Relapse remains a prevalent and significant problem in alcoholism, even after long periods of abstinence. Vulnerability to relapse is associated with an intense craving or desire to drink, so if we can help those cravings that’s great, right? Well new studies show that gabapentin, already used for neuropathic pain and seizure disorders, may reduce cravings and thus alcohol consumption in patients with alcohol dependence.
In a new large study, patients with alcohol dependence receiving gabapentin were more likely to remain abstinent or avoid heavy drinking and were less likely to have cravings. These results suggest using gabapentin 900 – 1800 mg a day worked better than placebo in patients with alcohol use disorder.
Gabapentin has been around forever, is well tolerated, and is available as a generic so that’s encouraging news. Naltrexone (Revia) and acamprosate (Campral) are also used for alcohol dependence to reduce cravings but both are more expensive than gabapentin. There are no head to head studies comparing these three medications for this purpose so we don’t know which one is better.