Gabapentin for Migraine Prevention

Gabapentin is a drug that is approved to treat seizures in people with epilepsy. It is also approved to treat nerve pain from shingles, which is a painful rash caused by herpes zoster infection. It’s 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 is believed that this action can 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.

What is migraine?

A migraine is not just a headache. Migraines are usually more severe and last longer than headaches. Migraines can last as long as 72 hours. The major symptom of a migraine is pain that you usually feel on one side of your head. This pain is typically moderate or severe. Migraines also include other symptoms, such as nausea, vomiting, and severe sensitivity to light and sound.

About 20% of people who have migraines experience an aura before the pain begins. An aura is a group of symptoms. You could have some or all of the following symptoms during a migraine aura:

  • Changes in your vision, such as seeing squiggly lines or having short-term, partial vision loss
  • Difficulty talking
  • Tingling or numbness of any part of your body

Migraine triggers

It is not known exactly why people have migraines. However, some people can track their migraine back to a certain trigger. Migraine triggers can include stress, lack of sleep, certain foods, and even hormone changes during a menstrual cycle.

Migraine prevention

Some people can prevent migraines by avoiding triggers. Others have prevented migraines successfully through relaxation techniques, acupuncture, or exercise. However, these therapies alone don’t work for everyone. Some people also need treatment with medication to reduce the number of migraines they have. The drugs used to prevent migraines are different from drugs that to treat migraines once a migraine starts. Drugs that prevent migraines, such as gabapentin, must be taken daily.

International and domestic studies that have evaluated Neurontin for migraine prevention suggest that it is effective. In a study of 63 patients with migraine (with or without aura), gabapentin significantly reduced migraine frequency and intensity among 30 patients who received it. In this study, adverse events were mild to moderate in severity.

Similarly, in a large study, 143 people with migraine received daily doses of Neurontin or placebo for 12 weeks. At the end of 12 weeks, the migraine rate had declined from 4.2 migraines before treatment to 2.7 migraines after treatment in those who received this drug.

This decrease was significantly greater than the decrease from 4.1 migraines to 3.5 migraines among those who received placebo. Of the 56 gabapentin recipients, 46% had at least a 50% reduction in the four-week migraine rate. Drug-related adverse events (sleepiness and dizziness) led to drug withdrawal in 13% of patients in the gabapentin group compared with 7% in the placebo group. The researchers concluded that this medication is an effective and well-tolerated preventive for migraine.