Gabapentin, recognized by brand names like Neurontin or Gralise, is a prescription anticonvulsant. It is prescribed to manage certain partial seizures and relieve nerve pain, such as pain following shingles or caused by diabetic neuropathy. Gabapentin works by affecting nerve signal transmission in the brain and spinal cord, calming over-excited neurons. While generally considered safe, taking gabapentin in excess of prescribed amounts is serious, and overdose is possible.
Is Overdose Possible
An overdose of gabapentin is possible, though the drug is relatively non-lethal when taken alone compared to substances like opioids. A toxic dose can lead to central nervous system (CNS) depression, slowing the body’s major functions. A pure gabapentin overdose typically involves severe sedation, confusion, and a noticeable lack of coordination. The severity depends significantly on the quantity ingested and the individual’s underlying health status. People with pre-existing kidney impairment are at a higher risk because gabapentin is excreted almost entirely unchanged by the kidneys, meaning the threshold for severe effects is much lower for vulnerable populations.
Recognizing Signs of Toxicity
Gabapentin toxicity manifests as a pronounced exaggeration of the drug’s intended effects and side effects. One of the most common observable symptoms is somnolence, which is deep drowsiness from which the person is difficult to rouse. This is often accompanied by significant dizziness and ataxia (lack of muscle control), causing unsteadiness and difficulty walking. Other signs include slurred speech (dysarthria) and double vision (diplopia). In severe cases, symptoms can progress to dangerously low blood pressure, a rapid heart rate, and ultimately, loss of consciousness or coma.
Increased Risks from Drug Interactions
The greatest danger and primary cause of severe or fatal outcomes arises when gabapentin is combined with other central nervous system depressants, creating a synergistic effect where the combined impact is much greater than the sum of the individual drug effects. Combining gabapentin with opioids (such as oxycodone or morphine) is especially hazardous because both suppress the respiratory drive, significantly increasing the risk of respiratory depression where breathing slows down or stops entirely. Similar risks are present when gabapentin is taken alongside benzodiazepines or with alcohol, as these substances compound the sedative effects and lead to profound sedation and increased likelihood of respiratory failure. The risk is also compounded for individuals with existing kidney problems, as impaired renal clearance causes the drug to accumulate to toxic levels more easily.
Immediate Emergency Steps
If you suspect a person has taken too much gabapentin, immediate action is required. Call emergency medical services (911 or local equivalent) right away, as timely medical attention is crucial. Contact Poison Control at 1-800-222-1222 in the United States for expert guidance while waiting for help. When speaking to responders, be prepared to state the person’s age, weight, the amount of gabapentin taken, and the approximate time of ingestion. Do not attempt to induce vomiting or give the person any food or fluids unless explicitly instructed by a medical professional.