Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Neurontin is a prescription medication used primarily to treat seizures. It’s the branded version of a drug with a generic name of gabapentin. These two medications both contain the same active ingredient, so we will refer to them interchangeably throughout this article.
In this article we’ll review the medical studies on Neurontin to determine if it’s safe and effective for treating seizures. We’ll also highlight side effects of the drug, dosing data and discuss whether it can also be used effectively to treat animals with seizures.
Does Neurontin Work?
Neurontin has been thoroughly studied in clinical trials spanning decades. As one example, a medical study published in the Psychiatry and Clinical Neurosciences journal examined the efficacy of Neurontin for the treatment of epilepsy, which causes seizures.
Patients were prescribed either Neurontin at 1,200 milligrams (mg) per day, Neurontin at 1,800 mg per day or a placebo capsule.. Both of the trial participant groups using Neurotin experienced a decline in seizures of more than 10% compared with the rate of those taking the placebo. The Neurontin group on a higher dose experienced around 5% fewer seizures than the lower-dose group.
A separate clinical trial from 1996 examined whether Neurontin could treat seizures in children. A group of children with regular seizures were prescribed Neurontin.. About 50% of them experienced a 25% or greater reduction in seizures after using the medication.
By the end of the trial, two patients (out of 32 total) taking Neurontin had a complete elimination of their symptoms and were seizure-free, and four more patients were only experiencing seizures once every few months (categorized as “almost seizure-free” by the study authors).
Neurontin is also effective for treating a specific type of seizure called partial-onset seizures, where the seizures only affect one part of the brain instead of the entire brain. The study, which was published in a medical journal called Epilepsea, used Neurontin as a monotherapy, meaning it was the only drug used to achieve the desired effect.
The group taking Neurontin experienced a statistically significant reduction in partial-onset seizures, and the researchers concluded that the results “provide good evidence of the efficacy and safety of Neurontin.”
We can conclude from the available evidence that Neurontin is effective for treating a wide variety of conditions related to seizures.
How Does Neurontin Work?
One interesting fact about Neurontin is that researchers don’t know exactly how it works, even with all of the medical research on the company. The StatPearls database, which is one of the largest medical databases in the U.S., describes Neurontin’s biological effects in the following manner: “The exact mechanism of action with the GABA receptors is unknown.”
Sometimes, pharma drugs can be effective without scientists knowing their exact mechanism of action. If a drug causes a patient’s depression scores to decrease by 20%, it may qualify for approval to treat depression even if researchers are unclear how it works. The efficacy and safety are what matters.
The brain is quite complex, and there are many synergies and interactions between different chemicals and electrical signals, making it challenging to parse out exactly what downstream effects a medication can have.
One medical review suggested that Neurontin may work because it modifies the function of voltage-sensitive calcium channels in the brain.
Neurontin Side Effects
Neurontin does cause side effects in some patients, as do most pharmaceutical medications that we’ve reviewed on Illuminate Health, but it doesn’t have a “black box” warning on its label, which is a good sign.
The black box warning is the most serious type of warning required by the Food and Drug Administration (FDA) in the U.S. It indicates a risk of potentially life-threatening side effects. Many medications we’ve recently reviewed, such as Strattera, had black box warnings on their label.
In 2019, the FDA published a warning letter about the side effects of Neurontin, which is not common. This letter indicated to patients that the drug may cause serious breathing problems. It described how patients with “respiratory risk factors” such as chronic obstructive pulmonary disease (COPD) were at increased risk of this side effect.
A meta-study of adverse events caused by Neurontin was published in the American Journal of Geriatric Psychiatry. It pooled results from three individual studies to report on the most common side effects of the drug.
Fascinatingly, patients at lower doses of Neurontin had higher rates of some specific side effects. Those taking a dose under 1,800 mg experienced dizziness more than 20% of the time, which was much higher than placebo. Trial participants at this dose also reported daytime sleepiness as a side effect 14.9% of the time, which was 9.1% greater than those taking placebo pills.
The most concerning side effect in our opinion which was noted in this trial was experienced by the higher-dose group. Those taking a Neurontin dose over 1,800 mg per day were more likely to experience a condition called peripheral edema, which refers to swelling of the extremities. 7.5% of patients at this dose experienced this side effect, which is a relatively high number for such an serious side effect.
Another side effect reported in a separate meta-study of Neurontin is called myoclonus. This is the medical term for repeated muscle jerking. The study authors reported that 1.9% of patients taking the medication in a medical study suffered with this side effect, but that it was resolved when Neurontin usage was stopped, which suggests that this effect is reversible.
Neurontin may be prescribed at a wide range of dosages depending on the condition and the severity of a patient’s condition. StatPearls lists the Neurontin dosage for treating seizures between 300 mg and 1,200 mg taken three times per day, which results in an overall daily dose between 900 mg and 3,600 mg.
