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Gabapentin, a medication often prescribed for seizures, nerve pain or restless legs syndrome, is generally considered safe when taken as directed. However, misuse, accidental overdose or combining gabapentin with other substances can lead to serious health risks.
Recognizing the signs of an overdose of gabapentin, knowing what steps to take and seeking proper treatment are critical for your safety. This article explores the symptoms of gabapentin overdose, immediate actions you should take and treatment options that support recovery and prevent complications.
What Is a Gabapentin Overdose?
A gabapentin overdose happens when the amount of the drug in the body exceeds what the body can safely process, either from taking too much at once or using it in ways not directed by your healthcare provider.
While gabapentin is prescribed for conditions like seizures, nerve pain and restless legs syndrome, misuse or accidental ingestion can overwhelm the system and lead to medical emergencies.
An overdose can happen when gabapentin is combined with other medications or substances, raising the risk of harmful interactions. While the drug has therapeutic effects, when combined with other substances, it can result in overdose symptoms that require immediate medical attention.
Because there is no antidote for gabapentin toxicity, supportive care in a medical setting is the only effective treatment. Recognizing that an overdose is possible highlights the importance of safe prescribing, careful use and timely emergency intervention.
Typical Gabapentin Overdose Symptoms
A gabapentin overdose happens when someone takes more than the prescribed amount of gabapentin, whether intentionally or accidentally. This produces toxic effects on the nervous system and other bodily functions.
Early signs usually include drowsiness, dizziness, slurred speech, blurred or double vision, nausea, vomiting and poor coordination.
In severe cases, gabapentin overdose symptoms can result in profound sedation, respiratory depression, coma or death, especially when gabapentin is combined with opioids, alcohol or other central nervous system depressants.
Emergency Steps
If you suspect a gabapentin overdose, act quickly and calmly.
First, call 911 immediately for signs of a life threatening emergency, which can include:
- Poor responsiveness
- Unconscious
- Collapse
- Seizure activity
- Difficulty breathing
- Cannot be awakened
For non life threatening exposures, call your local poison control center at 1-800-222-1222 or use webPOISONCONTROL for guidance.
If the person with a suspected gabapentin overdose is unconscious but breathing normally, place them in the recovery position to keep the airway open and reduce the risk of choking on vomit.
In the recovery position, you:
- Extend the nearest arm
- Bend the far knee
- Roll the person onto their side
- Support their head
- Continuously monitor breathing and level of consciousness until help arrives.
If you suspect the overdose also involves an opioid, give naloxone if you have it. Naloxone nasal sprays are available over the counter in the U.S.
It can rapidly reverse opioid respiratory depression, but Naloxone will not reverse gabapentin overdose symptoms. After administering naloxone, call 911 because further medical care is necessary. Follow the dispatcher’s instructions.
If the person stops breathing, begin CPR and remain with the person, keep them warm and in the recovery position. Give any medication containers or evidence of substance use to emergency responders.
Hospital Care
Hospital care after a gabapentin overdose focuses on stabilizing the person, preventing complications and supporting recovery. Once admitted, you will be assessed by a medical team that gathers information about the amount of drug ingested, when it was ingested and other substances involved.
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Airway, Oxygenation and Monitoring: When to Involve Poison Control
Continuous observation is essential because symptoms can shift quickly and overdose effects may worsen if gabapentin is combined with other drugs.
Providers use supportive care tailored to your needs, which may include:
- IV fluids
- Medications to ease agitation or nausea
- Monitoring vital signs
- Monitoring oxygenation and maintaining an airway
Poison control specialists are commonly consulted to guide hospital staff on evidence based management strategies.
Their input ensures care teams follow best practices and helps determine whether additional interventions are required. This comprehensive approach forms the backbone of effective management, reducing risks and improving outcomes.
The hospital setting ensures access to rapid interventions and reduces the risk of serious harm. After overdose symptoms are addressed, a hospital setting provides a pathway to follow up care that can address medical and behavioral health concerns.
Supportive care is the cornerstone of treating a gabapentin overdose, with the primary goal of keeping you safe while the drug clears from the body.
In a hospital setting, the priority is ensuring the airway remains open and that you receive adequate oxygen. Supplemental oxygen may be used if your breathing is impaired.
Continuous monitoring of your vital signs, heart rhythm and neurological status helps detect changes early, since symptoms can worsen rapidly. Providers also track hydration levels and may administer IV fluids to maintain stability.
In addition to physical treatment,mental health evaluations may be included, especially if intentional misuse of the drug is suspected.
Role of Hemodialysis in Toxicity and Renal Failure
Hemodialysis can play an important role in managing severe gabapentin toxicity, particularly when kidney (renal) function is impaired. Gabapentin is eliminated almost entirely by the kidneys, so with normal renal function, the body gradually clears the drug on its own.
