Gabapentinimproves sleep in the presence of alcohol

Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine (Impact Factor: 3.05). 08/2005; 1(3):284-7.
Source: PubMed


To evaluate the ability of a single dose of gabapentin to improve sleep disruption caused by alcohol consumption.
Double-blind, randomized, single-dose, crossover study of normal subjects (age 21-45 years) who were free of known sleep disorders or medical conditions that could interfere with sleep. Subjects first received baseline polysomnography and, upon awakening, subjective scales of drowsiness and functioning. One to 2 weeks later, they returned to the sleep lab. They consumed 4 ounces of 40% alcohol and gabapentin (300 or 600 mg) or placebo 1 hour prior to bedtime. Polysomnography and subjective scales were repeated. One to 2 weeks later, subjects returned and were given the same dose of alcohol and the other treatment, followed by repeat testing. Differences between baseline and placebo (alcohol) results were compared to the difference between baseline and gabapentin (alcohol) by paired t tests.
Thirteen subjects were enrolled; 12 completed the study. Mean age was 30.8 years (range 25-37 years). No difference in total sleep time was seen for any of the groups. Gabapentin (300 or 600 mg) showed a significant decrease in stage 1 (9.3% vs 5.5%) and number of awakenings (11 vs 6) with increased sleep efficiency (93% vs 96.2%). Subjects receiving 600 mg also showed increased slow wave sleep, decreased rapid eye movement sleep, and decreased arousals. No differences were seen in any of the subjective tests of drowsiness and performance.
Single-dose gabapentin at bedtime can improve sleep through decreased stage 1 sleep, increased slow-wave sleep, increased sleep efficiency, and decreased arousals. Gabapentin may be useful in the treatment of conditions in which frequent awakenings and decreased sleep efficiency are seen.

20 Reads
  • Source
    • "Indeed, low GABA levels are associated with, restlessness, anxiety, insomnia and a poor mood state [106–108]. Dietary GABA supplement in clinical studies relieves anxiety and increases alpha brain waves, which are associated with relaxation [109–111]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Drugs used to treat anxiety have many negative side effects including addiction, depression, suicide, seizures, sexual dysfunction, headaches and more. Anxiolytic medications do not restore normal levels of neurotransmitters but instead manipulate the brain chemistry. For example, selective serotonin reuptake inhibitors (SSRIs) prevent the reuptake of serotonin from the synapse allowing serotonin to remain in the area of activity for a longer period of time but does not correct the lack of serotonin production. Benzodiazepines, such as Valium and Xanax®, stimulate GABA receptors, thus mimicking the calming effects of GABA but again do not fix the lack of GABA production. Often, the brain becomes accustomed to these medications and they often lose their effectiveness, requiring higher doses or different drugs. In contrast to anxiolytic drugs, there are herbs and nutrients which can stimulates neurotransmitter synthesis and more naturally effect and even adjust brain chemistry in the absence of many of the side effects experienced with drugs. Therefore this paper explores several herbal and nutritional approaches to the treatment of anxiety.
    Medical science monitor: international medical journal of experimental and clinical research 04/2012; 18(4):RA40-8. DOI:10.12659/MSM.882608 · 1.43 Impact Factor
  • Source
    • "Felbamate has stimulant-like effects in epileptics (Ketter et al., 1996) and has been associated with insomnia (Leppik, 1995). Gabapentin increases SWS in healthy controls (Rao et al., 1988; Foldvary-Schaefer et al., 2002), including those who consumed alcohol prior to bedtime (Bazil et al., 2005). The most common side-effect of gabapentin when given three times daily in placebo-controlled trials as an adjunctive anticonvulsant was somnolence (19% versus 9% on placebo) (Beydoun et al., 1995). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Numerous substances can result in sleep dysfunction by directly altering brain systems that regulate sleep. Substances can also cause sleep dysfunction indirectly by exacerbating an illness or disorder associated with sleep impairment (for example, caffeine can exacerbate reflux disease causing pain and discomfort that disturb sleep). Substances included in this chapter are drugs of abuse, prescription medications, substances obtained over the counter and off the shelf in stores, and toxic heavy metals. The chapter focuses on the clinical studies and observations. Substance-related, population related, and methodology-related factors influence the observed effects of a substance on sleep in clinical research. Substance related factors include dose, timing of dose, acute versus chronic use, withdrawal from use, pharmacokinetics, mechanism of action, and interactions with other drugs. Population-related factors include age, gender, weight, genetics, psychological traits and states, and health status. Methodological factors include sample size, study design, and type of outcome measures (e.g., nocturnal sleep versus daytime sleepiness; self-report versus polysomnography (PSG))
    Handbook of Clinical Neurology 12/2011; 98:587-612. DOI:10.1016/B978-0-444-52006-7.00038-1
  • Source
    • "By contrast, studies of gabapentin to treat acute alcohol withdrawal reveal mixed results (Bonnet et al., 2003, 2007; Mariani et al., 2006; Voris et al., 2003). The potential efficacy of gabapentin to prevent relapse is particularly notable because it has low addictive potential (with some recently reported exceptions [Pittenger and Desan, 2007; Victorri- Vigneau et al., 2007]), does not undergo hepatic metabolism and has few interactions with other medications (Beydoun et al., 1995), is relatively safe when combined with alcohol (Bazil et al., 2005; Bisaga and Evans, 2006; Myrick et al., 2007), and is not associated with fatal overdoses when taken alone (Klein-Schwartz et al., 2003) Gabapentin was also safe and well-tolerated in this study. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Insomnia and other sleep disturbances are common, persistent, and associated with relapse in alcohol-dependent patients. The purpose of this pilot study was to compare gabapentin versus placebo for the treatment of insomnia and prevention of relapse in alcohol-dependent patients. Twenty-one subjects, including 10 women who met study criteria for alcohol dependence and insomnia and expressed a desire to abstain from alcohol, were recruited to the study. During a 1 to 2 week placebo lead-in and screening phase, a complete medical history, physical exam, blood tests, urine drug test, and structured interviews were performed to determine eligibility and patterns of alcohol use and sleep. Insomnia due to intoxication or acute withdrawal, psychiatric or medical illness, medications, and other sleep disorders were ruled out. Subjects were then randomized to either placebo (n = 11) or gabapentin (n = 10) for 6 weeks and titrated over a 10-day period to 1,500 mg or 5 pills at bedtime. After a 4-day taper, subjects were reassessed 6 weeks after ending treatment. Gabapentin significantly delayed the onset to heavy drinking, an effect which persisted for 6 weeks after treatment ended. Insomnia improved in both treatment groups during the medication phase, but gabapentin had no differential effects on sleep as measured by either subjective report or polysomnography. Because gabapentin is a short-acting medication that was taken only at nighttime in this study, it may possibly exert a nocturnal effect that prevents relapse to heavy drinking by a physiological mechanism not measured in this pilot study.
    Alcoholism Clinical and Experimental Research 07/2008; 32(8):1429-38. DOI:10.1111/j.1530-0277.2008.00706.x · 3.21 Impact Factor
Show more


20 Reads
Available from