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Drug Info

Gabapentin side effects in men

There may be sexual side effects of gabapentin, but they’re not very common and are treatable
A pill bottle spilling out round tablets: Gabapentin side effects in men

Key takeaways

  • Gabapentin is an anticonvulsant medication that’s FDA approved to treat partial-onset seizures, postherpetic neuralgia, and restless leg syndrome. It’s also sometimes prescribed off-label for mood disorders, alcohol use disorder, and other types of neuropathic pain.

  • Gabapentin’s side effects are generally similar for men and women, although there’s some evidence that it can cause erectile dysfunction in men.

  • Side effects typically set in soon after beginning the medication and last several days to a few weeks, often subsiding as the body adjusts.

Research shows that men are generally more susceptible to seizures than women, and gabapentin (sold under the brand names Neurontin and Gralise) is one of the most common anticonvulsant medications out there. In fact, it’s kind of a jack-of-all-trades drug, approved by the Food and Drug Administration (FDA) to treat epilepsy, postherpetic neuralgia, and restless leg syndrome. It’s also prescribed off-label for other types of nerve pain, diabetic neuropathy, mood disorders, and alcohol use disorder.

Gabapentin may cause certain side effects, and some may occur solely in men.

Common gabapentin side effects in men

Gabapentin is similar to gamma-aminobutyric acid (GABA), a neurotransmitter (chemical messenger) that helps calm certain overactive neurons. “The pharmacokinetics of gabapentin are similar between males and females, but the effective dose requirement is lower in females than in males,” says Brandon Gish, MD, board-certified anesthesiologist and pain medicine specialist at Lexington Clinic. “There is no evidence for variance in efficacy between genders, but side effects tend to be more frequent in females, likely owing to the dosing differences.”

Research backs up the idea that women are actually more likely to experience gabapentin’s adverse effects than men. Those side effects, however, are largely similar. According to clinical trials, the most common adverse reactions for people who took gabapentin for epilepsy were sleepiness, dizziness, ataxia (problems with balance and coordination), fatigue, and involuntary eye movements. Other common side effects of gabapentin may include:

  • Swelling of the extremities
  • Tremors
  • Weakness
  • Diarrhea
  • Dry mouth
  • Infection
  • Sore throat
  • Cough
  • Constipation
  • Nausea
  • Vomiting
  • Accidental injury
  • Blurred vision or double vision
  • Lazy eye
  • Abnormal thinking
  • Weight gain
  • Slurred speech
  • Memory problems
  • Depression
  • Upset stomach

Sexual side effects are possible in both men and women, including decreased libido, difficulty reaching orgasm, erectile dysfunction (ED), and difficulty with ejaculation. That said, a 2019 study in the American Journal of Obstetrics & Gynecology showed that gabapentin might actually improve sexual function in women with vulvodynia (chronic pain in the vulva). Research hasn’t found sexual improvement to occur in men who take gabapentin.

Does gabapentin cause erectile dysfunction?

“It is important to be aware that gabapentin can indeed cause sexual side effects, including erectile dysfunction, in some patients,” says Haleem Mohammed, MD, a franchise administrator of Gameday Men’s Health. “Although these side effects are not among the most frequently reported, they can occur and may impact a patient’s quality of life.”

Erectile dysfunction isn’t listed as a potential side effect on the Neurontin label, but one study from 2011 links gabapentin to sexual dysfunction, and a 2022 review of the FDA Adverse Event Reporting System found over 130 cases of gabapentin-induced erectile dysfunction over 10 years. It doesn’t require immediate medical attention, but it’s important to communicate any side effects to a healthcare provider so they can address them.

Serious side effects of gabapentin

In rare cases, gabapentin might also cause serious side effects, including:

  • Severe allergic reactions (symptoms may include hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat)
  • Suicidal thoughts and behaviors
  • Muscle damage
  • Breathing problems (respiratory depression)
  • Withdrawal (if the medicine is stopped too quickly)

Anyone experiencing one or more of these serious problems should get emergency medical help right away.

How soon do gabapentin side effects start?

Everyone responds differently to gabapentin, so how soon side effects begin can vary, and some people might not experience any. That said, side effects can appear shortly after taking the first dose of gabapentin. Many neurological medications require time for the brain and body to adjust, so even though some patients might experience side effects right away, they may subside after several days. 

