Gabapentin-Induced Severe Vivid Nightmares: A Case Series and Brief Review.
Jamal Hasoon, Anvinh Nguyen, Negaar Ada Safabakhsh, Omar Viswanath, Christopher L Robinson
Psychopharmacology Bulletin September 18, 2026 DOI: 10.64719/pb.20779 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Patients treated with gabapentin for spinal pain syndromes |
| Interventions | Gabapentin Pregabalin |
| Topics | Dreaming |
| Keywords | Adverse drug reaction Gabapentinoids Neuropathic pain Nightmares Sleep disturbance |
| Key findings | Argues that severe vivid nightmares may be an underreported psychiatric side effect of gabapentin. In two patients treated for spinal pain, nightmares resolved after gabapentin was discontinued and treatment was switched to pregabalin. |
Abstract
Gabapentin is widely prescribed for neuropathic and radicular pain syndromes. While somnolence and dizziness are well-recognized adverse effects, severe vivid nightmares may constitute an underreported psychiatric side effect that can significantly impair quality of life and treatment adherence. We present two cases of gabapentin-induced severe vivid nightmares in patients treated for spinal pain syndromes. Management strategies included medication discontinuation and transition to pregabalin. Both patients experienced resolution of nightmares following intervention. This report reviews the existing literature on gabapentin's effects on sleep architecture and discusses potential mechanisms, clinical implications, and management approaches.