Table of ContentsView AllTable of ContentsHow Gabapentin WorksUsesResearchFormulation and DosingSide EffectsInteractionsContraindications
Table of ContentsView All
View All
Table of Contents
How Gabapentin Works
Uses
Research
Formulation and Dosing
Side Effects
Interactions
Contraindications
Gabapentin is one such drug. It’s an anti-seizure drug sometimes used to prevent migraines, though there is conflicting scientific evidence supporting its effectiveness in this regard.
In the United States, gabapentin is sold in generic form and under the brand names Neurontin, Gralise, Horizant, and Neuraptine.
This article will discuss the off-label use of gabapentin for migraines, whether it works, dosing and formulations, side effects, and more.
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How Gabapentin Works for Migraine Prevention
The precise mechanism of gabapentin’s action is not well known. Even though this drug has a similar structure to a brain neurotransmitter called GABA (gamma-aminobutyric acid), it has no effect on its receptors. It is believed that gabapentin blocks calcium channels, modulating the release of excitatory neurotransmitters.
Uses of Gabapentin
Gabapentin is primarily used to treat epilepsy in people older than 12 and partial seizures in children ages 3 to 12. It is also FDA-approved to treat a condition calledpostherpetic neuralgia—the nerve-related pain complication of a herpes zoster attack (shingles) that can occur in adults.
Besides these uses, gabapentin is used off-label for a variety of other conditions like migraine prevention, as well as diabetic neuropathy,restless legs syndrome, andfibromyalgia.
Because of its benefit in treating these and other issues, gabapentin is what’s known as anadjuvant analgesic—a drug that can help control pain, despite it not being primarily intended to do so. Gabapentin may be used alone or with other medications when necessary.
What the Research Says
The American Academy of Neurology (AAN) and the American Headache Society (AHS) do not list gabapentin as “effective” or “probably effective” for preventing migraines in their 2012 guidelines.Instead, gabapentin is given a level U rating, which means the evidence is conflicting or inadequate to support or refute its use for migraine prevention.
A 2016 study found that gabapentin showed some benefits for migraine headaches. However, it concluded that there wasn’t enough evidence to recommend it as a primary therapy.Another study review in 2023 found that gabapentin was no more effective than a placebo in reducing monthly migraine days.
The medication is available as an immediate-release oral tablet, an extended-release oral tablet, and an oral solution. It can be taken with or without food.
Potential Side Effects
Like all drugs, gabapentin does have potential adverse effects, with the most common ones being dizziness and drowsiness. Less common but serious side effects include:
Tell your healthcare provider right away if any of these side effects occur.
A small number of people who take anticonvulsants for any condition may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your healthcare provider right away if you or a loved one notice any unusual or sudden changes in your mood, thoughts, or behavior including signs of depression, suicidal thoughts, or thoughts about harming yourself.
A very serious allergic reaction to gabapentin is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including fever, swollen lymph nodes, rash, itching/swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing.
Drinking alcohol may make some side effects of gabapentin more severe.
Types of drugs that are known to interact with gabapentin and may cause problems include:
If you do dipstick tests to check your urine for protein, tell your healthcare provider. Gabapentin may affect the results.
Your healthcare provider can advise you on whether you should avoid taking certain drugs with gabapentin entirely, or if the timing or dosage simply need to be adjusted.
Who Should Not Take Gabapentin
Currently, there is not enough research or well-controlled studies on humans to deem this medication safe for expecting mothers.Contact your healthcare provider to discuss whether the benefits of use may outweigh the risks in your case.
If you have chronic kidney disease, check with your healthcare provider before using gabapentin. Since the medication is solely metabolized in the kidneys, it can lead to serious adverse effects, such as delirium and respiratory depression.Lower doses of gabapentin may be less likely to cause adverse effects than higher doses.Your healthcare provider will help you decide what dosage may provide benefits while minimizing risks.
