- Gabapentin became the fifth most prescribed medication in the U.S. in 2024, according to a CDC analysis.
- From 2010 to 2024, prescriptions soared from 79.5 to 177.6 per 1,000 individuals.
- Older adults and women saw the most significant increases in prescribing rates.
In recent years, the use of gabapentin has surged. The generic medication was reported as the fifth most dispensed drug in American retail pharmacies for 2024, as indicated by a CDC analysis.
Between 2010 and 2024, the number of prescriptions climbed from 79.5 to 177.6 per 1,000 people, based on findings from Gery Guy Jr., PhD, and others from the CDC’s National Center for Injury Prevention and Control.
The total individuals receiving gabapentin skyrocketed from 5.8 million in 2010 to 15.5 million in 2024. This represented an increase from 18.9 to 46.9 prescriptions per 1,000 people over that period.
Initially, from 2010 to 2016, the prescribing rates doubled but the growth rate slowed between 2016 and 2024.
“Even though the increase in gabapentin prescriptions has decelerated since 2016, it remains on the rise and is now the fifth most prescribed drug in the U.S. as of 2024, compared to tenth place in 2017,” Guy and his co-authors noted.
“Some states have enacted policy changes since 2016, such as including gabapentin in prescription monitoring programs and redesignating it as a Schedule V controlled substance, possibly leading to reduced prescriptions in those regions,” they added.
Gabapentin is primarily approved for treating seizures and postherpetic neuralgia, while gabapentin enacarbil is indicated for restless legs syndrome. Despite its limited uses, gabapentin, along with pregabalin, is commonly prescribed off-label for various other pain-related conditions.
Common side effects include drowsiness, dizziness, blurred or double vision, and coordination issues. In 2019, the FDA warned of serious respiratory issues that could arise among gabapentin or pregabalin users with certain risk factors, including those taking opioids or those with conditions that impair lung function.
“The rise in gabapentin prescribing from 2010 through 2024 shows ongoing trends of increased usage in the U.S.,” remarked Tasce Bongiovanni, MD from the University of California San Francisco, who did not participate in the study.
“It’s vital to closely monitor gabapentin use—both for new and ongoing prescriptions—especially in older patients who may also be using opioids, due to the potential for harmful side effects,” Bongiovanni added.
The analysis conducted by Guy and his colleagues utilized data from the IQVIA National Prescription Audit and Total Patient Tracker pharmaceutical databases, examining trends in gabapentin prescriptions from 2010 to 2024. They pointed out that these databases account for about 94% of retail prescriptions dispensed in the U.S.
In 2024, women (57.1 per 1,000) and adults aged 65 and older (114.7 per 1,000) received prescriptions at higher rates compared to 2016. Prescription rates for older adults increased by 33.7% from 2016 to 2024, more than any other demographic.
Primary care providers were the leading prescribers in 2024, reaching 22.6 prescriptions per 1,000 individuals.
Interestingly, there was a significant rise in gabapentin prescriptions issued by advanced practitioners like nurse practitioners and physician assistants, from 2.5 to 19.5 prescriptions per 1,000 individuals over the study period. This might reflect extended prescribing privileges in some states, though further examination is necessary, according to Guy and his colleagues.
The study acknowledged that prescriptions filled outside of retail settings, such as hospitals or long-term care facilities, were not included, and that detailed clinical specialties for nurse practitioners and physician assistants were not available.
“Our research indicates a slowed but persistent increase in gabapentin dispensing from retail pharmacies in the U.S.,” concluded Guy and his team. “As gabapentin use remains on the rise, especially among older individuals, it’s crucial for prescribing healthcare providers to be aware of the potential adverse effects associated with its use.”
