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2017-04-23T15:26:27Z

‎References

Sharon: Created page with "=== Also known as === Horizant, neurontin, bud, bud lite, gaba, gabby, gabbies, lyrica, nerontin === Classification === Depressant, analgesic Category:Depressants Cat..."

2017-04-17T11:33:29Z

Created page with "=== Also known as === Horizant, neurontin, bud, bud lite, gaba, gabby, gabbies, lyrica, nerontin === Classification === Depressant, analgesic Category:Depressants Cat..."

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=== Also known as ===

Horizant, neurontin, bud, bud lite, gaba, gabby, gabbies, lyrica, nerontin

=== Classification ===

Depressant, analgesic
[[Category:Depressants]]
[[Category:Analgesics]]
=== Overview ===

Gabapentin is a prescription medicine used to treat a variety of conditions including epilepsy, neuropathic pain (pain related to problems with nerve signals) and anxiety disorders.

Some people use gabapentin recreationally and consequently there is an illicit trade in this drug, including through online pharmacies <ref name="1a">'''Gabapentin''', 2017, http://www.drugwise.org.uk/gabapentin/</ref>.

=== What does it look like? ===

Gabapentin comes as white, yellow or orange tablets/capsules. They are normally swallowed, although powder from capsules may be snorted <ref name="1a"/>.

=== Source ===

There has been an increase in the prescribing and use of this drug over the last five years, and with a growing black market of this drug being available without prescriptions through online suppliers <ref name="2a">'''Gabapentin''', 2015, http://www.dan247.org.uk/Drug_Gabapentin.asp</ref>.

=== Why take it? ===

==== Sought after effects ====

* improved sociability,
* euphoria,
* relaxation,
* a sense of calm <ref name="3a">'''Advice for prescribers on the risk of the misuse of pregabalin and gabapentin''', 2014, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/385791/PHE-NHS_England_pregabalin_and_gabapentin_advice_Dec_2014.pdf</ref>,
* cannabis-like high <ref name="2a"/>.

==== Undesired effects ====

* drowsiness,
* sedation,
* respiratory depression,
* death <ref name="3a"/>,
* vomiting,
* nausea,
* flatulence,
* constipation or diarrhoea,
* poor muscle control,
* visual disturbances <ref name="2a"/>.

=== How long do its effects last? ===
==== Onset of effects ====

* 30 - 90 minutes <ref name="4a">'''Gabapentin''', 2017, http://psychonautwiki.org/wiki/Gabapentin</ref>.
* all [[ROA]]'s - 30 - 90 minutes <ref name="5a">'''Gabapentin''', 2017, http://drugs.tripsit.me/gabapentin</ref>.

==== Duration of effects ====

* 5 - 8 hours <ref name="4a"/>.
* all [[ROA]]'s - 5 - 8 hours <ref name="5a"/>.

==== After-effects ====

* all [[ROA]]'s - 1 - 6 hours <ref name="5a"/>.

=== Pharmacology ===

Gabapentin modulates the action of glutamate decarboxylase (GAD) and branched chain aminotransferase (BCAT), two enzymes involved in [[GABA]] biosynthesis. In human and rat studies, gabapentin was found to increase [[GABA]] biosynthesis, and to increase non-synaptic [[GABA]] neurotransmission in vitro <ref name="12a">Taylor, C. P., '''Mechanisms of action of gabapentin''', ''Revue Neurologique (Paris)'', 1997, S39-S45, https://www.ncbi.nlm.nih.gov/pubmed/9686247</ref>. As the [[GABA]] system is the most prolific inhibitory receptor set within the brain, its modulation results in the sedating (or calming effects) of gabapentin on the nervous system.

Gabapentin has also been shown to bind to the α2δ-1 subunit of voltage-gated calcium ion channels which contributes to its analgesic effects. It is uncertain how this contributes to gabapentin's psychoactive effects <ref name="4a"/>.

==== Bioavailability ====

The bioavailability of gabapentin is relatively low and is inversely proportional to the dose. This means that higher doses have lower biovailability than lower doses. The bioavailability of gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day <ref name="4a"/>.

==== Half-life ====

Five to seven hours <ref name="6a">'''Gabapentin: Withdrawal Symptoms, Abuse & Use in Drug & Alcohol Detox''', 2017, http://americanaddictioncenters.org/addiction-medications/gabapentin/</ref>.