However, in cases of overdose complicated by kidney failure or significantly reduced kidney function, gabapentin can accumulate to dangerous levels because the body cannot effectively remove it.
Hemodialysis provides a direct method to filter gabapentin from the blood. Dialysis can significantly reduce plasma concentrations of the drug, leading to improvement in symptoms including confusion, profound sedation or respiratory depression.
Prompt recognition of renal impairment allows medical teams to decide if dialysis is necessary to prevent life threatening complications.
Hemodialysis is not typically needed for otherwise healthy people with a one time overdose, but it is a crucial intervention for someone with chronic kidney disease or acute renal failure, when you cannot clear the medication naturally.
Why Mixing Gabapentin with Opioids Is Dangerous
Combining gabapentin with opioids greatly increases your risk of life threatening respiratory depression, sedation and overdose. Since both drugs act on the central nervous system, when they are taken together, the effects intensify, slowing your breathing to dangerous levels.
This danger is not limited to people who misuse prescriptions intentionally. Even patients following prescribed regimens may face unexpected risks if their providers are unaware of all the medications they are taking.
Because gabapentin is sometimes perceived as a “safer” drug, it can be underestimated when combined with opioids, leading to accidental overdoses in both medical and nonmedical settings.
Health agencies, including the FDA and CDC, have documented rising concerns over this co-use.
Studies show that gabapentin is frequently detected in opioid related overdose deaths, underscoring the need for awareness among patients, families and healthcare providers. Open communication with a provider and careful monitoring are essential for reducing these risks.
If you or someone you know may be misusing gabapentin and opioids, call Poison Help at 1-800-222-1222 for immediate guidance. In a crisis or if suicidal thoughts are present, dial 988 for the Suicide & Crisis Lifeline.
What the FDA and CDC Say About Co-Use Risks
In 2019, the U.S. Food and Drug Administration (FDA) issued a safety communicationcautioning that serious breathing problems may occur when gabapentinoids, including gabapentin, are taken with central nervous system (CNS) depressants such as opioids.
The warning also emphasized elevated risks for individuals with underlying respiratory conditions, the elderly and those who use other sedating drugs.
Further underscoring the danger, the Centers for Disease Control and Prevention (CDC) analyzed national data in its Morbidity and Mortality Weekly Report (MMWR).
They found that co-use of gabapentin with illicit opioids, particularly fentanyl, is associated with higher overdose deaths. This trend highlights the growing role of gabapentin as a contributing factor in the opioid overdose epidemic.
Prevention & Safer Use
Preventing a gabapentin overdose starts with taking the medication exactly as prescribed and never adjusting your dose without medical guidance.
Always inform your healthcare provider about all other medications, supplements or substances you use, since combining gabapentin with opioids, alcohol or sedatives can raise the risk of dangerous interactions.
Regular follow up appointments give providers the chance to monitor effectiveness and watch for signs of misuse. If you ever feel tempted to take more than prescribed or mix gabapentin with other substances, reach out for help right away.
Using gabapentin safely not only protects your health but also ensures the medication continues to support your long term treatment goals.
Safe Practices: Renal Dosing, Interactions and Storage
Gabapentin is cleared through the kidneys, so dosing must be adjusted for people with reduced renal function to prevent a dangerous buildup of the drug. Always follow your provider’s instructions and never change your dose without medical guidance.
It’s also important to avoid alcohol and benzodiazepines while taking gabapentin, as these substances are CNS depressants and magnify sedation and breathing risks.
For safety at home, store gabapentin in a secure place, out of reach of children, teens or anyone for whom it was not prescribed. These precautions help ensure gabapentin is used effectively while minimizing the risk of harm.
Gabapentin Overdose FAQs
Will Naloxone Help a Gabapentin Overdose?
Naloxone does not reverse gabapentin’s effects. However, if opioids are also involved, naloxone can be lifesaving by restoring breathing. Always call 911 first in any suspected overdose and administer naloxone if opioid co-use is suspected.
Can Gabapentin Cause Serotonin Syndrome?
Gabapentin is not known to cause serotonin syndrome on its own. The condition is linked to drugs that increase serotonin, such as SSRIs. However, caution is advised when gabapentin is taken with other medications that affect neurotransmitters.
How Much Gabapentin is “Too Much”?
There is no single “toxic” dose because overdose risk depends on individual health, kidney function and other substances that may be taken. Taking more than prescribed or mixing gabapentin with opioids, alcohol or sedatives, can be dangerous and lead to an overdose.
If you or a loved one is struggling with gabapentin misuse, help is available. Call
800-681-1058
(Sponsored)
to speak to someone.
