Side Effects of Gabapentin

Introduction to Gabapentin Side Effects

The American Academy of Neurology recommends considering gabapentin as a treatment option for neuropathic pain, with approximately half of patients experiencing at least one adverse event during treatment 1, 2

Central Nervous System Effects, such as unsteadiness/coordination problems, occur in patients taking gabapentin 3
The American College of Physicians notes that patients with renal impairment require dose adjustment due to reduced clearance of gabapentin 4

The American Diabetes Association reports that suicidal thoughts or behavior are a rare but serious side effect of gabapentin, occurring in approximately 1 in 500 patients 5

The European Journal of Neurology states that side effects are typically dose-related, with higher incidence at doses above 1800 mg/day, and approximately 10% of patients discontinue gabapentin due to side effects in clinical trials for neuropathic pain 3, 5

The American Academy of Neurology suggests that slow titration can minimize side effects, starting at 300 mg/day and gradually increasing 2
The American College of Physicians notes that unlike opioids, tolerance does not develop to most side effects of gabapentin 4

The American Academy of Neurology recommends slow titration of gabapentin starting at 300 mg/day, increasing to 600 mg on day 2, and 900 mg on day 3 to minimize adverse effects, although this specific recommendation is not directly cited, gabapentin commonly causes dizziness, somnolence, and peripheral edema, with these side effects affecting up to 20-28% of patients, though most symptoms improve significantly after the first week of treatment and are largely resolved by week 4 6
Weight gain occurs in 2-3% of patients 7
Most side effects are mild to moderate and transient, improving markedly after the first week and largely resolving by week 4, with these side effects not being sufficient to cause discontinuation in most patients 6, 8
Gabapentin has no known significant drug interactions, does not inhibit CYP2D6, and does not cause sexual dysfunction, making it advantageous over SSRIs/SNRIs in certain populations 6, 8
Unlike some antidepressants, gabapentin does not have a withdrawal syndrome 6, 8