This post was written by Dr. Andrius Giedraitis, Pain Management at Parkview Bryan Hospital.
I frequently speak with patients who have been prescribed gabapentin but aren’t sure whether it’s helping or what it’s meant to treat. With recent discussions in the media and progressing research, it’s worth clarifying what gabapentin actually does, where it helps and where it doesn’t.
What it does
Gabapentin was developed to treat seizures and postherpetic neuralgia (nerve pain after shingles). It works by reducing abnormal nerve firing in the nervous system. Because of this mechanism, it can be effective for certain types of neuropathic pain—for example, painful diabetic neuropathy or some forms of nerve injury.
However, gabapentin is often prescribed off-label for conditions like low back pain, sciatica, fibromyalgia or general chronic pain. High-quality research shows inconsistent or minimal benefit in many of these cases, particularly for non-neuropathic back pain. Yet the volume of prescriptions has ballooned over the past decade, despite limited evidence.
Side effects and warnings
Many patients assume gabapentin is “safe” because it’s not an opioid. But it’s not without side effects. Commonly reported issues include:
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Dizziness and sedation
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Cognitive slowing (“brain fog”)
These side effects are more pronounced when gabapentin is combined with opioids, benzodiazepines or alcohol, which also increases dangers such as respiratory depression.
There’s also growing awareness of misuse and diversion, not because gabapentin produces a classic high, but because it has the ability to intensify the effects of other drugs and affect withdrawal symptoms in people with substance use histories. Some states now require monitoring gabapentin prescriptions to track possible misuse.
Closing remarks
In our practice, gabapentin is not a first-line default. We use it selectively, primarily when there’s clear evidence of neuropathic pain and when other strategies haven’t worked. Equally important is setting measurable treatment goals: improved function, sleep quality, as well as daily activity, not just a modest drop in pain score.
For many chronic pain patients, a multimodal method that includes targeted injections, physical therapy and other supportive interventions offers far more meaningful improvement than medication alone.
If you are taking gabapentin, that’s ok. But it may be worth talking with your physician about why it was prescribed, what benefits you should expect and whether it’s time to reevaluate your plan.
Find care
At Parkview Bryan Hospital's Pain Management Clinic in Ohio, our team offers personalized and balanced care, with no referral necessary. To learn more or schedule an appointment with one of our providers, call 419-633-7343.
At PPG—Pain Management in Indiana, appointments are by referral only. If you suspect you need to see a pain management specialist, contact your primary care physician.
