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Several agents are effective in the treatment of alcohol use disorder. However, minimal direct evidence supports one treatment as compared with another, therefore our choice is based on other factors such as prior history, presence of co-occurring conditions, treatment goal, and patient preference. Is gabapentin an effective treatment for alcohol use disorder (AUD)? Bottom line. Gabapentin treatment avoided more heavy drinking days (> 5 standard drinks/day) than placebo (27% vs 9%). Gabapentin can be a second-line, off-label option to treat AUD. However, there is mixed evidence and concerns about abuse-misuse, and drug-related harms. Evidence • For ongoing treatment of alcohol use disorder, gabapentin is taken 3 times a day. The total dose when you start is 300–900mg a day and it gradually increases to 1800mg per day. Some people may take more or less depending on what works for them. Evidence from single-site studies lend support to the safety and efficacy of gabapentin as a novel treatment for alcohol use disorder, with unique benefits for alcohol-related insomnia and negative affect, relative to available treatments. The combined use of gabapentin and opioids also increases the risk of respiratory depression and deaths in this patient population. 37 Although, gabapentin has a beneficial role in some substance use disorders such as alcohol use disorder, clinicians should adopt a cautious approach when considering prescribing gabapentin to patients with known How should I take gabapentin? The recommended dose of gabapentin for the treatment of alcohol use disorder is 300–600 milligrams (mg) 3 times daily. Gabapentin can be taken with or without food. Gabapentin has the potential for abuse, especially in those with a history of other substance use disorders, including alcohol, opioid, and cocaine use disorders. 52 One systematic review of 106 studies concluded that while there is not “convincing evidence of a vigorous addictive power of gabapentinoidsin patients without a prior abuse APA’s 2018 practice guideline on AUD pharmacotherapy suggests psychiatrists consider gabapentin for patients with moderate to severe alcohol use disorder who prefer gabapentin or are intolerant to or have not responded to the FDA-approved medications naltrexone and acamprosate. Is gabapentin an effective treatment for alcohol use disorder (AUD)? Gabapentin treatment avoided more heavy drinking days (> 5 standard drinks/day) than placebo (27% vs 9%). Gabapentin can be a second-line, off-label option to treat AUD. However, there is mixed evidence and concerns about abuse- • The recommended dose of gabapentin for the treatment of alcohol use disorder is 300–600 milligrams (mg) three times daily. • Gabapentin can be taken with or without food. The recommended dose of gabapentin for the treatment of alcohol use disorder is 300–600 milligrams (mg) 3 times daily. Gabapentin can be taken with or without food. If you take an antacid containing aluminum and magnesium, such as Maalox®, Mylanta®, Gelusil®, Gaviscon®, or Di-Gel™, you should wait at least 2 hours before taking your Some research shows that gabapentin has promise as an alcohol withdrawal treatment, possibly in combination with other medications. Gabapentin can: A clinical trial showed that people with NIH-funded study finds that gabapentin may treat alcohol dependence. Promising results from a randomized, controlled clinical trial of the medication. The generic anticonvulsant medication gabapentin shows promise as an effective treatment for alcohol dependence, based on the results of a 150-patient clinical trial of the medication. Gabapentin has been shown to be safe and effective for mild alcohol withdrawal but is not appropriate as mono-therapy for severe withdrawal owing to risk of seizures. During early abstinence, gabapentin may improve sleep, cravings, and mood—factors associated with relapse. Gabapentin for alcohol use disorder. Justin Weresch. MD CCFP. Jessica Kirkwood. MD CCFP(AM) Christina S. KorownykMD CCFP Clinical question (relative risk of 2.16), and might be at higher baseline Is gabapentin an effective treatment for alcohol use risk.7 Excess alcohol also increases mortality.8 disorder (AUD)? Gabapentin has been shown to be safe and effective for mild alcohol withdrawal but is not appropriate as mono-therapy for severe withdrawal owing to risk of seizures. During early abstinence, gabapentin may improve sleep, cravings, and mood—factors associated with relapse. Gabapentin is efficacious for the treatment of acute alcohol withdrawal symptoms 29,30 and also provides short-term relapse prevention after medicated alcohol detoxification, 31 perhaps by an effect on sleep normalization. 32,33 Post hoc analysis has shown effectiveness of treatment with gabapentin, in combination with flumazenil 34 or Keywords: alcohol use disorder, alcoholism, addiction, pharmacotherapy. Introduction. Alcohol use disorder (AUD) is a serious public health threat. It causes significant morbidity and mortality. Moreover, the economic burden of alcohol-related societal harm is nearly $250 billion annually in the United States (US) alone . • Taking medicine for an alcohol use disorder is not substituting one drug for another. How should I take gabapentin? • The recommended dose of gabapentin for the treatment of alcohol use disorder is 300–600 milligrams (mg) three times daily. • Gabapentin can be taken with or without food. If you take an antacid containing aluminum We included these moderator variables because a dosage effect of gabapentin was shown by Mason et al. in a study of AUD treatment, treatment duration was shown to predict outcomes in nicotine replacement therapy for smoking cessation , and the rate of study completion is lower in treatment trials of alcohol and drug use disorders than other
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