Gabapentin and Fatigue: How Common It Is, How Often It Occurs, and Practical Ways to Manage It

Fatigue is a recognized side effect of gabapentin, and it can occur in a noticeable minority of people who take the medicine. In clinical trials, fatigue occurred in about 11% of participants taking gabapentin compared with about 5% on placebo, indicating it is relatively common compared to not taking the drug. ^{[1] [2]} Gabapentin’s official patient and professional guides also list “feeling tired” (fatigue) among the most common side effects. ^{[3] [4]}

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How Common Is Fatigue with Gabapentin?

• Listed as a common side effect: Official medication guides for gabapentin consistently include “feeling tired” among the most common side effects. ^{[3] [5]}
• Trial‑reported frequency: In pooled adult trial data, fatigue was reported in approximately 11% of people on gabapentin versus 5% on placebo, supporting that fatigue is more frequent with gabapentin than without. ^{[1] [6]}
• Related CNS effects: Somnolence (sleepiness) and dizziness are also common and may overlap with how people experience fatigue day‑to‑day. ^{[7] [8]}

Selected Adverse Event Rates from Trials (Adults >12 years)

Side effect	Gabapentin (%)	Placebo (%)
Fatigue	11	5
Somnolence (sleepiness)	19	9
Dizziness	17	7
Ataxia (unsteady coordination)	13	6

These figures show that central nervous system (CNS) depressant‑type effects are relatively frequent with gabapentin, and fatigue sits within this cluster. ^{[1] [9]}

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Why Gabapentin Can Cause Fatigue

Gabapentin reduces neuronal excitability in the central nervous system, which can help pain and seizures but can also lower energy and increase sleepiness. Drugs acting on GABA‑related pathways tend to carry a higher risk of fatigue, and gabapentin is among those with notable incidence. ^[10] This CNS dampening can manifest as tiredness, sleepiness, slowed thinking, and coordination issues for some people. ^{[4] [11]}

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When Fatigue Is Most Noticeable

• Early in treatment or after dose increases: Feeling drowsy or tired is more likely when you start gabapentin or when the dose is increased, and it may improve as the body adjusts. ^{[12] [3]}
• With other sedatives or alcohol: Alcohol and other medicines that cause sleepiness can worsen gabapentin‑related fatigue and dizziness; combining them should be avoided unless a clinician advises otherwise. ^{[13] [14]}
• At higher doses or with renal impairment: As gabapentin doses rise, CNS adverse effects like somnolence and dizziness are reported more often; dose adjustments are recommended in kidney impairment to prevent excessive drug accumulation. ^{[15] [16]}

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Practical Strategies to Manage Fatigue

• Adjust timing: Taking larger portions of the daily dose in the evening can sometimes shift sleepiness away from daytime. Spacing doses no more than 12 hours apart helps maintain steady levels while allowing tailored timing. ^{[17] [18]}
• Slow titration: If starting or increasing gabapentin, a gradual approach may reduce early fatigue; if dose reduction or discontinuation is needed, taper gradually over at least one week to minimize withdrawal or rebound symptoms. ^{[19] [19]}
• Review dose and kidney function: If fatigue is persistent or problematic, discuss dose reduction or renal dose adjustment with a clinician; gabapentin dosing should be tailored to creatinine clearance. ^{[16] [20]}
• Avoid alcohol and sedating co‑medications: Steering clear of alcohol and other drugs that cause drowsiness can decrease additive fatigue and dizziness. ^{[13] [14]}
• Safety first: Because fatigue often coexists with dizziness and slowed thinking, avoid driving or operating machinery until you know how gabapentin affects you. This precaution is emphasized in official guidance due to the risk of falls and injuries. ^{[11] [3]}
• Give it time: For many people, tiredness improves after the body adapts over days to weeks; monitoring symptoms during this period is helpful. ^{[12] [3]}

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When to Contact Your Clinician

• Persistent or worsening fatigue: If fatigue does not improve with timing, titration, or avoidance of sedatives, it’s reasonable to reassess the dose or consider alternatives. ^{[15] [16]}
• Functional impact or safety concerns: If tiredness interferes with daily activities, driving, or increases fall risk, seek advice promptly. Gabapentin can slow thinking and motor skills, and professional guidance is recommended in such cases. ^{[11] [4]}
• Multiple side effects: If fatigue occurs alongside significant dizziness, gait unsteadiness, or other troublesome effects, it may be part of a broader tolerability issue that warrants adjustment. ^{[7] [15]}

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Key Takeaways

• Fatigue is a common gabapentin side effect and was reported in about 1 in 9 people on the drug versus about 1 in 20 on placebo in trials. ^{[1] [2]}
• Sleepiness and dizziness frequently accompany fatigue and increase the risk of falls; be cautious with driving or operating machinery. ^{[3] [11]}
• Management options include dose timing, slow titration, avoiding alcohol and other sedatives, and dose adjustment (especially with kidney issues). ^{[19] [16]}
• Many people find fatigue improves as the body adjusts, but if it remains problematic, speak with a clinician about tailoring your regimen. ^{[12] [15]}

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