This seizure dosing range is higher than the dose range for those using the drug to treat fibromyalgia. That range is from 400 mg to 800 mg taken three times daily, resulting in an overall daily dose between 1,200 and 2,400 mg.
Neurontin is also prescribed for neuropathic pain, though this is less common. Neuropathic pain refers to nerve pain which can affect nerves throughout the body. It’s a very uncomfortable condition. The dose range for this type of pain is the exact same as the dose range to treat seizures: between 900 mg and 3,600 mg per day, divided into three oral doses.
One medical study proved that Neurontin is cleared via excretion through the kidneys, so dosage is typically lower for patients with kidney disease, beacuse of the risk of overburdening these vital organs.
Neurontin Vs. Gabapentin
As we referenced earlier in this article, gabapentin is the generic name of the drug. Patients are often curious whether we recommend the branded version or the generic version, given that they contain the same active ingredient.
An insightful medical review from 2013 analyzed whether gabapentin or the branded version (Neurontin) was more effective, and the researchers found that both drugs were equally effective.
This makes logical sense, due to the fact that they contain the same active chemical compound. Unless there were quality control issues with the manufacturing process of one of the drugs, there’s no logical reason to think one would be superior to the other in regard to efficacy.
We would recommend that patients speak with their doctor about gabapentin rather than Neurontin, because the generic version is often cheaper, especially for patients without health insurance.
Neurontin may interact with other pharmaceutical medications, as described on its FDA label.
The label contains a “Drug Interactions” section which is a great resource for patients who are prescribed a drug.
In this case, the label indicates that Neurontin may interact with the drugs hydrocodone and morphine. Both are opioids and are used recreationally, as well as medicinally.
This suggests that patients taking Neurontin should mention it if they visit an urgent care clinic or an emergency room, because both hydrocodone and morphine are frequently used in these settings.
Neurontin may also interact with an over-the-counter (OTC) antacid called Maalox. The antacid reduces the absorption of Neurontin by 20%, which may make the drug less effective and be a risk to patients.
Neurontin also appears to interact with urinary protein tests. The label states that Neurontin may cause false positive readings on a specific dipstick test for urinary protein, which suggests that patients taking Neurontin should let their doctor know before taking any test for urinary protein to ensure accurate results.
Is Neurontin A Controlled Substance?
Neurontin has a strange legal status in the U.S. A controlled substance refers to a substance which is illegal without a prescription in the United States.
Neurontin is not a controlled substance federally, according to the Drug and Enforcement Agency (DEA). However, the drug is a controlled substance in an increasing number of states. Although Neurontin is federally legal, users in states where it’s illegal on the state level, due to its inclusion on the controlled substances list, would be taking a risk using the medication without a doctor’s prescription.
We would never recommend that patients use a prescription medication without a doctor’s prescription in any case.
A recent Pharmacy Today article states that Neurontin is a controlled substance in the following states: Alaska, Kentucky, Michigan, North Dakota, Tennessee, Virginia and West Virginia.
There’s also been a recent push by both the FDA and the DEA to make Neurontin a federally controlled substance due to data on the potential for abuse and addiction.
We recommend that patients in states where Neurontin is a controlled substance be very cautious to keep records of their prescription to reduce any legal risk.
Is Neurontin Addictive?
Whether or not a drug is addictive is difficult to definitively declare, because addiction varies so much between patients. A medical review analyzed the whether Neurontin was addictive by examining results from real patients involved in over 100 medical studies.
The researchers found that Neurontin was not likely to be addictive, at least for patients without a personal history of addiction or substance abuse:
“We did not find convincing evidence of a vigorous addictive power of gabapentinoids which is primarily suggested from their limited rewarding properties, marginal notes on relapses, and the very few cases with gabapentinoid-related behavioral dependence symptoms (ICD-10) in patients without a prior abuse history.”
A separate clinical trial suggested that Neurontin could cause drug-seeking behavior because it may increase dopamine, which is a neurotransmitter associated with pleasure and reward seeking. However, we should note that this trial was on animals rather than humans, so the quality of data is lower in our opinion than in the previous study which mainly reviewed studies with human trial participants.
We would suggest that patients with a history of addiction speak with their doctor about the risks of Neurontin addiction, because the risk seems higher in those who are genetically predisposed to addiction.
Can Neurontin Treat Anxiety?
Neurontin is not approved by the FDA for treating anxiety, so such use would constitute an “off-label” use, which we don’t recommend. Some doctors prescribe drugs for off-label uses, but we believe this to be a risky and potentially unethical practice.
A medical trial from 2012 published in the Breast Cancer Research and Treatment journal examined the efficacy of Neurontin for reducing anxiety in breast cancer survivors. The patients either took Neurontin at a 300 mg daily dose, or Neurontin at a 900 mg daily dose, or a placebo pill.
Both groups taking Neurontin experienced significantly reduced anxiety compared to those taking a placebo. One surprising element of the data was that the lower dose was more effective for decreasing anxiety levels. Both groups using Neurontin experienced more than double the anxiolytic (anxiety-reducing) effect of the placebo group.
