How long does it take for gabapentin to work?

In this article:

• How gabapentin works
• How long does it take for gabapentin to kick in?
• Gabapentin for nerve pain
• Gabapentin for epilepsy
• Gabapentin for anxiety
• Gabapentin for sciatica
• Gabapentin for tooth pain
• What to consider before taking gabapentin
• Gabapentin side effects
• Gabapentin warnings and interactions
• Proper use of gabapentin

In this article

• How gabapentin works
• How long does it take for gabapentin to kick in?
• Gabapentin for nerve pain
• Gabapentin for epilepsy
• Gabapentin for anxiety
• Gabapentin for sciatica
• Gabapentin for tooth pain
• What to consider before taking gabapentin
• Gabapentin side effects
• Gabapentin warnings and interactions
• Proper use of gabapentin

Gabapentin is an anticonvulsant and nerve pain medication often used to treat certain types of epilepsy as well as nerve pain due to conditions such as shingles, sciatica, diabetic neuropathy, and restless legs syndrome. It’s also sometimes used off-label as a treatment for anxiety.

Because gabapentin has such a wide variety of uses, there is a lot of variation in how well it works and how long it takes to kick in when used to treat any given condition. Here’s what to know about how long it takes gabapentin to work.

How gabapentin works

It may be hard to understand how one drug could be used in the treatment of so many different conditions, but gabapentin basically works by turning down the volume on your nerve and pain pathways. This lowers your body’s sensation of pain, and in the case of epilepsy, prevents your brain cells from becoming overexcited (i.e., agitated and firing rapidly), which can trigger or worsen a seizure.

Experts aren’t sure exactly how gabapentin works for some of the other conditions it’s used for, like restless legs syndrome or anxiety. But it most likely still involves the downregulation of the nervous system, with the medication suppressing the body’s usual responses to nerve pain and preventing brain cells from getting overexcited.  

How long does it take for gabapentin to kick in?

According to Alopi M. Patel, MD, associate professor in the Department of Anesthesiology and Perioperative Medicine at Robert Wood Johnson Medical School in New Jersey, some of gabapentin’s effects on the body can start within a few hours of taking it, but the actual pain modulating effect can take longer depending on the type and severity of your pain and various other factors. 

Gabapentin for nerve pain

If you’re taking gabapentin for nerve pain, it could take between one and two weeks to start having any effect, says Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in California. This makes gabapentin a slower-acting treatment than some other analgesics and pain relievers.

In fact, Dr. Patel says it may even take up to four weeks for gabapentin to reduce your pain. At that point, if you still don’t have much improvement, she recommends talking to your prescribing healthcare provider about either stopping taking gabapentin and trying another medication, or slowly increasing your dose of gabapentin.

Gabapentin for epilepsy

For long-term use in treating a chronic condition like epilepsy, the effects can take even longer. In general, most people taking antiepileptic drugs need to wait several months to see if the medication works for them. This is also true for gabapentin; even when people are able to quickly bring themselves up to a high dose for better seizure control, it may still be several months before the drug starts fully working.  

Gabapentin for anxiety

As for gabapentin’s use in managing anxiety symptoms, Eleanor Curry, MD, a psychiatrist with Mindpath Health, says the timeline largely tracks with its other uses and that it may take several weeks for you to feel like the medication is relieving any of your symptoms.

“Gabapentin can have some immediately noticeable effects for anxiety,” says Dr. Curry, “but it may take a few weeks to feel the full effects, like most of its other uses.” Although most people who take gabapentin for anxiety use it long-term, as a regular or daily medication, Dr. Curry adds that it can be used as needed for anxiety. “I find it to be especially helpful for nighttime anxiety because it can be sedating and help with sleep,” she explains. 

Gabapentin for sciatica

Sciatica is a type of nerve pain caused by pressure on a specific part of your lower spine. It can lead to pain that starts at your hip and radiates down your leg. Gabapentin can help with nerve pain caused by sciatica, but it isn’t usually a quick fix. Although it may have some immediate effects, you won’t know for a few weeks whether it’s really helping you.

Gabapentin for tooth pain

Treating tooth pain with gabapentin is currently an off-label use, but some healthcare providers will prescribe it to relieve pain after a dental procedure involving the nerves. 

