Gabapentin is effective at reducing nerve pain, but it has a lot of negative side effects. As a result, many people seek natural alternatives to gabapentin for nerve pain, such as hemp-derived CBD.
While CBD oil isn’t a proven replacement for gabapentin, research suggests that it has therapeutic potential to promote physical comfort as you manage your condition.
In this article, we give a thorough comparison of CBD oil vs. gabapentin for nerve pain so you can choose the option that best fits your needs.
Understanding Nerve Pain & Its Causes
Nerve pain, or neuralgia, is pain caused by damage to the nerves that feel pain. It may also stem from damage to the brain itself. It’s commonly characterized as a stabbing, shooting, or burning sensation.
Nerve pain can be caused by multiple sclerosis, diabetes, stroke, cancer, sciatica, fibromyalgia, and peripheral neuropathy, as well as by infections like shingles and HIV/AIDS.
Common treatments for nerve pain include:
- Physical therapy
- Relaxation therapy
- Massage therapy
- Acupuncture
- Medicines (gabapentin, pregabalin, topiramate, and others)
Typically, multiple modes of treatment are required to address nerve pain. In other words, patients aren’t just given gabapentin — they might also undergo physical therapy and acupuncture at the same time.
What is CBD Oil?
CBD oil is a liquid cannabidiol (CBD) product made by combining hemp extract with a carrier oil, such as MCT oil or hempseed oil.
CBD is a naturally-occuring cannabinoid in the cannabis sativa plant. When CBD is derived from hemp, a variant of cannabis sativa containing less than 0.3% THC by dry weight, it’s federally legal.
Preliminary research has investigated the therapeutic potential of CBD for pain, inflammation, anxiety, stress, sleep, and many other uses.
Oil is one of the most popular CBD delivery methods for therapeutic purposes because it offers flexible dosing and rapid onset.
What is Gabapentin?
Gabapentin is a medication in the drug class of anticonvulsants. It’s an analog of gamma aminobutyric acid (GABA), an acid within the body that reduces the excitability of nerve cells, which helps to reduce pain signaling.
Gabapentin was originally developed to treat seizures, but it’s now commonly used for treating nerve pain and restless leg syndrome.
How CBD Oil Works for Nerve Pain
CBD works for nerve pain by supporting your endocannabinoid system (ECS). The ECS is a receptor system in your body that’s responsible for regulating your vital functions, including the inflammatory and pain response [1]. By supporting and maintaining your ECS, CBD helps to promote physical balance.
Research also suggests that CBD increases the levels of the neurotransmitters anandamide and serotonin in your body [2,3]. Higher levels of these neurotransmitters are associated with reductions in pain sensations.
Through these mechanisms, CBD may have the following benefits for nerve pain:
- Analgesic & anti-inflammatory properties: Research suggests CBD may have analgesic (pain-reducing) and anti-inflammatory properties for nerve pain. A 2020 study looking at pain caused by sciatica concluded that cannabinoids have the potential to provide “long-term relief of chronic pain states” for people with this condition [4].
- Neuroprotective properties: A 2013 study found that CBD has neuroprotective properties. This is important for nerve injury and pain, as it suggests CBD may support the regeneration and repair of damaged nerves [5].
- Reduced reliance on other medicines: A 2022 study found that CBD use reduced the amount of gabapentin that nerve patients need to take [6].
It is important to note that, despite this preliminary research, CBD is not an FDA-approved treatment for nerve pain and more studies are needed before we know whether it reliably renders these benefits.
CBD products like the ones we sell are not designed to diagnose, cure, treat, or prevent any condition or disease.
How Gabapentin Works for Nerve Pain
Gabapentin is an analog of gamma aminobutyric acid (GABA), a neurotransmitter in the brain. An analog is a synthetic version of something else; gabapentin is designed to mirror the function of GABA in your body.
GABA reduces the release of excitable neurons, as well as the excitability of already-released neurons in the brain, which play a role in seizures and the transmission of pain signals. By fulfilling the same function, gabapentin calms excited neurons and reduces pain.