Summary
Gabapentin is an anti-seizure drug that is sometimes prescribed to help prevent migraines. However, there is conflicting research on whether it’s effective for this use. It may also be prescribed for conditions such as diabetic neuropathy, restless leg syndrome, and fibromyalgia.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Perloff MD, Berlin RK, Gillette M, Petersile MJ, Kurowski D.Gabapentin in Headache Disorders: What Is the Evidence?. Pain Med. 2016;17(1):162-71. doi:10.1111/pme.12931Estemalik E, Tepper S.Preventive treatment in migraine and the new US guidelines.Neuropsychiatr Dis Treat. 2013;9:709-20. doi:10.2147/NDT.S33769Pfizer, Inc.NEURONTIN® (gabapentin) [packaging insert]. Revised October 2017.Silberstein SD.Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2012 Apr 24;78(17):1337-45. doi:10.1212/WNL.0b013e3182535d20Lampl C, MaassenVanDenBrink A, Deligianni CI, et al.The comparative effectiveness of Migraine Preventive Drugs: A systematic review and network meta-analysis.The Journal of Headache and Pain. 2023;24(1). doi:10.1186/s10194-023-01594-1Sheikh S, Alvi U, Soliven B, Rezania K.Drugs that induce or cause deterioration of myasthenia gravis: An update.Journal of Clinical Medicine. 2021;10(7):1537. doi:10.3390/jcm10071537Park CM, Inouye SK, Marcantonio ER, et al.Perioperative gabapentin use and in-hospital adverse clinical events among older adults after major surgery.JAMA Internal Medicine. 2022;182(11):1117. doi:10.1001/jamainternmed.2022.3680Muanda FT, Weir MA, Ahmadi F, et al.Higher-dose gabapentinoids and the risk of adverse events in older adults with ckd: a population-based cohort study.American Journal of Kidney Diseases. 2022;80(1):98-107.e1. doi:10.1053/j.ajkd.2021.11.007Additional ReadingLinde M, Mulleners WM, Chronicle EP, McCory DC.Gabapentin or pregabalin for the prophylaxis of episodic migraine in adults.Cochrane Database Syst Rev. 2013 Jun 24l(6):CD010609. doi:10.1002/14651858.CD010609
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Perloff MD, Berlin RK, Gillette M, Petersile MJ, Kurowski D.Gabapentin in Headache Disorders: What Is the Evidence?. Pain Med. 2016;17(1):162-71. doi:10.1111/pme.12931Estemalik E, Tepper S.Preventive treatment in migraine and the new US guidelines.Neuropsychiatr Dis Treat. 2013;9:709-20. doi:10.2147/NDT.S33769Pfizer, Inc.NEURONTIN® (gabapentin) [packaging insert]. Revised October 2017.Silberstein SD.Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2012 Apr 24;78(17):1337-45. doi:10.1212/WNL.0b013e3182535d20Lampl C, MaassenVanDenBrink A, Deligianni CI, et al.The comparative effectiveness of Migraine Preventive Drugs: A systematic review and network meta-analysis.The Journal of Headache and Pain. 2023;24(1). doi:10.1186/s10194-023-01594-1Sheikh S, Alvi U, Soliven B, Rezania K.Drugs that induce or cause deterioration of myasthenia gravis: An update.Journal of Clinical Medicine. 2021;10(7):1537. doi:10.3390/jcm10071537Park CM, Inouye SK, Marcantonio ER, et al.Perioperative gabapentin use and in-hospital adverse clinical events among older adults after major surgery.JAMA Internal Medicine. 2022;182(11):1117. doi:10.1001/jamainternmed.2022.3680Muanda FT, Weir MA, Ahmadi F, et al.Higher-dose gabapentinoids and the risk of adverse events in older adults with ckd: a population-based cohort study.American Journal of Kidney Diseases. 2022;80(1):98-107.e1. doi:10.1053/j.ajkd.2021.11.007Additional ReadingLinde M, Mulleners WM, Chronicle EP, McCory DC.Gabapentin or pregabalin for the prophylaxis of episodic migraine in adults.Cochrane Database Syst Rev. 2013 Jun 24l(6):CD010609. doi:10.1002/14651858.CD010609
