Can I Take Gabapentin and Diazepam Together? Understanding the Risks

October 14, 2025 •

3 min read

The U.S. Food and Drug Administration (FDA) has issued specific warnings about serious breathing problems when gabapentinoids are combined with central nervous system (CNS) depressants like diazepam. Wondering, can I take gabapentin and diazepam together? This combination poses significant health risks.

Quick Summary

Combining gabapentin and diazepam (Valium) significantly increases risks of severe sedation, respiratory depression, cognitive impairment, and overdose. This is because both are Central Nervous System (CNS) depressants.

Key Points

Dangerous Interaction: Taking gabapentin and diazepam together is highly risky as both are CNS depressants, which can lead to synergistic, life-threatening effects.
Respiratory Depression: The most serious risk is severe respiratory depression (slowed or stopped breathing), which can be fatal, a danger highlighted by the FDA.
Impaired Function: The combination significantly impairs cognitive and motor skills, increasing the risk of accidents. Effects include extreme drowsiness, confusion, and poor coordination.
Overdose Risk: The synergistic effects increase the chance of an accidental overdose, the symptoms of which include unresponsiveness and bluish skin.
Medical Supervision is Crucial: This combination should only be used under the strict supervision of a doctor, who will use low doses and monitor the patient closely.
Different Mechanisms, Similar Effect: Gabapentin works on calcium channels while diazepam enhances GABA, but both result in slowing down the central nervous system.
Vulnerable Populations: The elderly and individuals with pre-existing respiratory conditions like COPD are at a much higher risk for severe complications.

A Dangerous Combination: The Risks of Mixing Gabapentin and Diazepam

Taking gabapentin and diazepam together can lead to a dangerous interaction with potentially life-threatening consequences. Both medications are Central Nervous System (CNS) depressants, meaning they slow down brain activity. When used in combination, their effects are not just additive, but can be synergistic, amplifying the risks exponentially. The U.S. Food and Drug Administration (FDA) has issued a warning about the risk of serious breathing difficulties when gabapentinoids (like gabapentin) are used with other CNS depressants, a category that includes diazepam and other benzodiazepines.

This interaction is classified as 'Major' or 'Moderate' by interaction checkers, which advise avoiding the combination unless under special, strictly monitored circumstances. The primary dangers include excessive drowsiness, dizziness, confusion, difficulty concentrating, and significant impairment of judgment and motor coordination. For elderly patients, the risk of falls and other injuries is particularly heightened.

Understanding Gabapentin (Neurontin)

Gabapentin is an anticonvulsant and analgesic drug that is structurally similar to the neurotransmitter GABA. Its primary action involves binding to a specific part of voltage-gated calcium channels in the brain, which reduces the release of excitatory neurotransmitters. This helps manage seizures and nerve pain. It is also used off-label for other conditions. While typically not causing severe respiratory depression alone, its depressive effects are amplified with other CNS depressants.

Understanding Diazepam (Valium)

Diazepam, a benzodiazepine, enhances the effects of the inhibitory neurotransmitter GABA at the GABA-A receptor, producing a calming effect on the CNS. It is used for anxiety, muscle spasms, seizures, and alcohol withdrawal. Diazepam carries risks of sedation, dependence, and respiratory depression, which increase significantly when combined with other depressants.

Comparison of Gabapentin and Diazepam


Feature	Gabapentin (e.g., Neurontin)	Diazepam (e.g., Valium)
Drug Class	Gabapentinoid, Anticonvulsant	Benzodiazepine
Primary Mechanism	Binds to voltage-gated calcium channels (α2δ-1 subunit), reducing excitatory neurotransmitter release.	Enhances the effect of the inhibitory neurotransmitter GABA at the GABA-A receptor.
Primary Uses	Seizures, neuropathic pain, restless legs syndrome.	Anxiety, muscle spasms, seizures, alcohol withdrawal.
Common Side Effects	Drowsiness, dizziness, fatigue, ataxia (poor coordination).	Drowsiness, fatigue, muscle weakness, ataxia.
DEA Schedule	Not a federally controlled substance (in most states).	Schedule IV controlled substance.

The Amplified Dangers of Co-Ingestion

The most severe risk of combining gabapentin and diazepam is profound respiratory depression, which can be fatal. Both drugs suppress the brain's drive to breathe. The FDA has reported cases of respiratory depression, including deaths, involving gabapentinoids and concurrent CNS depressant use.

Additional risks include:

Intense Sedation and Drowsiness: Leading to increased accident risk.
Impaired Cognitive and Motor Function: Making activities like driving dangerous.
Increased Risk of Overdose: The synergistic effect narrows the margin of safety. Overdose symptoms can include extreme drowsiness, confusion, slow breathing, and unresponsiveness.
Higher Risk for Specific Populations: The elderly and those with respiratory issues are particularly vulnerable.

When Might This Combination Be Prescribed?

This combination is rarely prescribed together and only under strict medical supervision due to the risks. In complex cases, such as certain seizure disorders, a doctor might weigh the potential benefits against the risks. If prescribed, doses will be low, increased cautiously, and patients will receive strict instructions on monitoring for side effects and avoiding other depressants like alcohol.

Conclusion: Prioritize Safety and Medical Guidance

Combining gabapentin and diazepam carries significant risks of severe sedation, cognitive impairment, and life-threatening respiratory depression and should be avoided unless directed by a healthcare professional. Always follow your doctor's instructions and discuss any concerns about prescribed medications. Never adjust doses or combine medications on your own.

For more information on drug safety, you can visit the FDA's Drug Safety and Availability page.

Frequently Asked Questions

Taking gabapentin and diazepam together can cause additive central nervous system depressant effects, leading to increased side effects like dizziness, drowsiness, confusion, difficulty concentrating, and impaired judgment and motor coordination.

No, it is generally not considered safe and should be avoided. Both are central nervous system depressants, and mixing them significantly increases the risk of severe side effects, including life-threatening respiratory depression.

The most serious risk is respiratory depression, which is severe, slowed, or stopped breathing. This can be fatal, especially when these CNS depressants are combined or taken by individuals with respiratory issues.

In rare cases, such as for managing complex seizure disorders unresponsive to other treatments, a doctor may decide the benefits outweigh the risks. This would be done with extreme caution, starting at low doses and with close patient monitoring.

Signs of overdose include extreme sleepiness, confusion, slurred speech, slowed or shallow breathing, unresponsiveness (not waking up), and blue-tinted lips or skin (cyanosis).

No. Alcohol is also a CNS depressant and will greatly potentiate the sedative and respiratory depressant effects of this combination, making it extremely dangerous. You should avoid alcohol completely.

Gabapentin primarily works by binding to voltage-gated calcium channels to reduce the release of excitatory signals. Diazepam works by enhancing the effects of GABA, an inhibitory neurotransmitter, to calm the nervous system.