Can Gabapentin help with Alcohol Withdrawal Management?

Gabapentin is currently FDA approved for restless leg syndrome, partial-onset seizures, and postherpetic neuralgia. Although not a first-line medication, recently many studies have shown gabapentin efficacy for alcohol withdrawal management. 

Gabapentin is one of those few medications that need dosage adjustment based on renal function. Let’s begin by answering this question first:

Welcome to your Gabapentin

Q: Gabapentin is eliminated from the systemic circulation by renal excretion. Which of the following is recommended total daily gabapentin dose range for patient with creatinine clearance of >15-29 mL/min?

Answer: (c) 200-700 mg/day

Here is the summary table from the gabapentin package insert on dosing gabapentin based on the renal function results: 

FOR PEFA ACADEMY MEMBERS:

This chapter will attempt to answer the following clinical questions:

  • Q.1: Which gabapentin withdrawal protocol can be used for acute alcohol withdrawal management?
  • Q.2: What is the lowest starting dose for gabapentin on day 1 for withdrawal management?
  • Q.3: Which patient population is less likely to respond to gabapentin protocol?
  • Q.4: Does gabapentin have benefits other than reducing alcohol withdrawal symptoms: during treatment and post-treatment?

Gabapentin Protocol for Alcohol Withdrawal Management

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