Gabapentin for the treatment of restless legs syndrome

Gabapentin for restless legs
Medically reviewed by Dr. Mehvish Khan

Key Takeaways

  • Gabapentin, primarily used for seizures and nerve pain, is also employed for Restless Legs Syndrome (RLS). It affects nerve signalling rather than muscles.
  • Gabapentin’s effectiveness for RLS may take weeks, with dosage ranging from 300 mg to 3,600 mg daily. It’s initiated at a low dose and increased gradually. Continuity in usage is crucial, as full effects may take up to four weeks.
  • Gabapentin has common side effects and rare serious reactions. It interacts adversely with substances like alcohol, CNS depressants, and antacids. Caution is advised for specific populations, including those with kidney issues, pregnant or breastfeeding women, the elderly, individuals with mental health concerns, and those with a history of substance abuse. Consulting a healthcare professional is crucial for personalized advice and monitoring.

Overview

The movement disorder known as restless legs syndrome (RLS) or Willis-Ekbom illness is a sleep-related condition marked by an overwhelming desire to move, mainly the legs. Other bodily organs, though, might also be affected. The four critical criteria used to diagnose RLS are the impulse to move the legs, with or without unusual sensations, worsening of symptoms at rest, relief of symptoms with activity, and worsening of symptoms in the evening/night.

Individuals with modest symptoms don’t need to be treated, but RLS needs to be addressed when symptoms interfere with sleep, daytime or social functioning, or quality of life.

Gamma-aminobutyric acid (GABA) analogs like gabapentin are used to treat pain syndrome and seizures. You can get a prescription to treat RLS. 

This article aims to evaluate the effects, mechanism of action, side effects of gabapentin on the legs and when to avoid it.

What does Gabapentin do to the legs?

One drug that is frequently used to treat seizures and nerve pain is gabapentin. Its primary function is on the neurological system; it does not directly affect the legs. It is thought that gabapentin functions by influencing how nerves communicate with the brain and regulating its electrical activity.

Gabapentin may help lessen pain signals and provide relief for neurological pain problems such as postherpetic neuralgia and diabetic neuropathy. Its effects on the legs are attributable to its impact on nerve signaling rather than any direct effect on muscle function because it is neither a muscle relaxant nor a medicine that targets the muscles directly.

“Restless leg syndrome can have serious health consequences that many doctors don’t recognize, “ says David Perlmutter, M.D., F.A.C.N., board-certified neurologist and fellow of the American College of Nutrition, author, and dedicated family man.

The sleep disruptions RLS causes can increase the risk of weight gain, diabetes and Alzheimer’s disease. ⁠”

How long does Gabapentin take to work for restless legs?

Depending on the illness being treated, gabapentin may take several weeks to take full effect. Appropriate uses for gabapentin include: 

It also depends on how the medication affects you specifically. There is variation in the duration of gabapentin’s action.

Additionally, the effective dosage of gabapentin varies greatly depending on the patient and the ailment being cured. The daily dose can range from 300 mg to 3,600 mg.

The fact that gabapentin is typically begun at a low dose and progressively increased to an adequate amount over time is another reason why it takes longer to start working. For instance, the first dose for treating nerve pain maybe 100-300 mg, which would then be increased by 300 mg every day for a few days until it reached a maximum of 600 mg three times daily. Research on treating nerve pain indicates that the most significant benefit can be obtained approximately four weeks after the pain starts to subside.

The drug gabapentin belongs to a group of drugs known as anticonvulsants. The exact mode of action of this medication is unknown. Gabapentin reduces the aberrant brain activity that results in seizures when used to treat a specific kind of seizure disease known as a partial-onset seizure. When gabapentin is used to treat neuralgia or nerve pain after shingles, it may lessen the body’s reaction to painful stimuli. The exact mechanism by which gabapentin reduces restless-legged syndrome symptoms is uncertain.

Although the full effects of gabapentin may not become apparent for up to 4 weeks, it’s crucial to continue taking it as prescribed. That could result in signs of withdrawal like:

Stopping abruptly when using gabapentin to prevent seizures may make you more likely to experience one.