Through this mechanism, gabapentin has the following benefits for nerve pain:
- Analgesic and anti-inflammatory properties: Gabapentin may reduce nerve pain directly. A 2017 research review looked at 530 patients who had either postherpetic neuralgia (related to shingles) or painful diabetic neuropathy. Patients of postherpetic neuralgia experienced twice as much pain relief when given gabapentin versus a placebo (dummy non-medicine substance), and patients of painful diabetic neuropathy experienced 1.5 times as much pain relief when given gabapentin versus a placebo [7].
- Pain stimuli control: Gabapentin may change the way you experience painful stimuli. In a 2021 study of chemotherapy-induced peripheral neuropathy, gabapentin significantly alleviated mechanical allodynia and thermal hyperalgesia in mice, demonstrating its analgesic potential in treating heightened pain responses for nerve pain patients [8].
- Sleep-supportive properties: Gabapentin may improve sleep disturbances that often accompany chronic nerve pain. A 2010 research trial found that gabapentin improved sleep outcomes in people with insomnia [9].
Gabapentin is FDA-approved for the treatment of nerve pain. There are many other studies that show similar results; this is just an example of what research says about the pain-relieving benefits of gabapentin.
CBD Oil vs. Gabapentin for Nerve Pain: Differences & Similarities
Here’s a breakdown of the differences and similarities between CBD oil and gabapentin for nerve pain:
Mechanism of action
Gabapentin binds to calcium channels in the nervous system, reducing nerve signal activity, while CBD oil works by interacting with your endocannabinoid system and neurotransmitters like serotonin and anandamide.
Gabapentin targets nerve signals directly, while CBD promotes relaxation by supporting your body’s regulatory systems in a more comprehensive way.
Benefits
Gabapentin is an FDA-approved treatment for nerve pain and related conditions. It reduces nerve pain and alters the way your body processes certain types of pain signals.
CBD is a natural supplement. While not approved by the FDA, research and anecdotal evidence suggests it can promote physical comfort and restful sleep.
Side effects
While it’s an effective painkiller, gabapentin has many adverse effects. Potential side effects of gabapentin include tiredness, dizziness, headache, nausea and vomiting, fever, difficulty speaking, recurring infections, memory loss, unusual eye movements and double vision, weight gain, and coordination problems & tremors.
CBD on the other hand, is comparatively mild. Potential side effects of CBD include dry mouth, drowsiness, diarrhea, reduced appetite, and fatigue.
Prescription status
Gabapentin requires a prescription to be used for nerve pain and other uses. CBD oil is sold over-the-counter if it contains under 0.3% THC. Gabapentin access is restricted; CBD is more widely available.
Legality
Gabapentin is legal with a prescription, though state rules vary. CBD is federally legal as long as it’s hemp-derived and the final product contains less than 0.3% THC (its legality does vary by state, however).
Drug interactions
Both gabapentin and CBD may interact with other medications. Gabapentin may increase sedation with other CNS depressants, while CBD can alter drug metabolism via liver enzyme interactions.
Because of this, always consult a medical professional before using either option if you’re already taking medications.
Other Natural Alternatives to Gabapentin for Nerve Pain
CBD has shown a lot of therapeutic promise at promoting physical comfort, but it’s not your only natural alternative to gabapentin. Here are some others:
- Cayenne: Research suggests capsicum annuum in the herb cayenne is useful for the treatment of neuropathic pain and post-herpetic neuralgia.
- Vitamin B12: Vitamin B12 supplements may help to naturally manage post-herpetic neuralgia and neuropathy. It is believed that B12 promotes myelination and improves the efficiency of the electrical transmission of nerves.
- Zinc: This is a natural trace element found in the central nervous system that’s known to regulate pain. Taking zinc supplements may help with nerve pain.
- Exercise: Research suggests that exercise (such as yoga) is beneficial against nerve pain, especially that which is related to spinal cord injuries. People who participate in yoga are shown to take less pain medication for chronic pain.
For the best results, we recommend talking to your doctor about how you can use CBD and natural options alongside gabapentin or the other medicine you’ve been prescribed.
Conclusion: Is CBD a Viable Alternative to Gabapentin for Nerve Pain?
CBD should be used to supplement gabapentin, rather than completely replace it.
From a strength and efficacy standpoint, gabapentin will bring more intense relief than CBD will. It’s a medically-proven, FDA-approved painkiller.