==== Lethal dosage ====

People who accidentally or intentionally overdose may experience drowsiness, sedation, blurred vision, slurred speech, somnolence and possibly death (if a very high amount was taken and particularly if combined with alcohol). Serum gabapentin concentrations may be measured to confirm diagnosis <ref name="7a">Baselt, R. C., '''Disposition of Toxic Drugs and Chemicals in Man''', 2008, 8th edition, Biomedical Publications, Foster City, CA, ISBN: 978-0-9626523-7-0, 677-678</ref>, <ref name="4a"/>.

A lethal dose of gabapentin was not identified in mice and rats receiving single oral doses as high as 8000 mg/kg. Signs of acute toxicity in animals included ataxia, laboured breathing, ptosis, sedation, hypoactivity, or excitation.

Acute oral overdoses of neurontin up to 49 grams have been reported. In these cases, double vision, slurred speech, drowsiness, lethargy and diarrhoea, were observed. All patients recovered with supportive care <ref name="8a">'''Highlights Of Prescribing Information''', Pfizer, 2014, http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020235s057020882s041021129s039lbl.pdf</ref>.

==== Toxicity ====

Gabapentin has a low toxicity relative to dose <ref name="4a"/>. Gabapentin should be used carefully in patients with renal impairment due to possible accumulation and toxicity <ref name="8a"/>.

==== Tolerance ====

Gabapentin is not considered psychologically addictive. However, it is possible to develop a physical dependence on the drug. In fact, people can experience withdrawal symptoms for up to 45 days after they stop taking gabapentin. Although gabapentin does give some people a euphoric 'high' which can cause abuse, gabapentin abusers do not present with the kind of compulsive, drug-seeking behaviour or strong cravings associated with other more common depressants such as opioids, alcohol or benzodiazepines.

Tolerance will develop to the anxiolytic effects with prolonged continous usage. After cessation, the tolerance returns to baseline in 7 - 14 days. Withdrawal symptoms or rebound symptoms may occur after ceasing usage abruptly following a few weeks or longer of steady dosing, and may necessitate a gradual dose reduction <ref name="4a"/>.

=== Mode of use ===

Gabapentin capsules and tablets are normally swallowed, but there have been reports of the powder from gabapentin capsules being snorted <ref name="9a">'''Gabapentin''', 2015, http://www.talktofrank.com/drug/gabapentin</ref>.

=== Effects ===

* dizziness,
* drowsiness,
* dry mouth,
* blurred vision,
* headache,
* diarrhoea,
* [[oedema]] <ref name="10a">'''Horizant: Reviews, Side Effects, Uses, Dosage and Directions''', 2017, http://addictionlibrary.org/prescription/horizant-reviews-side-effects-uses-dosage-and-directions.html</ref>.
* constipation,
* nausea,
* vomiting,
* tremors,
* flatulence,
* increases in blood pressure,
* trouble sleeping,
* weight gain,
* feelings of depression, hostility and anxiety <ref name="9a"/>.

==== Rarely ====

* hallucinations,
* suicidal thoughts,
* jaundice <ref name="9a"/>.

==== Physical effects ====

* muscle relaxation,
* physical euphoria,
* pain relief,
* perception of decreased weight,
* sedation,
* seizure suppression,
* dizziness <ref name="4a"/>.

==== Cognitive effects ====

* cognitive euphoria,
* depersonalisation,
* derealisation,
* dream potentiation,
* amnesia,
* anxiety suppression,
* decreased libido,
* emotion suppression,
* thought deceleration <ref name="4a"/>.

==== Visual effects ====

* visual disconnection,
* internal hallucinations <ref name="4a"/>.

==== Side-effects ====

* swollen hands and feet,
* headaches,
* abnormal thoughts,
* suicidal thoughts,
* shortness of breath,
* chest pain,
* mouth sores,
* chills,
* nausea,
* coughing,
* tremor,
* cold symptoms <ref name="2a"/>,
* drowsiness,
* weakness,
* dizziness,
* shaking in one part of the body,
* blurry or doubled vision,
* unsteadiness,
* anxiety,
* difficulty with memory,
* uncontrolled eye movement,
* vomiting,
* heartburn,
* diarrhoea,
* dry mouth,
* constipation,
* increased appetite,
* weight gain,
* back or joint pain,
* fever,
* ear pain,
* red, itchy eyes <ref name="6a"/>.

