Gabapentin Overdose: Signs, Symptoms, Risks & What to Do

Gabapentin is a prescription medication in the class of anticonvulsants and treatments for neuropathic pain conditions like postherpetic neuralgia or fibromyalgia. Gabapentin is prescribed primarily for the treatment of seizures, nerve pain, and other off-label uses. Under proper prescribing practices, gabapentin is considered safe. But still, some people are curious to know if gabapentin can cause an overdose in them.

It is also possible for a person to suffer from a gabapentin overdose due to taking too much gabapentin, either unintentionally or if they mix it with other depressants [1] like alcohol, opioids, or benzodiazepines. A gabapentin overdose can have mild to severe effects, ranging from sleepy/drowsy effects to having trouble breathing to losing consciousness.

Why Gabapentin Overdose May Happen

Gabapentin has been approved for several uses; however, doctors may also write off-label prescriptions for gabapentin for conditions that are not approved by the U.S. Food and Drug Administration (FDA). Gabapentin was initially developed as a medication for epilepsy, which is still used today for people with epilepsy. Gabapentin is also commonly prescribed to help relieve nerve pain [2] from conditions such as diabetic nerve pain and shingles. The off-label uses of gabapentin include treating anxiety, RLS (restless leg syndrome), and other chronic pain conditions.

Many individuals have successfully treated these conditions using gabapentin; however, these benefits can become problematic when individuals take excessive amounts of gabapentin over the recommended dose from the prescribing doctor or when the medication is taken alongside other depressant medications [3] or drugs.

Although gabapentin is not classified as an opioid, if taken in large doses, gabapentin can affect a person’s breathing, alertness, coordination, and mental function.

Can You Die From an Overdose on Gabapentin?

Yes, a person can die from an overdose of gabapentin. While overdosing on gabapentin is less common than overdosing on other substances, an overdose of gabapentin can be potentially deadly.

There are three ways a person may experience an overdose from gabapentin:

• Accidental overdoses — Like taking two or more doses of gabapentin very close together, as shown by misunderstanding the directions for taking gabapentin.
• Intentional misuse — Like using an excessive amount of gabapentin for recreational purposes or as a way to increase or intensify the effects of another drug.
• Polydrug overdoses — When the use of gabapentin in combination with other medications, such as alcohol, opioids, and/or benzodiazepines, results in severe respiratory depression [4], resulting in death.

So, when someone asks the question, “Can you die from either taking too much gabapentin or is gabapentin dangerous to use?” The answer depends on the amount taken, the person’s health status, and any other substances taken in combination.

When Does Gabapentin Overdose Occur?

Gabapentin overdoses occur when large amounts of gabapentin overwhelm the body’s ability to eliminate the medication. A large amount of gabapentin in the body causes the central nervous system to slow down, eventually resulting in impaired awareness, slowed breathing [5], sedation, and loss of consciousness.

Several factors increase the likelihood that a person will experience an overdose:

• Taking larger doses of gabapentin than what the prescribing doctor said to take, or having access to someone else’s gabapentin.
• Taking gabapentin in combination with alcohol, opioids, or benzodiazepines increases the effects of those agents and causes significant CNS depression.
• Having kidney disease [3], as the kidneys are the primary organs for eliminating gabapentin from the body, any additional gabapentin would increase its level in the body.
• As individuals age, they may have greater sensitivity to medications and slower metabolism, increasing the time any substances remain in the body.
• Widespread absorption of gabapentin at high doses means greater variation in how quickly or how much is absorbed when taking a large dose.

Due to the many variables related to how gabapentin is absorbed, it is impossible to predict for any individual the specific amount of gabapentin that will cause an overdose. This lack of predictability makes abusing gabapentin [6] a hazardous activity.

Recognizing a Gabapentin Overdose: Signs and Symptoms

Since an individual can live through a gabapentin overdose, it is essential to recognize any early signs and symptoms of an overdose of gabapentin. When gabapentin is used with it or is in the body with other CNS depressants [1], the signs and symptoms of life or death can be much more pronounced.

