Prescriptions of this common drug have increased 123 percent in 14 years

Gabapentin prescriptions in the United States rose from 79.5 to 177.6 per 1,000 residents between 2010 and 2024, an increase of 123 percent.

The study authors say this reflects a steep and sustained rise in use for a drug originally approved for seizures and a specific kind of nerve pain.

Over the same period, the number of people who filled at least one gabapentin prescription climbed from 5.8 million to 15.5 million. 

Those counts come from retail pharmacies across the country, drawn from databases that capture about 94 percent of prescriptions dispensed in these settings.

Why so many gabapentin prescriptions?

The work was led by Gery P. Guy Jr., PhD, at the CDC Division of Overdose Prevention in Atlanta. His research focuses on how prescribing patterns influence injuries and drug overdoses in communities.

Gabapentin is approved to help control partial seizures and to treat postherpetic neuralgia, long-lasting nerve pain that can follow shingles. 

A related medicine called gabapentin enacarbil is approved for restless legs syndrome, but both drugs are often used for many other long-lasting pain problems.

Earlier work found that use of gabapentinoids, drugs that calm overactive nerve signals, more than tripled in U.S. adults between 2002 and 2015. 

Many clinicians turned to these medicines as alternatives when concerns about opioid addiction grew, especially for people with chronic nerve pain.

Today, a large share of prescriptions goes to people using gabapentin off-label, for uses not formally approved by the FDA. 

Doctors may try it for neuropathic pain, anxiety symptoms, or sleep problems when other treatments have not worked well.

Gabapentin prescription trends

In the most recent data, women were dispensed gabapentin at a rate of 57.1 prescriptions for every 1,000 people. 

For adults age 65 and older, the rate reached 114.7 prescriptions per 1,000, representing a 33.7 percent rise since 2016.Primary care clinicians wrote the largest share of prescriptions, at 22.6 per 1,000 people. 

Prescribing by nurse practitioners and physician assistants increased from 2.5 to 19.5 per 1,000 during the 2010 to 2024 period, as their authority to write more medications expanded in many states.

“Gabapentin was the fifth most prescribed medication in the United States in 2024, compared with the 10th most prescribed in 2017,” said Dr. Guy Jr. In practical terms, this once niche drug now sits near the top of national prescribing charts. 

Safety warnings changed the picture

Gabapentin can make people feel drowsy or dizzy and can blur vision. Some people also have trouble with balance or concentration, especially when doses are adjusted upward.

The FDA warned that serious breathing problems may occur when gabapentin or related drugs are used in people with certain risk factors. 

Those risks include taking opioids or other medicines that slow the central nervous system, the brain and spinal cord, having lung disease, or being older.

One large study found that people taking both gabapentin and prescription opioids had about a 50 percent higher chance of dying from an opioid overdose compared with people taking opioids alone. 

Researchers think the combination can worsen respiratory depression, very slow or shallow breathing that can be life threatening, especially at higher gabapentin doses.

Misuse and overdose warning signs

Public health scientists are also watching for signs of misuse and overdose involving gabapentin itself. 

A CDC report found that in 2019 and 2020, nearly 90 percent of U.S. overdose deaths where gabapentin was detected also involved an opioid, often illicit fentanyl.

Beyond overdose, some people misuse gabapentin for its mood-changing or sedating effects. A research estimated that among people already misusing opioids, 15 to 22 percent also misuse gabapentin.

Next steps for patients and doctors

As prescriptions climbed, several states began to place gabapentin under tighter control, such as listing it in their prescription monitoring databases or classifying it as a Schedule V controlled substance, a drug with relatively low but real abuse potential. 

These steps make it easier for regulators to spot very high-dose or multiple-prescriber use and can slow rapid spikes in prescribing. Clinicians are being urged to weigh these patterns before they start or renew the drug. 

“Careful attention to the use of gabapentin, both new and persistent prescribing, is crucial, especially in older adults who are also taking opioids due to potentially dangerous side effects when taken in combination,” said Tasce Bongiovanni, MD, of the University of California San Francisco (UCSF).

For patients, the message is not to panic but to ask good questions. People starting gabapentin can talk with their clinician about why it is being prescribed, what non-drug options are available, how long they might need it, and how it interacts with any opioids or other sedating medicines they already take.

Anyone already taking gabapentin should avoid suddenly stopping it, since that can trigger withdrawal or seizures, and instead should work with a clinician on any dose changes. 

Checking in regularly about side effects, mood changes, or new breathing problems can help make sure the benefits of the drug outweigh the risks as prescribing continues to grow.

—–

Like what you read? Subscribe to our newsletter for engaging articles, exclusive content, and the latest updates.

Check us out on EarthSnap, a free app brought to you by Eric Ralls and Earth.com.

—–