family with compassion, respect, and genuine care during an incredibly difficult time.
The communication throughout the process was thoughtful and professional, and it was clear that everyone involved truly wanted the best possible outcome. Mountainside provides best-in-class treatment in a safe, supportive, and welcoming environment. Knowing our loved one was in such caring and capable hands gave us comfort and hope when we needed it most.
We are deeply grateful for the support, guidance, and dedication of the entire team. Highly recommend.
Adriana Popa
4 months ago
Going to Mountainside in Huntington was a life changing experience. I could not recommend it more!
Violet White
1 year ago
As a clinical social worker running a local group practice, I regularly collaborate and refer clients to Mountainside Treatment Center. Their staff has always been exceptional, especially Courtney Hulse and Dan Sexton, who go above and beyond in tailoring their treatment plans for each client and family. Mountainside serves as a tremendous resource, providing quality substance abuse treatment that is critically needed here on Long Island. We are enthusiastic about continuing to work with Mountainside to best serve our community and families. Thank you for all you do Mountainside. Highly recommend!
Gordon Gooding
2 years ago
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4 
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1
Top 10 Rehab in MD
Rehab Score
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9.38 / 10 | Bracebridge Hall is an inpatient facility located in Earleville, Maryland under the umbrella of Recovery Centers of America. It’s on 560 acres with a view of the Sassafras River. They offer substance use disorder (SUD) treatment and mental health treatment for co-occurring disorders. They accept and are in network with most major insurance plan | Treatments Programs Payment Options AlcoholismDrug AddictionDual DiagnosisMental Health and Substance AbuseOpioid AddictionSubstance Abuse Adult ProgramMilitary ProgramYoung Adult ProgramLGBTQ Program Private insuranceSelf-Pay Options Financial AidSliding Scale Payment AssistanceMilitary InsurancePrivate InsuranceMedicaidMedicare+1 | 
RCA and its facilitors were exceptional. Intake and discharge was streamlined and efficient. A variety of flexible groups and speakers were scheduled weekly. Educational classes regarding medications and planning for discharge are also available. The facility provides lesiure activities such as fishing, recovery walks, and a gym. Facility was well maintained and clean. A variety of meals are offered for breakfast, lunch, dinner, and a night snack. Substitute protein options are also available. RCA will meet and exceed expectations and provide all one needs for a successful recovery.
Juan Najera
1 day ago
My stay at RCA Bracebridge was truly life-changing. This was my first experience in rehab, and I honestly didn’t know what to expect, but it exceeded everything I could have imagined.
The groups were both educational and life-changing, providing valuable knowledge and tools that I can carry with me throughout my recovery. The staff were exceptionally supportive, caring, and informative. It was comforting to know that someone was always there whenever I needed help or support.
My therapist, Jessica V., is amazing, and I will never forget her. Mr. Dan, Mike H., Mrs. Jessie, and Mrs. Amber were also incredibly supportive and generously shared their knowledge and experience, which made a meaningful difference in my recovery.
The RSS staff were outstanding, and words cannot fully express my gratitude for everything they did. The kitchen staff, especially Eric, went above and beyond to make sure we were comfortable and had what we needed. That support allowed us to focus on what mattered most—our recovery.
Mr. Tariq always listened and showed genuine care and compassion toward the clients. His kindness and willingness to be there for us meant a lot.
I will forever be grateful to RCA Bracebridge for helping save my life and giving me the coping skills and tools I need to continue recovering one day at a time. I am leaving with gratitude, hope, and a renewed commitment to my recovery. Thank you to everyone who played a part in this journey
Shawnda
1 day ago
RCA gave me the confidence and tools to live the life of sobriety. Im truly grateful for everyone involved in my treatment there and the compassion and understanding of my treatment. I cant truly describe the gratefulness I have for this facility that has changed my life.
Jerry Chandler
2 days ago
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5 5 
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