Can you overdose on gabapentin? Yes. Taken alone, a large amount usually causes heavy drowsiness, slurred speech and double vision; the real danger comes when gabapentin is mixed with opioids, alcohol or other sedatives, because together they can slow or stop breathing. That combination shows up in a lot of overdose deaths.
Gabapentin has a reputation as a “safe” medication, and for most people taking it as prescribed, it’s a useful one. That reputation is exactly why people underestimate it.
What Is Gabapentin?
Gabapentin (brand name Neurontin, among others) is an anticonvulsant. According to MedlinePlus, it’s used with other medicines to control certain seizures, to relieve the nerve pain that can linger after shingles, and, in an extended-release form, to treat restless legs syndrome. Doctors sometimes prescribe it for other kinds of nerve pain, too.
It isn’t an opioid. It works differently and, on its own, is far less likely to stop someone’s breathing. But it does slow the nervous system, and MedlinePlus notes it can cause drowsiness and dizziness even at normal doses.
Can You Overdose on Gabapentin Alone?
You can, though it’s less often deadly by itself. MedlinePlus lists the symptoms of a gabapentin overdose as double vision, slurred speech, drowsiness and diarrhea. Wikipedia’s summary of the medical literature adds that very high amounts are linked to breathing suppression, coma and possibly death, especially when alcohol or opioids are involved.
Treat any suspected overdose seriously. Even if the person seems “just really sleepy,” they need help.
Gabapentin and Opioids: The Dangerous Mix
Most serious gabapentin overdoses involve other drugs. A CDC report looked at overdose deaths in 23 states and Washington, D.C., during 2019 and 2020. Gabapentin was detected in 9.7% of those deaths, and in about half of those cases, it was listed as contributing to the death. Opioids were involved in nearly 90% of the deaths where gabapentin was found. The CDC authors also note that gabapentin deaths are probably undercounted, since it isn’t always tested for.
Here’s why the combination is so risky. Opioids slow breathing. Gabapentin adds to that sedation. The FDA has warned that serious, potentially fatal breathing problems can happen when gabapentin is taken with opioids or other drugs that depress the central nervous system, and in people who already have lung problems or are older. Alcohol, benzodiazepines and sleep medications all fall into that category.
Our post on how opioids affect the brain explains why breathing is the first thing to go in an opioid overdose.
Gabapentin Overdose Symptoms
Watch for these, especially if gabapentin may have been mixed with anything else:
- Extreme sleepiness, or nodding off mid-sentence
- Slurred speech or double vision
- Confusion or stumbling, poor coordination
- Slow, shallow or noisy breathing
- Bluish lips or fingertips
- Not responding when you shake them or call their name
What to Do in a Gabapentin Overdose
Call 911 right away if the person has collapsed, had a seizure, is having trouble breathing or can’t be woken up. Do it even if they seem to come around; sedatives can keep working after someone looks like they’re improving.
If opioids could be involved, and you have naloxone (Narcan), use it. It can reverse the opioid part of an overdose, though it won’t undo the gabapentin or alcohol. Stay with the person, keep them on their side if they’re breathing, and tell paramedics everything they took.
For a possible overdose that isn’t an emergency yet, or if you’re unsure, call Poison Control at 1-800-222-1222.
Why Gabapentin Gets Misused
Gabapentin isn’t a controlled substance under federal law, so it’s easier to get than opioids or benzodiazepines. Wikipedia notes that several states, including Kentucky, have made it a Schedule V controlled substance, and that the UK reclassified it as a controlled drug in 2019. Those moves happened because misuse was rising.
Most people who misuse gabapentin are current or former opioid or sedative users. Some take it to intensify an opioid high, or to take the edge off opioid withdrawal. Others combine it with alcohol or benzodiazepines. Each of those combinations raises the overdose risk.
Signs of a gabapentin problem
- Taking more than prescribed, or using someone else’s pills
- Combining it with opioids, alcohol or benzodiazepines
- Seeing more than one doctor for prescriptions
- Feeling anxious, sweaty, nauseated or unable to sleep without it
Don’t Stop Gabapentin Suddenly
If you’ve been taking gabapentin for a while, talk to your doctor before stopping. MedlinePlus warns that quitting suddenly can cause withdrawal symptoms like anxiety, trouble sleeping, nausea, pain and sweating, and that people taking it for seizures may have seizures more often. A doctor will usually lower the dose gradually.
Treatment for Gabapentin Misuse
Because gabapentin misuse so often travels with opioids, alcohol or benzodiazepines, treatment usually has to address the whole picture. Medically supervised detox manages withdrawal from every substance involved. After that, therapy works on why the drugs became necessary: chronic pain, anxiety, depression or trauma. Our prescription drug addiction page and co-occurring disorders treatment page explain how we approach it.
Frequently Asked Questions
Can you overdose on gabapentin?
Yes. MedlinePlus lists overdose symptoms including double vision, slurred speech and drowsiness. The risk of a life-threatening overdose rises sharply when gabapentin is combined with opioids, alcohol or other sedatives.
Can gabapentin overdose kill you?
It can contribute to death, most often alongside opioids. In a CDC review of 2019 and 2020 overdose deaths, gabapentin was found in 9.7% and played a role in about half of those.
Is gabapentin a controlled substance?
Not federally. Some states have made it Schedule V because of misuse. Check your state’s rules and talk to your pharmacist if you’re unsure.
What should I do if someone took too much gabapentin?
Call 911 if they’re hard to wake, breathing poorly, have had a seizure or have collapsed. Otherwise, call Poison Control at 1-800-222-1222.
Get Help at Covenant Hills
Covenant Hills is a Christian residential treatment center in Orange County. We help people safely stop misusing prescription drugs like gabapentin, along with the opioids, alcohol or sedatives that often come with it. Explore our levels of care, or call 800-662-2873 for a free, confidential assessment.
