Neurontin side effects: what to expect and how to handle them

Gabapentin (Neurontin) helps many people with nerve pain and seizures, but it also causes side effects. Dizziness and drowsiness are the most common, affecting about 10–30% of users. Other frequent issues include tiredness, coordination problems, blurred vision, and weight gain. Most of these improve in a few days or weeks as your body adjusts.

Common and serious side effects

Here are the common side effects to watch for:

  • Dizziness and sleepiness: can make driving or operating machinery unsafe.
  • Unsteady walk and coordination loss: may cause falls, especially in older adults.
  • Peripheral swelling: ankles and feet can swell; this is usually mild but can bother daily activities.
  • Weight gain and increased appetite: track your weight if you start gabapentin.
  • Blurred or double vision: often resolves, but report persistent vision changes.
  • Dry mouth, nausea, and constipation: manageable with diet and hydration.

Serious but less common reactions:

  • Mood changes or depression: gabapentin has been linked to new or worsening mood problems and, rarely, suicidal thoughts. Tell your prescriber if you feel unusually sad, hopeless, or notice mood swings.
  • Allergic reactions: hives, facial swelling, or breathing trouble need immediate emergency care.
  • Severe rash or fever: stop the drug and seek medical advice.
  • Respiratory depression when combined with opioids or alcohol: never mix without medical approval.

How to manage interactions, risks, and stopping

How it interacts and who should be careful:

Kidney function matters. Gabapentin is cleared by the kidneys, so lower doses are needed if you have reduced kidney function.

Antacids with magnesium or aluminum can reduce gabapentin absorption. Take gabapentin two hours after such antacids.

Combining gabapentin with opioids, benzodiazepines, or heavy drinking increases sedation and breathing risks.

Pregnant or breastfeeding women should talk to their doctor about risks and benefits.

Practical tips to reduce side effects:

  • Start low and go slow. Many prescribers ramp up the dose to reduce dizziness and sleepiness.
  • Take your dose at night if it makes you sleepy.
  • Avoid driving or risky tasks for the first few days or after a dose increase.
  • Stay hydrated and watch salt intake to reduce swelling.
  • Keep a symptom diary: note side effects, when they occur, and how severe they are. This helps your clinician adjust treatment.

Stopping safely:

Do not stop gabapentin suddenly. Withdrawal can cause increased seizures, anxiety, or insomnia. Your clinician will recommend a taper.

If you notice severe symptoms — trouble breathing, chest pain, fainting, severe rash, or suicidal thoughts — seek emergency care. For mild problems, call your prescriber to discuss dose changes or switching medications. Honest, early communication with your healthcare provider prevents small side effects from becoming big problems.

Most side effects show up in the first two to four weeks; if problems continue beyond a month, ask about changing drugs. Alternatives include pregabalin, certain antidepressants used for nerve pain, or topical treatments — each has its own risks. Make sure your kidney tests are up to date and report any new problems at follow-up visits. Keep questions ready and don’t tolerate avoidable harm. Ask for a taper plan.