Ready to put those restless nights to rest? Discover the transformative power of gabapentin for Restless Legs Syndrom. Consult now

What is the most common side effect of Gabapentin?

Gabapentin use carries several possible adverse effects, just like any medication. While most adverse effects are not likely to occur in a person, and others may not even occur at all, some that are possible with gabapentin include:

  • Lightheadedness
  • Tiredness
  • Walking challenges
  • Your feet swell
  • Jittery eye movements, or nystagmus
  • Vomiting or feeling queasy
  • Shakiness
  • Hazy vision
  • Absence of feeling
  • Constipation or diarrhea
  • Virus Infection
  • Mouth dryness
  • Headache
  • Runny nose
  • Stupid reasoning
  • Slurred words
  • Upset stomach
  • Gaining weight

Potential Serious Reactions

Serious side effects of gabapentin occur rarely but can include:

  • Abnormal blood counts (leukopenia or thrombocytopenia)
  • Continuous seizures
  • Withdrawal after stopping the drug abruptly
  • Abnormal movements
  • Depression or suicidal thoughts
  • Fractures
  • Severe rash
  • Kidney failure

What to avoid when taking Gabapentin?

Gabapentin is beneficial for a wide range of illnesses. However, it can also have typical side effects, like any medication. These include, but are not limited to, tremors, tiredness, weakness, dehydration, difficulty moving, weight gain, dizziness, and sleepiness. On the other hand, gastrointestinal adverse symptoms like nausea, vomiting, constipation, or diarrhea are also possible. 

Even if some gabapentin side effects cannot be reduced, it’s crucial to understand how the drug interacts with other medications to prevent any negative responses. The following six items are to be avoided when using gabapentin.  

Alcohol 

When taking this drug, it’s a good idea to choose mocktails over cocktails because gabapentin and alcohol don’t mix well. The combo will make you more drowsy and dizzy.

Alcohol depresses the central nervous system and affects a person’s mobility, gait, processing speed, and cognitive function, 

according to Kobi Nathan, Pharm.D., who founded the Geriatric Academy in Rochester, New York. Gabapentin also performs the majority of these functions. Thus, consuming alcohol with gabapentin will impair it additively or synergistically. 

Central nervous system depressants

Because gabapentin depresses the central nervous system (CNS), using it alongside other CNS depressants like oxycodone, Ambien (zolpidem), Valium (diazepam), or Xanax (alprazolam) can be harmful. 

The FDA declared in 2019 that it would be enforcing new warnings on gabapentanoids, which includes gabapentin, regarding the possibility of fatal respiratory distress while taking the drug in combination with opioids or other CNS depressants. An increased risk of respiratory problems is seen in older adults and those with pre-existing respiratory conditions (such as asthma or COPD). 

Some vitamins and supplements

Make sure your healthcare provider is aware of all the prescriptions you take, including vitamins and supplements. Although there are no known vitamin interactions with gabapentin, there are situations when having too much or too little of a particular vitamin can mimic a condition that could be treated with gabapentin. For instance, defects in B6 and B12 might result in neuropathy and damage to the nerves. Your doctor will be better able to diagnose and prescribe for you if they know what you are taking.

Avoid ginkgo biloba if you are taking gabapentin for epilepsy. Seizures can be brought on by excessive doses of ginkgo toxin, which is present in ginkgo biloba. It is, therefore, plausible that ginkgo may lessen the anticonvulsive effects of gabapentin. Antacids

If you experience heartburn or upset stomach, it could be tempting to take an antacid. However, because they prevent the body from absorbing as much gabapentin, antacids can lessen its effectiveness. 

If you must take an aluminum- or magnesium-containing antacid, such as Maalox or Mylanta, wait at least two hours before taking your next gabapentin dosage. In this way, the mineral is absorbed before the gabapentin enters the bloodstream. Alternatively, find out from your doctor if you should try a different kind of heartburn medicine, such as Nexium (esomeprazole).  

Dehydration

Given that gabapentin might occasionally result in moderate dehydration or dry mouth as potential side effects, drink plenty of water intentionally. It’s critical to be aware of this risk and make an effort to drink during the day. Dehydration symptoms to watch out for include dark urine with a strong odor and decreased frequency of urination. While taking gabapentin, dehydration might have its own unique set of complications. 

