Multiple sclerosis (MS) is a disease that causes the immune system to attack the fatty coating on nerve cells known as myelin. As a result, this causes nerve symptoms such as numbness and muscle twitching. One treatment you may be prescribed is gabapentin (sold as Neurontin and Gralise), which helps ease these symptoms. Some MyMSTeam members have asked about gabapentin and how effective it is. Others have shared their experiences with the medication.

What Is Gabapentin?

Gabapentin was originally approved by the U.S. Food and Drug Administration (FDA) as an anticonvulsant drug, which is used to treat seizures in people with epilepsy. Its unique mechanism of action makes it versatile, and it is also used to treat postherpetic neuralgia, the painful burning sensation that lasts after a shingles attack. An extended-release form of gabapentin is used to treat restless legs syndrome (RLS).

In neurological conditions like seizures, gabapentin works to calm abnormal excitement in the brain. It also changes how the body perceives pain signals, acting as a pain reliever. Researchers aren’t quite sure how gabapentin treats RLS.

How Is Gabapentin Used To Treat Numbness in MS?

In addition to its approved uses, gabapentin can also be prescribed “off-label” (for a non-FDA-approved use) for treating symptoms of MS caused by nerve damage. It’s often used to treat neuropathic pain (nerve pain), numbness, pins and needles, or burning sensations known as paresthesia. Gabapentin may also be used to treat muscle spasms and nystagmus, which is an uncontrollable condition in which the eyes move back and forth rapidly.

Researchers aren’t quite sure how gabapentin works to treat numbness and muscle twitching in MS. A few studies have looked at gabapentin for treating muscle spasms in MS, and they found that it significantly improved spasticity (muscle stiffness and pain) compared to a placebo (inactive drug). Other studies from the Iranian Journal of Pharmaceutical Research have looked at gabapentin for treating numbness in different conditions such as carpal tunnel syndrome. However, there are no studies that explore gabapentin as a treatment specifically for numbness and muscle twitching in MS.

MyMSTeam Members and Their Experiences With Gabapentin

One MyMSTeam member asked, “My hands have been numb with the pins-and-needles feeling along with the tingling sensation since February. I’ve been taking gabapentin since April, and I am now up to eight pills a day. My question is, did or does anyone else have this problem and if so, did the gabapentin help? If it did help, how long did it take for the numbness to go away?”

Other members replied with their experiences taking gabapentin. One shared, “I have numbness in my hands and my legs. The numbness in my legs has gone away, but my hand is still numb. I am on gabapentin as well. I have 600 mg three times a day.”

“I know for me, gabapentin prevents the painful muscle spasms. As far as the numbness I get, it seems like it will always be that way,” shared another member.

Another MyMSTeam member asked, “Has anyone had success at treating muscle twitching with gabapentin? For the past two months, I have had bodywide muscle twitching. At night, my body jerks, and it is very difficult to sleep. I’ve now been on 600 mg of gabapentin at bedtime and sleep through the night, which is wonderful! However, I’m still having bodywide twitching during the day. My left arm is also very fatigued and at times feels weaker than the right.”

Another member in a similar situation replied, “My neurologist prescribed one gabapentin capsule prior to bedtime to allow me to sleep and also control the involuntary movement of my legs. The gabapentin capsule worked very OK through the night.”

Side Effects of Gabapentin

Like all medications, gabapentin has several possible side effects. MyMSTeam members have described some of the side effects they’ve experienced. One member shared, “I was on gabapentin for about six months, but it caused greater degrees of fatigue. Reduced from 600 mg to 300 mg to 100 mg and am now off of it. Tried taking caffeine pills to reduce fatigue, and it did not work.”

The most common side effects of gabapentin include:

• Extreme tiredness or fatigue
• Sleepiness or drowsiness
• Sedation, or a decline in motor skills and thinking
• Vision problems, such as blurry or double vision
• Anxiety
• Nausea and vomiting
• Diarrhea or constipation
• Dizziness
• Difficulty remembering things
• Weight gain
• Dry mouth
• Fever
• Peripheral edema (swelling in feet, ankles, legs, hands, and arms)

These side effects tend to be worse when first starting gabapentin, and they’ll likely get better over time as your body adjusts to the medication.

Gabapentin may also cause more serious side effects. For example, some people may have an allergic reaction to the drug. If you notice any of these symptoms, seek medical attention immediately, as they may be life-threatening:

• Swelling of your lips, tongue, face, throat, or eyes
• Itching or skin rashes
• Trouble breathing or swallowing
• Hoarseness of your voice

Who Should Not Take Gabapentin?

Like all medications, gabapentin may not be for everyone. People who shouldn’t use gabapentin include those who are pregnant or breastfeeding because it can lead to early birth or babies with low birth weight.

Gabapentin shouldn’t be taken at the same time as heartburn medications such as antacids because they can interfere with how well the drug is absorbed in the stomach. The less gabapentin that’s absorbed, the less effective it is. It’s recommended to wait at least two hours between taking gabapentin and antacids.

Gabapentin works on the central nervous system to slow down signaling related to breathing. If you have a condition that causes breathing problems (such as chronic obstructive pulmonary disease) or if you take medications that affect your ability to breathe (such as opioid painkillers), gabapentin may not be for you. The FDA has issued a warning for those with underlying lung conditions or taking other medications along with gabapentin. People who do not have these risk factors are less likely to experience breathing problems while taking gabapentin.

Talk to Your Doctor if You Have Questions About Gabapentin

Talk to a health care professional if you’re concerned about symptoms like numbness or muscle twitching. They can go over the risks and benefits of gabapentin to help determine the right choice for you. They may recommend prescribing other treatment options used to manage MS symptoms.

Talk With Others Who Understand

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, more than 193,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Do you use gabapentin to treat numbness or muscle twitching? Does it work well? Share your experience in the comments below, or start a conversation by posting on your Activities page.