Gabapentin is a drug that’s approved to help prevent seizures in people with epilepsy and treat nerve pain from shingles. It’s also sometimes used off-label for migraine prevention.
Gabapentin belongs to a class of drugs called anticonvulsants. A class of drugs is a group of medications that work in a similar way.
Anticonvulsants help calm nerve impulses. It’s believed that this action may help prevent migraine pain.
This drug comes as a capsule, tablet, or solution. You take it by mouth.
Gabapentin is available as the brand-name drugs Neurontin, Gralise, and Horizant. It’s also available as a generic drug.
Off-label drug use
Using a drug off-label means that a drug has been approved by the FDA for one purpose, and it’s being used for a different purpose that hasn’t been approved. A doctor can still prescribe it for this purpose because the FDA regulates the testing and approval of drugs, not how doctors use them to treat their patients. Your doctor can prescribe a drug off-label if they think it’s best for your care.
Gabapentin’s role in migraine prevention isn’t well known.
It’s believed that it may influence electrical activity in the brain through neurotransmitters and block calcium channels. It may also be a factor in reducing excitatory neurotransmitters like glutamate.
Still, more research needs to be done to determine why it works.
Generally, gabapentin isn’t used as a primary therapy for migraine prevention, but as an additional treatment to support other therapies.
The drugs used to prevent migraine attacks are different from drugs that treat an acute attack. Drugs that prevent migraine symptoms, such as gabapentin, must be taken on an ongoing basis to work properly.
The dosage for gabapentin for migraine ranges from 300 to 3,600 milligrams (mg) per day, depending on your age and other health factors.
Gabapentin for migraine prevention can be taken with or without food and comes in an extended release tablet, an immediate release tablet, or an oral solution.
Side effects of gabapentin include:
- vision changes such as blurred vision
- unusual eye movements
- ataxia (loss of coordination)
- swelling in the limbs or feet
It’s important to follow your doctor’s recommendations on dosage and weaning off of the medication if needed. Never take more than is recommended by your doctor, even if you miss a dose.
Results from some clinical trials have shown a modest benefit to using gabapentin for migraine prevention.
However, in 2013, the American Academy of Neurology (AAN) — the organization that provides guidance for the use of drugs to prevent migraine attacks — stated that there’s not enough evidence at this time to support the use of gabapentin for migraine prevention.
More recent data has supported the use of gabapentin when other preventive therapies haven’t worked, or as an additional treatment.
A 2016 study showed evidence that gabapentin benefits headache syndromes, but it still wasn’t recommended as a primary therapy.
If you’re experiencing migraine attacks or your current treatments aren’t working, speak with your doctor about migraine prevention options.
Your doctor knows your medical history and can be the best person to help you find a treatment plan that will work for you.
While your doctor may prescribe gabapentin off-label, they’ll likely have you first try commonly used migraine prevention drugs if you haven’t already tried them.
Your insurance company may be more likely to cover these drugs for preventing migraine than an off-label drug. However, many plans do cover gabapentin for migraine prevention, so if you have insurance, you can call your company to find out.