Gabapentinoids & Withdrawal Symptoms

Gabapentinoids (gabapentin and pregabalin) are antiepileptic agents commonly used to treat neuropathic pain.

Gabapentinoids uses

Gabapentin is used to treat epilepsy and is taken for nerve pain, which can be caused by different conditions, including diabetes and shingles. Nerve pain can also happen after an injury. In epilepsy it’s thought that gabapentin stops seizures by reducing the abnormal electrical activity in the brain. Gabanpentin is classified as an anticonvulsant medicine not as an opioid or painkiller.

People taking Gabapentin and Pregabalin can experience feelings of relaxation, calmness, and euphoria. Other effects include confusion, drowsiness, and loss of memory. In high doses there is a risk of physical injury caused by a lack of coordination when taking gabapentin. Part of their continued appeal is their ability to enhance and increase the effect of opioids therefore people need to take less of any opioid drugs to achieve the intended effect.

People misusing gabapentin and pregabalin can describe improved sociability, euphoria, relaxation and a sense of calm. Gabapentin and pregabalin have the propensity to cause depression of the central nervous system resulting in drowsiness, sedation, respiratory depression, and at the extreme, death.

Gabapentin comes in different strengths. You may require different strengths to allow you to follow the reduction plan. The amount and time will depend on your current dose and how long you have been taking the medication.


Pregabalin is used to treat Epilepsy to prevent seizures by reducing the abnormal electrical activity in the brain. It is also used to treat anxiety. Pregabalin stops your brain from releasing the chemicals that make you feel anxious. It can be used to treat nerve pain and other illnesses including diabetes and shingles or an injury as it blocks pain by affecting the pain messages travelling through the brain and down the spine.

Following concerns about abuse pregabalin has been reclassified as a Class C controlled substance and is now a Schedule 3 drug but is exempt from safe custody requirements. Healthcare professionals are advised to evaluate their patients carefully for a history of drug abuse before prescribing pregabalin and observe patients for signs of abuse and dependence. Patients should be informed of the potentially fatal risks of interactions between pregabalin and alcohol and with other medications can cause central nervous system depression, particularly opioids.

Pregabalin comes in different strengths. You may require different strengths to allow you to follow the reduction plan. The amount and time will depend on your current dose and how long you have been taking the medication.

Withdrawal symptoms

Dependence on pregabalin is characterised by both a physical and psychological dependence on the drug that results in a compulsive need to use it time and time again. While use of the drug may induce calming and pleasurable feelings withdrawal tends to induce the exact opposite. For instance diarrhea, which is a withdrawal symptom, is the opposite of the constipation often induced during pregabalin abuse.

Withdrawal involves an array of symptoms that kick in when you discontinue your pregabalin use abruptly. Withdrawal will start to happen when your body and brain have become dependent on pregabalin to function normally and when you decrease your dose rapidly or stop taking the drug abruptly. It is one of the main reasons why people that have a dependency find it hard to quit. If you last for several days after your last dose without using again you will get a psychological signal that you’re about to experience discomforting symptoms. This will cause you to seek out the drug to stop that from happening.

Pregabalin travels to the brain to block the release of certain neurotransmitters that induce pain and excitatory signals. These neurochemicals include glutamate and noradrenaline. They are nerve-exciting agents that also transport pain signals to damaged nerves. By blocking their release pregabalin induces a feeling of pain relief and calmness which is useful for conditions such as anxiety disorder, diabetes, and epilepsy among others.

When you continue taking the drug your brain will gradually get used to the high levels of pregabalin and the state of calmness associated with it. The body will begin to rely on the drug for the continuation of this feeling. Over time you will need higher doses of pregabalin to replicate the original effects that smaller doses produced in the past. Therefore reducing your dose drastically or abruptly discontinuing use will trigger withdrawal.

Physical withdrawal symptoms

Physical withdrawal symptoms kick in within the first few hours of stopping, and last for days after your last intake. The severity of your physical symptoms will depend on your level of tolerance to the drug and other factors such as withdrawing from other drugs alongside pregabalin. You may experience stronger symptoms if you have a medical condition that existed prior to using pregabalin.

There are common physical withdrawal symptoms that you will likely face when you quit or reduce your intake of pregabalin after long-term use. However, you should keep in mind that you may experience these symptoms differently as there are individual variations associated with withdrawal. Physical symptoms are:

  • Headaches
  • Weight gain

  • Body aches

  • Chills

  • Diarrhea
  • Fatigue
  • Dizziness
  • Hot flushes
  • Flu-like symptoms
  • Joint pain
  • Itching

  • Muscle spasms

  • Nausea

  • Shortness of breath

  • Stomach pain

  • Seizures

  • Excessive Sweating

If you initially took pregabalin to treat a medical condition such as fibromyalgia, epilepsy or neuropathic pain please consult your doctor before you quit the drug.

Psychological Withdrawal Symptoms

Anxiety: Pregabalin is a prescription-only drug prescribed on the National Health Service (NHS) to treat generalised anxiety disorders. If you stop taking the drug, you will likely experience a rebound of anxiety.

Depression: Withdrawal from pregabalin could lead to a chemical imbalance in the brain which results in depressive thinking. It has also been suggested by some studies that pregabalin reduces the levels of norepinephrine, a chemical responsible for moods. This may go on to induce depression.

Depersonalization: During withdrawal you may feel unlike yourself or without emotion. This happens because of changes in the brain’s circuitry after using pregabalin.

“I felt I was awake in my nightmares with anxiety, little did I know it was my medications, my life has turned around, only sweet dreams”

GD Bristol

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