However, it’s unclear how long it would take gabapentin to work for tooth pain since it’s not a typical use of the drug. Some studies suggest it isn’t any more effective than other pain medications and typically provides the most benefit when combined with other pain relievers rather than taken alone.

What to consider before taking gabapentin

Although gabapentin isn’t a federally controlled substance like narcotic pain relievers (which are often prescribed to relieve symptoms of nerve pain), it does have a risk for abuse. Certain states monitor patient gabapentin use through state monitoring programs, and some states have classified gabapentin as a controlled substance at the state level. 

You should still be aware of gabapentin’s safety profile when taking this drug, including its common side effects and interactions.

Gabapentin side effects 

Gabapentin can cause a number of side effects, including dizziness, drowsiness, headache, vision problems, loss of coordination, fatigue, memory problems, upset stomach, and swelling. Not everyone will experience these side effects, but they are considered common. Dr. Curry says even these common side effects can be serious if they are severe enough, especially in people like older adults who are prone to falls.

There are also rare but potentially dangerous side effects with gabapentin, including slow breathing, allergic reaction, depression, and suicidal thoughts. Children may experience behavioral changes on gabapentin, like mood swings, agitation, and aggression. People with kidney dysfunction may experience more side effects, according to Dr. Patel, because their bodies don’t clear the medication as well, causing them to have higher amounts of the drug in their system.  

That said, Dr. Segil says some people are very sensitive to gabapentin while others are not. “It’s usually hit or miss—people either feel a lot better with it or are unable to tolerate it because of the side effects.” Healthcare providers typically start patients on a low dose, gradually increasing to an effective dose while minimizing side effects. 

Gabapentin warnings and interactions

The gabapentin label has several warnings because it poses potentially life-threatening risks to some people. Specifically, some of the warnings include:

• Serious breathing problems, especially in people who take opioid pain relievers, older adults, and people with respiratory conditions like chronic obstructive pulmonary disease (COPD)
• Abuse and dependence, similar to the risks of opioid medications used to relieve pain
• Suicidal thoughts, which are rare but still worth noting, especially if you have any history of depression or past suicidal thoughts

If you are pregnant, planning to become pregnant, or breastfeeding, talk to your healthcare provider about taking gabapentin. Experts don’t know whether gabapentin is safe to use during pregnancy. Animal studies have shown a potential risk, but there is a lack of research on the drug’s effect on humans. 

A small amount of gabapentin shows up in the breast milk of nursing mothers, but it doesn’t appear to cause any harm to nursing babies. Still, you should always talk to your healthcare provider before using any medication while breastfeeding.

Some medications and substances can interact with gabapentin. Before taking gabapentin, tell your healthcare provider about all the medications you take, including prescription and  OTC drugs, vitamins, and supplements. You should avoid alcohol while taking gabapentin. Some drugs that may interact with gabapentin include:

• Opioid pain medicines such as morphine or oxycodone
• Any other medicine that makes you sleepy or dizzy
• Antacids such as Maalox

Talk to your healthcare provider about drug interactions and how they may affect you.

Proper use of gabapentin 

Dr. Curry says gabapentin is well-tolerated by many people, but its side effects can range from bothersome to dangerous. However, there may be ways for you to manage some of the bothersome side effects while taking this medication. 

For example, dizziness and drowsiness can be worse when you first start taking gabapentin, explains Dr. Curry, so your healthcare provider may help you slowly increase your dose over time to lessen these effects. “Similarly, taking your medication at night (or, if you take multiple doses per day, taking a larger dose at night) can alleviate symptoms like fatigue, sedation, and dizziness,” she adds. You should not drive or operate machinery until you know how gabapentin affects you.

However, you should never ignore dangerous side effects related to gabapentin. If you are having signs of an allergic reaction, difficulty breathing, or extreme confusion or sleepiness, you should seek urgent medical attention by calling 911 and going to the emergency room, or call or text 988 for the Suicide & Crisis Lifeline if you are experiencing sudden depression, any suicidal thoughts or ideations, or other sudden and significant changes to your mental health, like panic attacks, mania, insomnia, or aggression.

Bottom line

“For the most part, how quickly or slowly gabapentin works isn’t hugely impacted by factors like your age, weight, or sex,” says Dr. Curry. Older adults do often experience more gabapentin side effects than younger adults, though, and other medications you’re taking could interfere with how well gabapentin works for you.