==== Overdose ====

* double vision,
* slurred speech,
* drowsiness,
* diarrhoea <ref name="6a"/>.

==== Allergic reaction ====

* increased seizures,
* fever,
* swollen glands,
* body aches,
* flu-like symptoms,
* skin rash,
* easy bruising or bleeding,
* severe tingling, numbness, pain, or muscle weakness,
* upper stomach pain,
* loss of appetite,
* dark urine,
* jaundice,
* chest pain,
* irregular heart rhythm,
* short of breath,
* confusion,
* nausea and vomiting,
* swelling,
* rapid weight gain,
* change in urination,
* new or worsening cough,
* fever,
* trouble breathing,
* rapid back and forth movement of your eyes,
* severe skin reaction <ref name="10a"/>.

=== Risks ===

* dizziness,
* forgetfulness,
* drowsiness,
* confusion <ref name="9a"/>.

==== Short-term ====

* drowsiness,
* unsteadiness,
* loss of coordination,
* clumsiness,
* vision disturbances <ref name="2a"/>.

==== Long-term ====

* insomnia,
* weight gain,
* dependence,
* hallucinations,
* heart problems - including heart failure,
* depression,
* agitation
* panic attacks <ref name="2a"/>.

=== Purity ===

It's likely that most of the gabapentin that is available on the black market has been either stolen from a hospital or pharmacy or stolen (possibly bought) from people who have been prescribed gabapentin. They might have also been imported from abroad.

You cannot normally be sure of the purity unless you are certain that the drug you have is a genuine pharmacy medicine <ref name="9a"/>.

=== Addiction ===

==== Can you get addicted ====

It is recommended that prescribed gabapentin use is not stopped abruptly as it may cause anxiety, insomnia, nausea, pain and sweating <ref name="9a"/>.

=== Dangerous interactions ===

Gabapentin significantly potentates the effects of alcohol, benzodiazepines and other GABAgenics which may lead to blackouts <ref name="4a"/>.

=== Withdrawal ===

Symptoms of withdrawal typically begin within 12 hours of the last drug use and may last up to a week <ref name="6a"/>.

* anxiety,
* disturbed sleep,
* nausea,
* pain,
* sweating <ref name="9a"/>,
* insomnia,
* headache,
* diarrhoea <ref name="2a"/>.

=== Harm Reduction ===

* '''do not take the drug in higher doses''', more frequent doses, or for longer than you were prescribed to do so by a doctor,
* '''do not stop taking gabapentin suddenly'''. Unless you are experiencing extreme side-effects caused by the drug, you must talk to your doctor before you stop taking it. Stopping the medication suddenly can lead to 'withdrawal symptoms such as anxiety, difficulty falling asleep or staying asleep, nausea, pain, and sweating',
* '''let your doctor know if you have any history of drug abuse''' before you start your gabapentin regimen. If you are taking the drug as part of a treatment program for addiction, make sure you attend therapy sessions and discuss your treatment needs with your doctor on a regular basis <ref name="11a">'''Gabapentin abuse''', 2016, https://www.addictions.com/gabapentin-abuse/</ref>.

=== Legality ===

Gabapentin is a prescription only medicines and can only be prescribed following a consultation with a doctor.

In January 2016, the [[ACMD]] recommended that gabapentin should be controlled under the Misuse of Drugs Act 1971 as Class C substances <ref name="1a"/>.

==== Did you know? ====

Like drinking and driving, driving while under the influence of drugs is illegal - with some drugs you can still be unfit to drive the day after using. You can get a heavy fine, be disqualified from driving or even go to prison <ref name="9a"/>.

=== Paraphernalia ===

If the drug is snorted/sniffed - a razor blade will be used to chop it into lines on a hard level surface such as a mirror or a sheet of glass or a tile <ref name="2a"/>.

----

== References ==

<references />

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Gabapentin - Revision history

Sharon: /* References */

Sharon: Created page with "=== Also known as === Horizant, neurontin, bud, bud lite, gaba, gabby, gabbies, lyrica, nerontin === Classification === Depressant, analgesic Category:Depressants Cat..."