These medications are sometimes used off-label to help with withdrawal symptoms, particularly anxiety and pain — but they carry their own considerations worth understanding.
What they’re used for in this context: Both are anti-seizure medications also used for nerve pain and anxiety; some prescribers use them off-label to help with withdrawal-related anxiety, sleep difficulty, or pain, though this isn’t an FDA-approved use for opioid withdrawal specifically.
The evidence: Limited but somewhat supportive for symptom relief in this context; these aren’t considered core, first-line withdrawal medications the way clonidine or lofexidine are, but some clinicians use them as an adjunct.
The misuse consideration: Gabapentin and pregabalin have their own, separate potential for misuse, particularly in people with a history of substance use disorder — combined with opioids, they can also increase respiratory depression risk. This isn’t a reason to avoid them entirely, but it is a reason for careful, monitored prescribing rather than open-ended use.
What this means practically: If a provider suggests one of these for withdrawal symptom management, it’s reasonable to ask directly about the plan for how long you’d use it and how it will be monitored, given the misuse consideration.
Medically reviewed by [pending]. Sources: clinical literature on gabapentinoid use in withdrawal management; FDA safety communications on gabapentinoid respiratory risk.