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Perloff MD, Berlin RK, Gillette M, Petersile MJ, Kurowski D.Gabapentin in Headache Disorders: What Is the Evidence?. Pain Med. 2016;17(1):162-71. doi:10.1111/pme.12931Estemalik E, Tepper S.Preventive treatment in migraine and the new US guidelines.Neuropsychiatr Dis Treat. 2013;9:709-20. doi:10.2147/NDT.S33769Pfizer, Inc.NEURONTIN® (gabapentin) [packaging insert]. Revised October 2017.Silberstein SD.Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2012 Apr 24;78(17):1337-45. doi:10.1212/WNL.0b013e3182535d20Lampl C, MaassenVanDenBrink A, Deligianni CI, et al.The comparative effectiveness of Migraine Preventive Drugs: A systematic review and network meta-analysis.The Journal of Headache and Pain. 2023;24(1). doi:10.1186/s10194-023-01594-1Sheikh S, Alvi U, Soliven B, Rezania K.Drugs that induce or cause deterioration of myasthenia gravis: An update.Journal of Clinical Medicine. 2021;10(7):1537. doi:10.3390/jcm10071537Park CM, Inouye SK, Marcantonio ER, et al.Perioperative gabapentin use and in-hospital adverse clinical events among older adults after major surgery.JAMA Internal Medicine. 2022;182(11):1117. doi:10.1001/jamainternmed.2022.3680Muanda FT, Weir MA, Ahmadi F, et al.Higher-dose gabapentinoids and the risk of adverse events in older adults with ckd: a population-based cohort study.American Journal of Kidney Diseases. 2022;80(1):98-107.e1. doi:10.1053/j.ajkd.2021.11.007
Perloff MD, Berlin RK, Gillette M, Petersile MJ, Kurowski D.Gabapentin in Headache Disorders: What Is the Evidence?. Pain Med. 2016;17(1):162-71. doi:10.1111/pme.12931
Estemalik E, Tepper S.Preventive treatment in migraine and the new US guidelines.Neuropsychiatr Dis Treat. 2013;9:709-20. doi:10.2147/NDT.S33769
Pfizer, Inc.NEURONTIN® (gabapentin) [packaging insert]. Revised October 2017.
Silberstein SD.Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society.Neurology. 2012 Apr 24;78(17):1337-45. doi:10.1212/WNL.0b013e3182535d20
Lampl C, MaassenVanDenBrink A, Deligianni CI, et al.The comparative effectiveness of Migraine Preventive Drugs: A systematic review and network meta-analysis.The Journal of Headache and Pain. 2023;24(1). doi:10.1186/s10194-023-01594-1
Sheikh S, Alvi U, Soliven B, Rezania K.Drugs that induce or cause deterioration of myasthenia gravis: An update.Journal of Clinical Medicine. 2021;10(7):1537. doi:10.3390/jcm10071537
Park CM, Inouye SK, Marcantonio ER, et al.Perioperative gabapentin use and in-hospital adverse clinical events among older adults after major surgery.JAMA Internal Medicine. 2022;182(11):1117. doi:10.1001/jamainternmed.2022.3680
Muanda FT, Weir MA, Ahmadi F, et al.Higher-dose gabapentinoids and the risk of adverse events in older adults with ckd: a population-based cohort study.American Journal of Kidney Diseases. 2022;80(1):98-107.e1. doi:10.1053/j.ajkd.2021.11.007
Linde M, Mulleners WM, Chronicle EP, McCory DC.Gabapentin or pregabalin for the prophylaxis of episodic migraine in adults.Cochrane Database Syst Rev. 2013 Jun 24l(6):CD010609. doi:10.1002/14651858.CD010609
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