Gabapentin for Sleep: Does It Work, and What Are the Risks?

Gabapentin (Neurontin) is a prescription medication that’s FDA approved to treat certain types of seizures and nerve pain. It has many off-label uses, too, such as for anxiety, fibromyalgia, and hot flashes. But what about taking gabapentin for sleep? Is it a safe and effective option? Here’s what you should know.

What does the research say about taking gabapentin for sleep?

Drowsiness is one of the most commonly reported gabapentin side effects. So it’s not surprising that gabapentin is sometimes prescribed to help people sleep.

Most studies on gabapentin for sleep are in people who have sleep troubles due to other health conditions, such as alcohol use disorder, hot flashes during menopause, and fibromyalgia. One large review of studies found that gabapentin improved sleep for people with these and other conditions. But people also often stopped taking it due to side effects, and many also experienced withdrawal symptoms.

We don’t have much research on whether gabapentin is effective for insomnia (trouble sleeping) that isn’t caused by an underlying health condition. Some small studies show that low doses of gabapentin (250 mg or 500 mg) may help you sleep longer, but it doesn’t seem to help you fall asleep faster.

So, what’s the verdict?

Gabapentin isn’t considered a first-choice option for insomnia. But if your insomnia is caused by another condition that gabapentin helps treat, such as nerve pain or hot flashes, your prescriber may recommend it.

What are the risks of taking gabapentin for sleep?

Like any medication, gabapentin has possible side effects and drug interactions to consider before taking it.

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Common gabapentin side effects

In addition to drowsiness, other common gabapentin side effects include:

• Dizziness

• Edema (excess fluid)

• Coordination problems

• Weight gain

• Blurred vision

Some of these side effects may cause fewer issues if you’re only taking gabapentin at bedtime. But it’s common to take gabapentin several times a day if you’re also treating another health condition. Regardless, it’s best to be careful when you first start taking it. Avoid doing any activities that require alertness (such as driving) until you know how gabapentin affects you.

Serious gabapentin risks

Gabapentin isn’t an opioid. But it does have a risk for misuse and dependence. In fact, gabapentin is classified as a controlled substance in some states. So it may not be the best choice if you have a history of substance misuse.

Other rare, but serious gabapentin side effects include: 

• Severe allergic reactions

• Trouble breathing or overdose — especially when combined with other sedating medications, such as opioids or benzodiazepines

• Withdrawal symptoms, such as agitation and restlessness, if you stop taking gabapentin abruptly

• Suicidal thoughts or behaviors

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• Gabapentin interactions: Learn about which medications could interact with gabapentin and how to manage side effects.

Drug interactions

Most gabapentin interactions occur with medications or substances that also cause drowsiness, such as: 

• Alcohol

• Opioid pain medications

• Some over-the-counter (OTC) antihistamines, such as diphenhydramine (Benadryl)

• Benzodiazepines, such as alprazolam (Xanax)

• Prescription sleep medications, such as zolpidem (Ambien)

In fact, the FDA issued a warning in 2019 about the dangers of combining gabapentin with these substances. In some cases, your prescriber might still OK combining gabapentin with the above substances. But you shouldn’t do so on your own.

Who shouldn’t take gabapentin?

Gabapentin is generally safe. But some people are more likely to experience gabapentin side effects. This includes people who:

• Are age 65 or older 

• Have kidney problems

• Take other medications that cause drowsiness

• Drink alcohol

• Have a history of substance misuse

What are alternatives to gabapentin for sleep?

Experts generally recommend making lifestyle changes to improve sleep over taking medications, especially in the long term. Some lifestyle changes you might try include:

• Following a set wake and sleep schedule every day

• Limiting use of screens before bed

• Keeping your bedroom dark and cool

• Avoiding caffeine late in the day

If you’re still having trouble sleeping, it’s best to check in with your healthcare team. They may be able to pinpoint an underlying cause, which may help resolve your sleep issues. They may also recommend OTC products or prescription medications that can help you get some Zs. We’ll cover a few of these options below.

OTC options

OTC sleep aids are typically best for occasional sleep troubles. They aren’t recommended for long-term use, and they have side effects and drug interactions to consider. So it’s best to check with your prescriber or pharmacist before trying one.

Two common OTC options for sleep are:

• Benadryl (diphenhydramine): Though it’s mostly used for allergies, Benadryl is also FDA approved for short-term use (less than 2 weeks) for sleep problems. Due to a higher risk of side effects — such as constipation, dizziness, and falls — it’s usually not recommended for older adults.

• Melatonin: Melatonin supplements can help you fall asleep faster. But they’re typically most effective for sleep problems due to jet lag or a change in your sleep schedule. Still, 3 mg to 5 mg of melatonin at bedtime is considered a safe option for most adults. Just don’t take it for more than a week or two without a prescriber’s OK.

Prescription medications

Common prescription sleep medications include:

• Z-drugs, such as zolpidem and zaleplon (Sonata) 

• Ramelteon (Rozerem)

• Orexin antagonists such as suvorexant (Belsomra) or daridorexant (Quviviq)

• Some benzodiazepines, such as temazepam (Restoril)

• Some antidepressants, such as doxepin (Silenor) and trazodone

The best sleep medication may depend on your specific needs. For example, some sleep medications are better at helping you fall asleep, while others are better at helping you stay asleep. Also, some sleep medications are controlled substances, while others aren’t. Your prescriber can help you find the right sleep medication based on your personal history and preferences.

Keep in mind that most prescription sleep medications are only meant for chronic insomnia (trouble sleeping at least 3 times a week for 3 months). And most aren’t approved for long-term use, either. If your sleep troubles persist without a clear cause, it may be necessary to do a sleep study. This can help your healthcare team find out what’s going on and how to address it.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Austin Ulrich, PharmD, BCACP

​​Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. Ulrich’s experience includes direct patient care in hospital and community pharmacies.

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