How long do gabapentin side effects last?

Again, it’s different for each person, but according to Poison Control, gabapentin’s side effects can last anywhere from several days to a few weeks. This can depend on factors such as the dose, the condition it’s treating, the patient’s other conditions and medications, or the patient’s lifestyle. “When starting gabapentin, it is best to start with the lowest dose and titrate slowly upward to effect, being observant of any side effects as they often present initially and can diminish after several weeks of treatment,” Dr. Gish says.

What are the long-term side effects of gabapentin?

Perhaps the most prevalent long-term side effect of gabapentin is its risk of addiction and abuse. It’s not federally classified as a controlled substance by the Drug Enforcement Administration, but some states consider it to be one. It’s less addictive than opioids, which is why it’s often used as an alternative for pain management, but research shows that gabapentin misuse is a growing and dangerous trend.

Case studies have reported gabapentin dependence and withdrawal, which often leads to misuse. But when someone uses gabapentin in ways other than it’s prescribed for, it leads to an increased risk of side effects. One study found that the rate of gabapentin misuse in the general population was 1.1%, but in drug abuse treatment centers, it was 22%—so it’s important to speak with your healthcare provider about any prior substance abuse issues.

Treatment of gabapentin ED

“Unfortunately, the best treatment to combat this side effect is to reduce the dose or discontinue the drug altogether under medical supervision,” Dr. Gish says. “Alternatively, one could wait until after sexual activity before taking the medication, but if multiple doses are taken throughout the day, this may prove unsuccessful.”

Healthcare providers make this determination on a case-by-case basis. “We take a comprehensive approach to evaluating potential medication-related ED. This involves assessing the patient’s overall health, reviewing all current medications, and considering other possible contributing factors such as underlying health conditions or psychological influences,” Dr. Mohammed says. “If gabapentin is suspected to be a contributing factor to ED, we may explore alternative treatment options or adjust the dosage. We also consider the use of ED medications for short-term management while the patient is on medications that can cause ED.”

How to avoid gabapentin side effects

The best way to deal with side effects is to prevent them from happening in the first place. Unfortunately, some side effects are unavoidable, but there are certain steps you can take to make them less likely. Here are a few:

  1. Talk to your healthcare provider: Before taking gabapentin, consult a healthcare professional for medical advice on potential side effects and how to avoid them. You should also tell them about any other prescription drugs, supplements, or over-the-counter medications you’re taking, since they may interfere with gabapentin or worsen side effects.
  2. Follow the dosing instructions: You might be eager to feel better, but taking more than the prescribed dose increases the risk of side effects. Healthcare providers sometimes prescribe the lowest dose to start and slowly increase it to help the patient adjust to their new medication.
  3. Drink plenty of water: This is good advice for your overall health, but also for preventing gabapentin side effects. Dry mouth and mild dehydration are both possible reactions, and drinking water can prevent or mitigate them.
  4. Take it with food: Since some of gabapentin’s side effects are gastrointestinal, taking it with a meal might help.
  5. Avoid alcohol: Drinking alcohol can cause central nervous system side effects like dizziness and drowsiness, which might compound gabapentin’s effects.
  6. Take it every day: If you forget to take gabapentin—especially if it’s for a few days in a row—withdrawal symptoms can kick in. But don’t take a double dose if you forget. Instead, just take the next dose as soon as you remember.
  7. Don’t go cold turkey: Stopping gabapentin abruptly can lead to withdrawal symptoms like anxiety, agitation, insomnia, fatigue, restlessness, irritability, dizziness, headache, sweating, nausea, and more. Follow your healthcare provider’s instructions to taper off gabapentin.

Bottom line: Is gabapentin safe?

Yes, the use of gabapentin is safe when it’s taken according to the prescribing healthcare provider’s exact instructions. But even safe prescription drugs can cause side effects, and for men, some of those gabapentin side effects might include sexual dysfunction. The good news is that those reactions are relatively uncommon, and even when they occur, there are ways to treat them. Just be sure to consult your healthcare provider before starting gabapentin treatment, and about any side effects you experience.