A separate case study published in Case Reports for Psychiatry documented how a 59 year old woman who was prescribed Neurontin successfully treated her Generalized Anxiety Disorder (GAD) symptoms.
It seems from early research that Neurontin may be effective for treating anxiety, but more studies are needed to say so conclusively. The FDA may approve Neurontin for treatment of anxiety if more research emerges proving it’s effective for that condition.
Can Neurontin Cause Withdrawal Symptoms?
Neurontin can cause withdrawal symptoms, and is proven to do so at least in some patients. Another case report published in the Annals of Pharmacotherapy medical journal documented how a 76 year old woman developed a condition called akathisia while withdrawing from Neurontin. This condition causes patients to be restless and unable to sit still. It’s quite subjectively uncomfortable. In this case, the condition resolved itself after 3 days.
Another meta-study highlighted 18 individual patient case reports who experienced withdrawal symptoms from Neurontin as well as addiction to the drug. This study listed “a history of alcohol or substance abuse” as an independent risk factor for becoming addicted to Neurontin.
Withdrawal symptoms varied in the meta-study, but the most common reported were confusion and disorientation (experienced by 45% of patients), excessive sweating (36%) and gastrointestinal discomfort (23%).
Because Neurontin may cause uncomfortable withdrawal symptoms, we would strongly recommend that patients considering stopping use of the medication speak with their doctor first, because tapering off according to research standards can make the quitting process safer and decrease the risk that a patient experiences withdrawal symptoms.
Does Neurontin Cause Weight Gain?
Use of Neurontin is associated with weight gain. A medical review titled “Drugs Commonly Associated With Weight Change” documents how Neurontin is associated with an average of 2.2 kilograms (kg) of weight gain, which equates to 4.85 pounds (lbs), after 1.5 months of use. This is a relatively high weight gain rate in our opinion.
Researchers are not clear about what causes the apparent weight gain effect from Neurontin use, and are also unclear on whether the medication directly causes weight gain or if instead it causes biological effects which have a downstream effect of weight gain.
We would recommend that patients who are overweight or obese speak with their doctor about this potential side effect.
Neurontin And Alcohol
Neurontin may be prescribed to reduce cravings for alcohol and to reduce dependence on alcohol. A clinical trial on the medication found that it was effective for reducing alcohol dependence to a statistically significant degree.
In the trial, only 4.1% of alcoholic patients taking a placebo drug were able to fully refrain from alcohol use, while 11.1% of patients taking 900 mg of Neurontin and 17% of patients taking 1,800 mg of Neurontin were able to fully refrain.
Neurontin’s FDA label also describes how there are contraindications of using alcohol while on the drug. Alcohol should not be used while taking Neurontin. This contraindication makes the use of the drug for alcoholism risky, since it may directly harm the health of patients whose alcoholism the drug doesn’t treat.
Neurontin User Reviews
Neurontin has an average review score on Drugs.com of 7.5 out of 10 for treating epilepsy, which is a high score. Only four total reviews have been made. Drugs.com allows patients to publish reviews of prescription medication they’re taking.
We cannot verify the accuracy or authenticity of any of the reviews, but we find the website to contain valuable information that’s hard to find elsewhere.
The top positive review of Neurontin is published by a user named “4mymeds” who claims the drug successfully treated their condition:
“Has controlled my seizures, in conjunction with Tegretol, for over fifteen years, seizure free.”
The top negative review of Neurontin is written by a user named “abusick88” who claims the medication was not effective and caused side effects:
“well neurotin has really not done anything for me..i was an alcoholic and had seizures..nope not doing anything I still feel like I'm about to have a heart attack/seizure...just aint doing it for me”
Can Neurontin Be Used For Dogs?
There are health conditions that dogs can get which cause seizures and pain, and thus many people are curious about whether Neurontin can treat dogs as well as humans.
While it may be difficult to measure pain in dogs, a clinical study which used Neurontin to ameliorate post-operative pain with dog participants attempted to do so. The study authors utilized morphine as a proxy to measure the dogs’ pain: the more morphine that was required, the more pain the dog was likely in, and less morphine required suggested less pain.
The animals in the study were administered morphine based on whether they were aggressive and in visible distress, which is how the researchers qualified pain. Those receiving Neurontin required significantly less morphine, suggesting that the drug may be effective for reducing pain in dogs.
A separate clinical trial tested the effects of Neurontin on dogs with a seizure condition. 6 of the 11 animals studied experienced a positive response to the medication, and in that group of responders, the average number of seizures per week as well as the average number of days without a seizure per week decreased by the end of the study.
These studies suggest that Neurontin may be efficacious for reducing seizures and pain in dogs, but we strongly recommend only giving the medication to a pet if the it was prescribed by a veterinarian. The dosage differs between humans and dogs, and pet owners that give prescription drugs to their dog are putting the animal’s life at risk.