Should the Schedule Change on Gabapentin?

The number of prescriptions being written for gabapentin — typically used to treat seizures and painful nerve diseases — is at an all-time high.1 According to a report by IMS Health, 57 million prescriptions for gabapentin were written in the United States in 2015, a 42% increase since 2011.

Gabapentin is a medication that is structurally related to the inhibitory neurotransmitter GABA. It does not bind to the GABA receptors but instead modulates the release of excitatory neurotransmitters, which participate in nociception.

The medication has several off label uses as well such as migraine, hot flashes, fibromyalgia, and more. Adverse events associated with the drug include: jerky movements, loss of coordination, drowsiness, and dizziness. Higher doses can cause withdrawal symptoms such as seizures, suicidal ideation, and irritability.

Gabapentin is not scheduled as a controlled substance, meaning that the medication has little potential for addiction and abuse. However, the drug does show characteristics of various medications associated with misuse and addiction such as benzodiazepines, producing similar withdrawal syndromes and psychoactive effects.

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