Early or moderate symptoms

A person suffering from an overdose of gabapentin may display some of the following early signs or symptoms:

• Excessively sleepy or drowsy
• Dizziness or lacking balance
• Uncontrolled movements
• Difficulty speaking correctly
• Illness, nausea, or vomiting
• Loss of coordination or lack of balance
• Confused or unsure of what is going on, or have difficulty understanding the world around them

Severe or life-threatening symptoms

Some potentially severe (or life-threatening) symptoms may indicate that the person is in the process of collapsing or suffering from a life-threatening event [4]:

• Respiratory depression (slow, shallow, or labored breathing)
• Loss of consciousness or coma
• Rapid heartbeat or irregular heartbeat
• Cyanosis, blue lips or fingertips (cyanosis), also occurs in some overdoses
• Strange muscle movements (seizures) occur when someone has overdosed
• The person will not be able to wake up

Anytime a person shows severe symptoms associated with a drug overdose, it is considered a medical emergency.

How Medical Professionals Diagnose Overdose

There is not one test that identifies a gabapentin overdose; therefore, medical professionals use clinical judgment, the report of ingestion, and the physical findings of the patient.

Medical professionals evaluate the patient’s vital signs [3], including breathing rate, heart rate, blood pressure, and oxygen saturation. In addition, blood tests may be performed to monitor kidney function and possibly rule out the presence of other drugs. Since there is no specific antidote for gabapentin, medical professionals focus on identifying and treating symptoms and supporting the patient until they recover.

Emergency Response: What to Do if You Suspect an Overdose

It is essential to take action quickly if you believe someone has overdosed on gabapentin.

If the person has exhibited any of the severe symptoms, such as difficulty breathing, is unconscious, has had seizures, or has bluish lips [2], you should call 911 (or emergency services) immediately. If the symptoms are not as severe but you feel they are worrisome, please contact Poison Control immediately at 1-800-222-1222.

While waiting for help to arrive:

• Put the person in a recovery position. (On their side) to reduce the risk of choking.
• Monitor their level of responsiveness and breathing.
• Do not induce vomiting.
• Stay with the person until help arrives.

Do not wait for symptoms to go away. Overdose symptoms can worsen very rapidly.

Treatment Options and Hospital Care

Treatment for a gabapentin overdose consists of providing supportive care. At the emergency room, the medical staff may supply the patient with oxygen, provide airway support, give intravenous fluids, and check vitals [5] continuously while treating the patient for an overdose.

If a patient is still within the timeframe to use activated charcoal to reduce absorption of oral medication, it may be used in conjunction with the other treatments mentioned above. In extremely high overdoses [6], we may need to use hemodialysis to remove gabapentin from the body, especially when the person has impaired kidney function.

As there is no reversal agent for gabapentin, the person must be closely monitored until their symptoms stabilize and they have cleared gabapentin.

Risk Factors That Increase Severity

Certain factors can make a gabapentin overdose more severe.

• Using gabapentin with alcohol, other central nervous system depressants (e.g., opioids and benzodiazepines).
• Age over 65 years and/or having a frail physique.
• Chronic kidney disease or a history of chronic kidney disease.
• History of misuse or access to other types of addictive medications [6] or drugs.
• Using extremely high-dose gabapentin for conditions other than those for which it was prescribed.
• Genetic/metabolic factors can affect the way your body metabolizes and utilizes medications.

By recognizing these risk factors and being aware of your own and your loved ones’ risks, you may make better, safer decisions in the future.

Prevention and Safe Gabapentin Use

The best way to prevent a gabapentin overdose is to follow safe medication practices:

• Take only what your doctor prescribes.
• Do not increase or double the dose or frequency of the medication without consulting your physician.
• Be sure to inform your doctor or healthcare providers of all medicines and drugs you’re taking (including gabapentin).
• Do not use alcohol or sedatives unless you are specifically permitted to do so by your doctor.
• Always store gabapentin properly and dispose of the medication according to safety standards for disposal of unused drugs.

If someone is risking misusing or taking gabapentin, seek out professional assistance [5] to reduce the chances of harm related to misuse and help them recover.

How Ikon Recovery Can Help

At Ikon in Saddle Brook, NJ, we genuinely understand the intersection of prescription medications and mental health, trauma, and addiction. Recovery from substance use is more than just stopping the substance. Recovery means healing the whole person through comprehensive, evidence-based treatment approaches.