Research suggests 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.
TAKEAWAYS:
- CBD is most effective when used to supplement gabapentin, rather than replace it.
- Research suggests CBD can reduce the amount of gabapentin you need to take, but no studies have looked at using CBD to replace gabapentin all together.
- CBD and gabapentin can be taken at the same time because gabapentin is not metabolized by the liver.
What is Nerve Pain, and What Causes It?
Nerve pain, or neuralgia, is pain caused by damage to, or the injury of, 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, and cancer, as well as by infections like shingles and HIV/AIDS.
Additionally, conditions such as sciatica, fibromyalgia, and peripheral neuropathy can cause nerve pain.
Treatments for nerve pain (apart from addressing its root cause) include:
- Physical therapy
- Relaxation therapy
- Massage therapy
- Acupuncture
- Medicines such as gabapentin, pregabalin, topiramate, carbamazepine, and lamotrigine
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 Gabapentin?
Gabapentin is a medication in the drug class of anticonvulsants.
It’s known as 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.
What is CBD Oil?
Cannabidiol (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.
CBD is one of more than 100+ cannabinoids in hemp, but it’s one of the two most abundant, along with THC.
Preliminary research has investigated the therapeutic potential of CBD for pain, inflammation, anxiety, stress, sleep, and many other uses.
CBD oil is a CBD product that combines cannabinoid extracts with a carrier oil, such as hempseed oil or MCT oil.
Oil is one of the most popular CBD delivery methods for therapeutic purposes because it offers a fast onset and flexible dosing.
Research on Gabapentin for Nerve Pain
Gabapentin was first approved by the Food and Drug Administration (FDA) in the mid-1990s, and many studies indicate that it has the ability to reduce nerve pain.
One 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 [1].
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.
Research on CBD Oil for Nerve Pain
While CBD oil isn’t a proven treatment for nerve pain, preliminary research suggests CBD and cannabis products have therapeutic potential for this use.
In a 2020 study, University of Washington researchers examined the effects of CBD on pain caused by sciatic nerve injury.
Researchers concluded that cannabinoids have the potential to provide “long-term relief of chronic pain states” for people with this condition [2].
Another study investigated the benefits of CBD for nerve pain. The researchers found that CBD helped to reduce the amount of gabapentin that patients needed to take.
The researchers also found that neuropathic pain patients using any kind of cannabis-based medicine (CBD, THC, etc.), were hospitalized for fewer total days than those not using these natural supplements [3].
Anecdotally, many people use CBD for sciatica, a type of nerve pain.
Based on this research, it’s clear that CBD has therapeutic potential for people dealing with nerve pain. However, more studies are needed to further confirm these results.
CBD Oil vs. Gabapentin: How They Work for Nerve Pain
CBD and gabapentin work differently in the body to render their benefits. Here’s a bit about the mechanism of action of each:
How Gabapentin works
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, in essence, GABA, and is designed to mirror its function in the body.
GABA reduces the excitability of nerve cells (neurons) in the brain, which play a role in seizures and the transmission of pain signals. By doing the same thing, Gabapentin calms excited neurons and reduces pain.
How CBD works
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.
Ultimately, the job of the ECS is to keep your mind and body in a state of balance and good health.
There are two types of receptors in your ECS:
- CB1 receptors, which influence the mind if stimulated
- CB2 receptors, which influence the body if stimulated
Although CBD doesn’t bind strongly to the CB1 or CB2 receptors as many cannabinoids do, research suggests that it supports the function of your ECS by preventing the breakdown of its natural processes [4].
There is also research suggesting that CBD can help with pain by increasing the levels of the neurotransmitters anandamide and serotonin in your body [5,6]. Higher levels of these neurotransmitters are associated with reductions in pain sensations.
More clinical research is needed before we understand exactly how CBD works for nerve pain. However, the research so far indicates CBD has substantial therapeutic promise in this area.
CBD Oil vs. Gabapentin for Nerve Pain: Side Effects & Safety
Although it’s an effective painkiller, gabapentin has quite a few adverse effects. CBD’s side effects, on the other hand, are comparatively very mild.
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
- Coordination problems & tremors
Potential side effects of CBD include:
- Dry mouth
- Drowsiness
- Diarrhea
- Reduced appetite
- Fatigue
Given the study above, in which patients taking CBD were able to use less gabapentin, it seems that CBD may have the benefit of allowing patients to reduce their reliance on gabapentin, and therefore experience fewer downsides.
Can You Take CBD With Gabapentin?
Yes, you can take CBD and gabapentin together. While CBD does have interactions with some drugs, it doesn’t interact harmfully with gabapentin.
Normally, CBD causes problems with drugs that are metabolized (transformed by the body such that they can be easily eliminated) by the liver. Because CBD inhibits liver enzymes, it prevents the breakdown of drugs, causing them to build up in the liver in potentially toxic concentrations.
But 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.
Other Natural Alternatives to Gabapentin for Nerve Pain
CBD is a naturally occurring compound in the cannabis sativa plant, and research and anecdotal evidence suggest it has therapeutic potential for nerve pain.
However, it isn’t your only option. There are many naturally-occurring pain relievers that work similarly to gabapentin:
- 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.
There are many natural supplements and methods you can use to manage nerve pain. However, remember that the most effective treatments usually integrate traditional and alternative medicine.
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?
So, is CBD an alternative to gabapentin?
Based on what we know, it makes more sense to use CBD 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.
CBD is, however, 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.
Does CBD take away nerve pain?
Research suggests CBD may promote physical comfort and relaxation, and it’s commonly used for nerve pain-related conditions, like sciatica. However, more research is needed before we know whether or not CBD can take away nerve pain.
What’s a natural alternative to gabapentin?
Natural alternatives to gabapentin include CBD, cayenne, vitamin B12, zinc, and exercise.
Can you mix gabapentin and CBD?
Yes, you can safely mix gabapentin and CBD. CBD won’t cause a drug interaction with gabapentin, because gabapentin isn’t metabolized by the liver.
Is CBD better than gabapentin for nerve pain?
Preliminary research suggests CBD has therapeutic potential for nerve pain, and studies have indicated that CBD may reduce the amount of gabapentin patients need to take. However, more research on CBD is needed before we know if it can reliably reduce nerve pain, and no research directly comparing CBD and gabapentin has been done.
Sources
[1] 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
[2] 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
[3] 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
[4] 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
[5] 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
[6] 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
