What is gabapentin? Here’s why it’s so controversial.

Most of the prescription medications that most people misuse or misuse are brands that most people have heard of. Painkillers, also known as opioids, are the most commonly abused, according to data from the New York State Department of Health. These include morphine, codeine, oxycodone and hydrocodone, under the brand names OxyContin, Vicodin and Lortab. Depressants used to treat anxiety and sleep disorders include brands like Valium and Xanax and are also commonly abused. Ditto for stimulants that treat ADHD such as Ritalin, Dexedrine and Adderall.

Dr. Holly Geyer, an addiction medicine specialist and lead physician for the Mayo Clinic Opioid Management Program in Arizona, says that in an effort to combat opioid-related drug abuse, many doctors have turned toward a class of drugs that isn’t classified as a controlled substance: gabapentinoids. This contributed to a drug called gabapentin becoming the sixth most prescribed drug in the United States.

As a result, and somewhat ironically, “we are now seeing the emergence of patterns of gabapentin abuse across the country,” Geyer says, adding that such abuse can occur with gabapentin alone, “or in combination with d other drugs, such as opioids. »

Here’s who gabapentin was initially approved for, what it’s used for today, and why it’s becoming a drug of growing concern about abuse and misuse.

What is gabapentin?

Gabapentin is a prescription medication approved by the United States Food and Drug Administration in 1993 as a treatment for epilepsy. It works by binding to a type of calcium channel in nerve cells, “which would change how the nerve functions,” says Dr. Tom Lombardi, medical director of neuroscience for Intermountain Health in Salt Lake City.

As such, the drug can help control specific types of nerve pain and treat seizure disorders, “because it works on the nervous system to help reduce nerve transmission,” says Geyer.

It is typically administered as an oral medication, is typically taken two to three times a day by mouth, and is available in pill or liquid form, says Andrea Tedeschi, a neuroscientist at the Ohio State University College of Medicine and co- author of research related to gabapentin. . It is available “both as a branded product and as a lower-cost generic,” he says. Brands include Neurontin, Horizant and Gralise.

What are the side effects of gabapentin?

Although gabapentin may be helpful in a number of circumstances, some of the common side effects associated with taking the medication as directed include drowsiness, dizziness, headache, dry mouth, weight gain, swelling hands, feet or ankles, back or joint pain. and flu-like symptoms such as nausea, fever and body aches, according to Harvard Medical School.

Rare but serious side effects include rash, itching, yellowing of the skin, swelling of the face and throat, speech problems, difficulty swallowing, and changes in memory, personality or the ability to concentrate.

The more you know: If left untreated, heartburn can develop into that more serious digestive illness: GERD.

What is gabapentin used for?

When used as directed, gabapentin is known for its many uses and benefits. It has been approved by the FDA to help control and treat seizures and decrease a specific type of nerve pain called restless legs syndrome – which often follows a diagnosis of shingles.

In addition to these FDA-approved uses, Tedeschi says gabapentin is also sometimes prescribed off-label by providers for a variety of other medical conditions. (Off-label use means there is evidence that a drug is useful in treating conditions other than those for which it has been approved by the FDA.)

Known off-label uses for which doctors prescribe gabapentin include treating hot flashes, mood disorders, anxiety, and reducing diabetes-related nerve pain or associated neck and back pain. to conditions such as sciatica.

Among the reasons it’s so popular is that “it’s a generic drug, so relatively inexpensive,” Lombardi says. It also provides “excellent pain control for many medical conditions caused by damaged nerves,” says Geyer.

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What is the controversy surrounding gabapentin?

Despite its FDA approval and proven benefits, gabapentin is often misused. Although not considered addictive, “in some patients, the drug can cause a ‘high,’ which increases its potential for abuse,” notes Geyer.

It is also known to enhance the psychological effect of opioids, Tedeschi says, and thus may contribute to their continued abuse — even to the point of being associated with overdose deaths, notes Harvard Medical School. Because of these factors, “several states have made the decision to list gabapentin as a Schedule V controlled substance,” Lombardi says.

Its abuse can occur by taking a prescribed version of the drug differently than directed and, like other illicit substances, “can also be purchased without a prescription on the dark web,” says Geyer.

She says that for most people, gabapentin is a safe medication to take, “however, its potential for abuse is increasingly being recognized.” She says it’s impossible to predict who might be susceptible to abusing the drug, but a history of addiction to other drugs can be a risk factor. “Patients should be informed of this potential side effect at the start of treatment,” she warns, “and encouraged to speak up if they have any concerns.”

This article was originally published on USA TODAY: What is gabapentin used for? Additionally, side effects