In multiple sclerosis (MS), the immune system attacks nerve cells, causing symptoms such as numbness and muscle spasms. Some people with MS are prescribed gabapentin (sold as Neurontin and Gralise) to help manage these symptoms. But is gabapentin effective for muscle spasms? Some MyMSTeam members have shared their questions and experiences about using this medication for MS.

What Is Gabapentin?

Gabapentin was first 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 way of working makes it useful for other conditions, too, such as postherpetic neuralgia — the painful burning sensation that can happen after a shingles attack.

In neurological conditions like seizures, gabapentin works to calm abnormal brain activity by binding to calcium channels (parts of nerve cells that help send signals). The drug also changes how the body perceives pain signals, acting as a type of pain reliever.

How Is Gabapentin Used To Treat Numbness in MS?

In addition to its approved uses, gabapentin can be prescribed off-label (for a non-FDA-approved purpose) to help manage MS symptoms caused by nerve damage. It’s often used to treat different types of 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, a condition in which the eyes move back and forth quickly without control.

The dose of gabapentin for muscle spasms can vary. Always take gabapentin and other medications exactly as prescribed by your doctor.

Neurology researchers aren’t exactly sure how gabapentin works to treat numbness and muscle twitching in MS. A few studies have looked at gabapentin for treating MS-related muscle spasms, and they found that it significantly improved spasticity (muscle stiffness and pain) compared with a placebo (inactive drug). Additional research on nerve-related symptoms in other conditions has also shown that gabapentin helps with neuropathic pain and spasticity.

Here’s what the research says about using gabapentin to treat nerve pain and muscle symptoms in MS and other conditions:

• Systematic reviews of gabapentin for neuropathic pain, such as nerve pain after shingles or related to diabetes, show that about 30 percent to 40 percent of people had significant pain relief.
• One small MS-specific clinical trial looked at gabapentin’s effects on spasticity and muscle cramping. The findings showed benefits for participants taking a certain dose three times a day.

However, no studies have specifically explored gabapentin as a treatment for numbness and muscle twitching in MS.

Is Gabapentin a Strong Muscle Relaxer?

Gabapentin isn’t considered a traditional muscle relaxant like baclofen. However, by calming overactive nerve signals, it may help reduce painful muscle spasms and stiffness. Research shows that gabapentin is effective at managing MS-related spasticity and muscle symptoms, especially at moderate doses.

MyMSTeam Members and Their Experiences With Gabapentin

“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,” one MyMSTeam member said. “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, describing their experiences:

• “I’ve been on gabapentin long term. I have never felt any relief, but my neurologist says he has nothing else to offer me.”
• “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.”

Another MyMSTeam member asked, “Has anyone had success at treating muscle twitching with gabapentin? For the past two months, I have had body-wide muscle twitching. At night, my body jerks, and it’s very difficult to sleep. I’ve been taking it at bedtime and sleep through the night, which is wonderful! However, I’m still having body-wide twitching during the day.”

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

Side Effects of Gabapentin

Like all medications, gabapentin can cause side effects, as some MyMSTeam members have described. One member shared, “I was on gabapentin for about six months, but it caused greater degrees of fatigue.”

The most common side effects of gabapentin include:

• Extreme sleepiness or drowsiness, affecting motor skills and thinking
• Vision problems, such as blurry or double vision
• Anxiety
• Nausea and vomiting
• Diarrhea or constipation
• Dizziness
• Difficulty with memory
• Weight gain
• Dry mouth
• Fever
• Swelling in feet, ankles, legs, hands, and arms

These side effects tend to be worse when first starting gabapentin and often get better over time as your body adjusts.

Gabapentin may also cause more serious side effects. For example, some people may have an allergic reaction. If you notice any of these potentially life-threatening symptoms, get medical attention immediately:

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

Who Should Not Take Gabapentin?

Gabapentin isn’t right for everyone. People who are pregnant or breastfeeding should avoid this medication because it can increase the risk of early birth or low birth weight.

Gabapentin also shouldn’t be taken at the same time as some heartburn medications, such as antacids with magnesium and aluminum, because they can interfere with how well gabapentin is absorbed in the stomach. It’s best to wait at least two hours between taking gabapentin and these antacids.

Gabapentin affects the central nervous system and may slow down signaling related to breathing. If you have breathing problems (such as chronic obstructive pulmonary disease) or take medications that affect breathing (such as opioid painkillers), gabapentin may not be safe for you. The FDA has issued a warning for people with lung conditions or people taking these types of medications. People who don’t have these risk factors are less likely to experience breathing problems while taking gabapentin.

Talk to Your Doctor

Talk to a healthcare 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 if it’s the right choice for you. They may also suggest other treatment options to help manage MS symptoms and improve your quality of life.

Find Your Team

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, 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.