Sally asked
I have a concern about someone. I was wondering what are the effects of someone taking 300mg gabapentin at high doses? The prescription was for 90 pills and this person took all 90 pills in a 5 day range. Is there an effect of making you high with this? I’m trying to figure out what the reason would be that they felt the need to do this.
Answer
Gabapentin (brand name Neurontin) has increasingly become a drug of abuse, misuse and diversion. Although it is available only via prescription, it is not a scheduled controlled substance. However, It does appear that gabapentin has a higher abuse potential than previously thought, which may be a result of large doses being prescribed to patients for both indicated and non-indicated uses such as for neuropathic pain and migraine prophylaxis.
The exact mechanism of action of gabapentin is not well known but the drug is thought to have properties relating to GABA, a inhibitory neurotransmitter. Gabapentin is thought to reduce the release of excitatory neurotransmitters, and increase the effects of our bodies dopaminergic reward system. High doses have shown the ability to produce a "high" or "euphoric" feeling
Gabapentin Abuse/Misuse Effects
In 2011, over 30 million prescriptons for gabapentin were written and experts are worried this increase isn't explained by legitimate medical use. Misuse of gabapentin can reportely cause the following effects in users:
- Decreased anxiety
- Euphoria
- A similar "high" to marijuana
- Sedative reactions
At very high doses, gabapentin is reported to have dissociative and psychedelic effects in some users.
In addition, data indicates that gabapentin may blunt or diminish the withdrawal effects of alcohol and opioid medications. It has been reported that drug misuse may include the use of gabapentin as an "additive" to other illilct substances (e.g. heroin) to either enhance their effect or blunt the negative reactions to them.
As with most medication, high doses of gabapentin can be dangerous and potentially fatal. Gabapentin has known CNS (central nervous system) depressant effects and large doses could induce coma or respiratory depression.
Safe Use Of Gabapentin
It should be noted that the studied medicinal dose range of gabapentin is quite large. Gabapentin has been used effectively in doses all the way up to 3,600 mg per day for neuropathic symptoms (although this is an off-label use). The more common dosage range is between 600 mg and 1,800 mg per day. High doses however, are a result of slow titration and were not started at such a level.
Per your question, using 90 of the 300 mg capsules in 5 days does indicate abuse, misuse or diversion. This equates to 5,400 mg per day, well above a medically studied dose.
As we become more aware and cognizant that gabapentin has the potential to be abused, it is important to look out for certain signs that could be indicative of this including:
- Using the medication too quickly
- Multiple early refills
- Multiple problems with "losing" the medication
- Altered personality
- Sedation/euphoria symptoms
Due to the situation you described, it is important to consider the possibility that gabapentin may be being misused in this case. Historically, gabapentin hadn't typically raised concerns regarding abuse potential but based on what is now known, it would be prudent to act if you suspect abuse, misuse or diversion.
