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Treatment effects of gabapentin for primary insomnia

Treatment effects of gabapentin for primary insomnia
 

HOW DOES GABAPENTIN AFFECT SLEEP?

With gabapentin’s calming and anti-anxiety effects, it’s not surprising that studies have found it to be helpful in treating insomnia and sleep disorders. Many anti-anxiety medications, particularly those with sedative-like effects, can help users fall asleep more easily.

One interesting aspect of gabapentin’s effect on sleep (in the limited research available) is its impact on quality of sleep.

In one 2010 study, gabapentin not only helped to treat study participants’ insomnia symptoms by decreasing spontaneous arousal — like waking up in the middle of the night — but it also improved their sleep quality by enhancing slow-wave sleep.

Slow-wave sleep, also known as deep sleep, is the type of sleep that makes individuals feel rested in the morning.

During this important stage of sleep, the pituitary gland secretes much-needed hormones, like the human growth hormone, which is essential to the repair and development of the cells in the body. During deep sleep, glucose metabolism in the brain also increases, supporting memory and learning.

Gabapentin was shown to increase sleep efficiency and allow for longer, deeper sleep.

HOW DOES GABAPENTIN AFFECT DREAMS?

There is limited research available on gabapentin’s effect on dreams, but many online reports and comments in online forums indicate users may experience especially vivid dreams, especially when they first begin taking the drug.

If users begin to experience problematic dreams or night terrors, they should immediately consult their doctor.

WHY IS GABAPENTIN USED?

Gabapentin is a prescription drug most commonly used to treat seizures and postherpetic neuralgia (pain from nerve damage caused by shingles).

It also prescribed by psychiatrists to treat anxiety.

Gabapentin is taken orally, as a capsule, and it is available under the brand name Neurontin. Before choosing gabapentin as a medication option, it’s helpful to understand more about the drug, including how it actually affects sleep and sleep quality.

 
HOW DOES GABAPENTIN WORK?

Gabapentin is classified as an anticonvulsant drug.

Because of its name, many think gabapentin works by interacting with GABA (gamma-Aminobutyric acid) receptors in the central nervous system, as many other sedative-type medications do. This is not the case.

It’s not fully understood how gabapentin works, although there are indications it affects calcium levels to treat different disorders.

For postherpetic neuralgia, it is thought to prevent the increase in sensitivity that occurs as a result of the pain the condition causes. Thus, users feel less pain and reduced sensitivity.

This soothing of nerve sensitivity, and the relaxing effect it can produce, is also why gabapentin is prescribed by psychiatrists to treat anxiety.In its treatment of seizures, gabapentin seems to manipulate the effect and levels of calcium. Low levels of calcium may cause seizures.

WITHDRAWAL AND SLEEP

While gabapentin may be considered a safer alternative to other sedative-like medications, like benzodiazepines, it has many side effects, including sleepiness, trouble speaking, hostility, and viral infections. Side effects may also include increased pain sensitivity and irritability.

More serious side effects include allergic reactions, dangerous drug interactions, and changes in mood or behavior. If it appears that a user is experiencing suicidal thoughts, emergency medical help should be sought after immediately. Gabapentin can increase the risk of suicide.

Users of gabapentin can become dependent on the drug, and withdrawal symptoms can be severe, including sweating, gastrointestinal problems, tremors, and increased heart rate.

Reports indicate that users may begin to experience their worst withdrawal symptoms about three days after stopping the drug. Some of the most common withdrawal symptoms of gabapentin are sleeplessness and sleep problems.

Individuals with a history of mental problems or substance abuse problems may be at more risk for experiencing severe withdrawal symptoms from gabapentin and should not attempt to quit gabapentin “cold turkey” or without the supervision of a medical professional.

Those with a history of epilepsy, bipolar disorder, psychosis, and depression should only undergo gabapentin withdrawal and detox in a medically supervised setting.

Users should consult with a medical professional to determine a withdrawal plan for tapering off the drug rather than abruptly discontinuing use.

CONCLUSION

Gabapentin is considered a safe and effective treatment for seizures, nerve pain, and anxiety. It has also shown promise as a sleep aid and possible treatment for insomnia. It may even increase sleep quality and efficiency.

More evidence-based research is needed to conclude that gabapentin is safe for long-term use as a sleep medication, however, especially since it has shown some potential for abuse and the withdrawal symptoms may be severe, negatively impacting sleep.

Gabapentin users with a history of mental illness, substance abuse, or epilepsy should only attempt detox and withdrawal from gabapentin in a medically supervised setting.

OBJECTIVES:

The prevalence of insomnia is very high in our society. Although pharmacological treatment of insomnia is available, most hypnotics have been shown to alter sleep architecture and have many adverse effects. Gabapentin was originally designed for antiepileptic therapy; however, some studies reported that its use increases slow-wave sleep in healthy volunteers or patients. Our goal was to evaluate the benefits of gabapentin in the treatment of primary insomnia in patients.

METHODS:

Eighteen patients with primary insomnia participated in the study. They received gabapentin treatment for at least 4 weeks. All patients received polysomnography, a biochemical blood test, and neuropsychological tests before and after the treatment period. All measures were analyzed with Student t test to examine the treatment effects of gabapentin, except that the measures of heart rate variability were analyzed with analysis of variance.

Results: Polysomnographic study revealed increased sleep efficiency and slow-wave sleep, decreased wake after sleep onset, and spontaneous arousal index after gabapentin treatment. The biochemical blood test revealed decreased prolactin levels in the morning after treatment. Electroencephalographic power spectral analysis showed increased delta-2 and theta power in sleep stage 1 and decreased sigma activity power in sleep stages N2 and N3 after gabapentin treatment. Heart rate variability analyses also showed a significant increase in normalized high frequency percentage in sleep stages N2 and N3 and low frequency-high frequency ratio in sleep stage N2 after treatment. In addition, neuropsychological tests revealed the elevation of visual motor processing speed after gabapentin treatment.

Conclusions: Gabapentin enhances slow-wave sleep in patients with primary insomnia. It also improves sleep quality by elevating sleep efficiency and decreasing spontaneous arousal. The results suggest that gabapentin may be beneficial in the treatment of primary insomnia.