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Our analysis of pooled data provides evidence that the use of gabapentin to manage alcohol withdrawal symptomatology and related cravings is at least moderately effective. However, given the limited number of available well-designed studies, these findings require further support through more rigoro Objective: Gabapentin (GBP) and pregabalin (PGB) have been used to treat alcohol use disorder (AUD) and alcohol withdrawal, but with inconsistent results. In this meta-analysis, we explored the effects of GBP/PGB treatment on AUD and their effects on withdrawal, craving, depression, and sleep disturbance in AUD patients. An alcohol interaction study showed that gabapentin alone impaired balance and, although it did not significantly alter the subjective or performance effects of alcohol or alcohol craving, it dose-dependently increased alcohol-induced tachycardia . Conducted by scientists supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, the study found that alcohol dependent patients using gabapentin were more likely to stop drinking or refrain from heavy drinking than those taking placebo. The anticonvulsant drug gabapentin is used off-label to treat alcohol-related withdrawal, cravings, anxiety, and insomnia. Although it is well tolerated and has demon-strated effi cacy for mild alcohol withdrawal and early abstinence, there is concern about its potential for abuse. Gabapentin should be prescribed only as a second-line al- First-line pharmacotherapy includes naltrexone and acamprosate. Naltrexone can be initiated any time at a dose of 25 mg/d and titrated to 50 mg/d (number needed to treat [NNT] of 12 to reduce heavy drinking; NNT of 20 for abstinence in combination with psychosocial interventions).3 Adverse effects include transient dizziness and nausea (number needed to harm [NNH] of 16 and 9, respectively). Gabapentin reduces alcohol consumption and craving, which may help patients to maintain abstinence. These results, together with the virtual absence of side effects and a favorable safety profile, support gabapentin as a potential drug for the treatment of alcohol withdrawal and dependence. Gabapentin is a calcium channel GABAergic modulator that is widely used for pain. Studies showing reduced drinking and decreased craving and alcohol-related disturbances in sleep and affect in the months following alcohol cessation suggest therapeutic potential for alcohol use disorder. 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 Five common medications used to treat alcohol dependence are naltrexone, disulfiram, acamprosate, topiramate, and gabapentin. These drugs work in different ways and have fared differently in research studies. Regardless of which one you use, it’s best to combine medication with other forms of treatment, such as therapy and support groups. In summary, the studies showed a significant reduction in the number of weekly drinks among patients receiving gabapentin monotherapy, 4 as well as reduced alcohol craving, positively affected mood and sleep symptoms, and increased rates of abstinence with an 1800-mg daily dose of gabapentin. 5 Both studies also suggest favorable safety 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. (2014) tested oral gabapentin at 900 or 1800 mg/day, versus placebo, combined with manualized counseling, and found that the 1800 mg dosage was effective in promoting abstinence, reducing heavy drinking, improving sleep, and decreasing alcohol craving (Mason et al. 2014). Anton et al. ment with gabapentin in reducing alcohol consumption and craving. METHOD Subjects Of 152 alcohol-dependent outpatients consecutively referred to an addiction psychiatrist for alcohol depen-dence treatment, 60 met the inclusion criteria. After all eligible patients had signed a written informed consent While gabapentin is not yet an FDA-approved treatment for alcoholism, a number of studies support the its use withdrawal and cravings: In a 12-day study detoxifying with either gabapentin or lorazepam (a benzodiazepine prescribed with the brand name Ativan), the former was less likely to drink – and had less craving, anxiety, and sedation. Some research shows that gabapentin has promise as an alcohol withdrawal treatment, possibly in combination with other medications. Gabapentin can: Help stop the impulse to drink, especially Baclofen, Topiramate & Gabapentin are all off-label medications that reduce alcohol cravings by altering brain chemicals and managing anxiety. Baclofen specifically reduces anxiety and other triggers, while Topiramate changes brain chemicals related to addiction, making drinking less appealing. Excessive alcohol use is a leading cause of preventable death in the United States, contributing to an estimated 1 in 5 deaths among adults 20 to 49 years of age between 2015 and 2019. 1 Alcohol In a 28‐day, placebo‐controlled, randomized, double‐blind clinical trial, investigators found that gabapentin (300 mg, twice daily) can reduce AUD patients’ number of drinks per day, the mean percentage of heavy drinking days, craving for alcohol, and increased percentage of days of abstinence in the gabapentin group than those in the Because protracted alcohol withdrawal symptoms of insomnia, anxiety, dysphoria, and alcohol craving can complicate the immediate period of recovery after detoxification, short-term maintenance treatment with gabapentin may relieve these symptoms and reduce relapse rates.
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