Caffeine

Caffeine and gabapentin are safe to use together when taken as prescribed, despite some animal research suggesting that a high caffeine intake may reduce the medication’s efficacy in preventing seizures. Remember to tell your doctor if you have caffeine sensitivity or drink a lot of tea, coffee, or energy drinks.

Learn about gabapentin’s role in treating Restless Legs Syndrome. Consult now!

Who cannot take Gabapentin?

Certain people should use caution or abstain from taking gabapentin as it may not be appropriate for them. Here are some things to think about:

Allergic Reaction

You shouldn’t use gabapentin if you have an allergy to any of its ingredients. The symptoms of allergic responses can be minor, moderate, or severe or include breathing difficulties, rash, swelling, itching, or severe disorientation.

Kidney Problems

Individuals with kidney problems or on hemodialysis should use gabapentin with caution. Adjustments to the dosage may be necessary based on kidney function.

Pregnancy and Breastfeeding

Before using gabapentin, women who are pregnant or nursing a child should consult their doctor. Considering the advantages and risks is essential because it may pass into breast milk.

Elderly Patients

Older adults may be more susceptible to gabapentin’s adverse effects, including sleepiness and dizziness. Depending on each person’s tolerance, the dosage might need to be changed.

Mental Health Concerns

When taking gabapentin, anyone with a history of depression, mental disorders, or suicide ideation should be continuously watched. Suicidal thoughts or actions may become more likely as a result of the medicine.

Substance Abuse

Individuals with a history of substance abuse should use gabapentin with caution, as there have been reports of misuse and dependence associated with the medication.

Other Medical Conditions

Individuals with certain medical conditions, such as respiratory problems or myasthenia gravis, may need special consideration and monitoring while using gabapentin.

Consult a doctor

Consult a healthcare professional for questions or symptoms related to gabapentin. Only a doctor can provide personalized advice based on your health, medical history, and medications. Discuss any changes in dosage with your doctor for a safe and effective treatment plan. If you experience severe side effects or health changes, seek immediate medical attention.

FAQs about Gabapentin for restless legs

How many hours before bed should I take gabapentin?

Within two to three hours of taking a dose, gabapentin begins to act on the body. Thus, taking 2 hours at least before you fall asleep is advised. But it might take up to two weeks for gabapentin’s full benefits to become apparent, and some people might need to wait longer to see a notable improvement in their level of pain.

What causes restless leg syndrome to flare up?

According to experts, RLS may be brought on by low brain iron levels. Another thought is that dopamine imbalance plays a part. Certain drugs, sleep deprivation, stress, alcohol or caffeine usage, and certain medications can all cause flare-ups of restless legs syndrome (RLS). A low iron level and other illnesses may also aggravate the symptoms of RLS. Together with the proper medical care, recognizing and controlling these triggers can help reduce symptoms.

Can gabapentin cause weight gain?

Although weight gain is not a common side effect of gabapentin, it is possible. According to studies, a tiny percentage of patients using the medication gabapentin, which is used to treat postherpetic neuralgia and epilepsy—saw an increase in weight. After six weeks of use, those who gain weight may gain approximately five pounds.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Garcia-Borreguero, D., et al. “Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study.” Neurology 59.10 (2002): 1573-1579.
  • Adler, Charles H. “Treatment of restless legs syndrome with gabapentin.” Clinical neuropharmacology 20.2 (1997): 148-151.
  • Happe, Svenja, et al. “Treatment of idiopathic restless legs syndrome (RLS) with gabapentin.” Neurology 57.9 (2001): 1717-1719.
  • Bogan, Richard K., et al. “Long-term maintenance treatment of restless legs syndrome with gabapentin enacarbil: a randomized controlled study.” Mayo Clinic Proceedings. Vol. 85. No. 6. Elsevier, 2010.
  • Kim, Esther S., and Emma D. Deeks. “Gabapentin enacarbil: a review in restless legs syndrome.” Drugs 76 (2016): 879-887.

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