On the other hand, while CBD has shown promise, more studies are needed to confirm its efficacy for people with nerve pain. However, it’s more versatile than gabapentin: while gabapentin only reduces pain, CBD promotes both mental and physical health.
CBD functions in a fundamentally different way than gabapentin does — neither is necessarily more effective. Instead, they can each play a role in supporting your health as you navigate nerve pain.
Related: CBG for Nerve Pain
CBD Oil vs. Gabapentin for Nerve Pain: Frequently Asked Questions
Here are some questions our customers frequently ask us about CBD oil vs. gabapentin for nerve pain.
What’s a natural alternative to gabapentin?
Natural alternatives to gabapentin include CBD, cayenne, vitamin B12, zinc, and exercise.
Can you take CBD and gabapentin together?
Yes, you can take CBD and gabapentin together. While CBD does have interactions with some drugs, it doesn’t interact harmfully with gabapentin. Since gabapentin isn’t metabolized by the liver and doesn’t need to be broken down by your liver enzymes, it isn’t dangerous if used alongside CBD.
What form of CBD is best for neuropathy?
While CBD isn’t a proven treatment for neuropathy, full-spectrum CBD will generally be the most effective for promoting physical comfort. Full-spectrum CBD contains all the naturally-occurring compounds in hemp, which make it more therapeutically beneficial than CBD isolate.
Is gabapentin similar to CBD?
Gabapentin and CBD have some similar benefits – both substances may promote physical comfort and restful sleep. However, they’re also very different: gabapentin has many more side effects than CBD, and it’s FDA-approved as a painkiller while CBD is not.
Sources
[1] Haney, Margaret. “Cannabis Use and the Endocannabinoid System: A Clinical Perspective.” The American journal of psychiatry vol. 179,1 (2022): 21-25. doi:10.1176/appi.ajp.2021.21111138
[2] Hua, Daniel Ying-Heng et al. “Effects of cannabidiol on anandamide levels in individuals with cannabis use disorder: findings from a randomised clinical trial for the treatment of cannabis use disorder.” Translational psychiatry vol. 13,1 131. 21 Apr. 2023, doi:10.1038/s41398-023-02410-9
[3] De Gregorio, Danilo et al. “Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain.” Pain vol. 160,1 (2019): 136-150. doi:10.1097/j.pain.0000000000001386
[4] Abraham, Antony D et al. “Orally consumed cannabinoids provide long-lasting relief of allodynia in a mouse model of chronic neuropathic pain.” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 45,7 (2020): 1105-1114. doi:10.1038/s41386-019-0585-3
[5] Fernández-Ruiz J, Sagredo O, Pazos MR, García C, Pertwee R, Mechoulam R, Martínez-Orgado J. Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid? Br J Clin Pharmacol. 2013 Feb;75(2):323-33. doi: 10.1111/j.1365-2125.2012.04341.x. PMID: 22625422; PMCID: PMC3579248.
[6] Hjorthøj, Carsten et al. “Cannabis-based medicines and medical cannabis for patients with neuropathic pain and other pain disorders: Nationwide register-based pharmacoepidemiologic comparison with propensity score matched controls.” European journal of pain (London, England) vol. 26,2 (2022): 480-491. doi:10.1002/ejp.1874
[7] Wiffen, Philip J et al. “Gabapentin for chronic neuropathic pain in adults.” The Cochrane database of systematic reviews vol. 6,6 CD007938. 9 Jun. 2017, doi:10.1002/14651858.CD007938.pub4
[8] Klazas, M., Naamneh, M. S., Zheng, W., & Lazarovici, P. (2022). Gabapentin Increases Intra-Epidermal and Peptidergic Nerve Fibers Density and Alleviates Allodynia and Thermal Hyperalgesia in a Mouse Model of Acute Taxol-Induced Peripheral Neuropathy. Biomedicines, 10(12), 3190. https://doi.org/10.3390/biomedicines10123190
[9] Lo HS, Yang CM, Lo HG, Lee CY, Ting H, Tzang BS. Treatment effects of gabapentin for primary insomnia. Clin Neuropharmacol. 2010 Mar-Apr;33(2):84-90. doi: 10.1097/WNF.0b013e3181cda242. PMID: 20124884.
