CBD vs gabapentin for nerve pain

Nerve pain affects millions of people worldwide. It can be tricky to find effective relief since the nervous system is complex and unresponsive to many painkillers.

Two treatments that have gained attention are gabapentin, a prescription medication, and CBD (cannabidiol), a compound derived from hemp. While both can relieve nerve pain, they can cause side effects and require caution. We’ll compare both options based on current scientific evidence.

nama™ CBD gummies let you tap into the nerve pain-relieving properties of cannabis with lab-backed confidence and delicious flavors.

Gabapentin for nerve pain

Gabapentin is an anticonvulsant medication originally developed to treat seizures. Since its FDA approval in 1993, it has also been prescribed for neuropathic pain conditions, particularly postherpetic neuralgia (pain following shingles) and diabetic neuropathy.

How gabapentin relieves neuropathic pain

Gabapentin binds to voltage-gated calcium channels in the nervous system. This reduces the release of neurotransmitters that signal pain, which helps dampen the abnormal nerve signals characteristic of neuropathic pain.

Effectiveness of gabapentin for nerve pain

According to a comprehensive literature review, gabapentin is moderately effective at relieving neuropathic pain. The review found that at therapeutic doses of 1800–3600 mg daily, approximately 30–40% of patients with diabetic neuropathy or postherpetic neuralgia achieve at least 50% pain reduction, compared to 10–20% of those who received a placebo.

Gabapentin works best for specific neuropathies. Patients with postherpetic neuralgia and diabetic peripheral neuropathy respond better than those with other types of nerve pain. However, this means that for every patient who experiences significant relief, another may experience side effects without meaningful pain reduction.

Side effects of gabapentin

Most of gabapentin’s side effects are mild and similar to other pharmaceuticals. The include:

• Dizziness
• Drowsiness/somnolence
• Peripheral edema
• Gait disturbance
• Confusion
• Fatigue
• Headache

More than half of gabapentin users experience side effects. Some users also experience more severe side effects, including suicidal ideation. If you or a loved one has recently started taking gabapentin, keep in mind that these side effects can happen, and seek help from a professional if any issues arise.

Cognitive concerns with long-term gabapentin use

Recent research has raised serious concerns about gabapentin's long-term cognitive effects. The study found that patients who received six or more prescriptions of gabapentin showed a 29% increased risk of developing dementia and an 85% increased risk of mild cognitive impairment.

Even more concerning, these risks were more than doubled in adults aged 18–64, with younger adults (35–49 years) showing particularly elevated risks. The researchers noted that non-elderly adults prescribed gabapentin had over twice the risk of dementia and 2.5 times the risk of mild cognitive impairment compared to those not taking the medication.

CBD for nerve pain

CBD is a non-psychoactive cannabinoid that interacts with multiple systems in the body, including the endocannabinoid system, glycine receptors, and various ion channels involved in pain signaling.

How CBD relieves nerve pain

Research published in the Biomolecules Journal explains that CBD appears to reduce neuropathic pain through several mechanisms:

• Potentiating glycine receptors in the spinal cord, which inhibit pain signals
• Modulating inflammatory responses through interaction with immune cells
• Activating vanilloid receptors (TRPV1) involved in pain perception
• Affecting serotonin receptors that influence both pain and mood

Learn about the benefits of microdosing cannabis for neuropathic pain.

Is CBD effective for neuropathy treatment?

The evidence for CBD and neuropathic pain treatment is mixed but promising.

A study published in Current Pharmaceutical Biotechnology found that transdermal CBD significantly improved sharp pain, cold sensations, and itchy feelings in patients with peripheral neuropathy of the lower extremities. The treatment was well-tolerated with no adverse events reported.

The Cleveland Clinic Journal of Medicine notes that while preclinical studies are promising, clinical evidence remains limited. Some patients report substantial benefits, particularly with topical applications, while others experience minimal relief.

Research also indicates that CBD may work better in combination with other cannabinoids. Studies show that CBD combined with low-dose THC can provide synergistic pain relief while CBD helps counteract THC's psychoactive effects. Through this entourage effect, cannabinoids and terpenes work together to enhance therapeutic benefits beyond what any single compound achieves alone. 

Side effects of CBD

CBD generally has fewer serious side effects than gabapentin:

• Mild drowsiness
• Dry mouth
• Reduced appetite
• Diarrhea (primarily at high doses)
• Potential drug interactions through cytochrome P450 enzyme inhibition

CBD does not appear to cause the cognitive impairment, suicidal ideation, motor coordination problems, or dependence issues associated with gabapentin.

How to take CBD for nerve pain

Some people find results by taking a daily edible can provide baseline relief and a topical application for breakthrough pain. Allow 2–4 weeks of consistent use to evaluate effectiveness before you adjust your routine.

Topical CBD

Apply creams, balms, or gels directly to the painful area 2–3 times daily. Best for localized nerve pain like sciatica or peripheral neuropathy in hands and feet. Massage thoroughly into skin for better absorption. Effects typically begin within 15–45 minutes and last 2–4 hours.

CBD edibles

Gummies, capsules, or chocolates provide consistent, long-lasting relief. Start with 10–25 mg daily, preferably with food for better absorption. Effects take 1–2 hours to begin but last 4–8 hours. Ideal for widespread nerve pain or when you need all-day relief.

Our Pain Plus gummies combine 10 mg CBD with 10 mg THC and CBG, as well as 5 mg of CBN and CBC for enhanced pain relief through the entourage effect. 

CBD oils and tinctures

Place drops under the tongue and hold for 60 seconds before swallowing. Allows for precise dosing and faster onset (30–60 minutes) than edibles. Start with 0.25–0.5 ml and adjust as needed. Good for those who want flexible dosing control.

CBD drinks

Mix cannabis powder, such as our Buzz Packs, or liquid drops into beverages. Convenient for those who dislike pills or oils. Onset time is similar to edibles but may be slightly faster on an empty stomach. Easy to incorporate into daily routine.

Can CBD and gabapentin be taken together?

The interaction between CBD and gabapentin requires caution. Using gabapentin with cannabidiol may increase dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impaired thinking, judgment, and motor coordination.

While CBD and gabapentin are metabolized differently (gabapentin is eliminated unchanged by the kidneys while CBD is processed by liver enzymes), they both affect the central nervous system. This means their sedating and cognitive effects can be additive or even synergistic when combined.

The interaction between CBD and gabapentin can cause:

• Increased dizziness and drowsiness
• Confusion and cognitive impairment
• Difficulty concentrating
• Motor coordination problems
• Effects are more pronounced in elderly patients

Make an informed choice for neuropathy treatment

While gabapentin remains an evidence-based treatment for specific types of neuropathic pain, the emerging research about its cognitive risks warrants serious consideration, especially for long-term use. CBD shows promise as a safer alternative, though more clinical research is needed to establish dosing guidelines and delivery methods.

nama full-spectrum CBD gummies provide precisely measured doses of hemp-derived cannabinoids that naturally fight pain. We also offer broad-spectrum CBD gummies for those who need THC-free relief.

Always consult with a healthcare provider before starting, stopping, or combining any treatments for neuropathic pain.

Resources

Patel, R., & Dickenson, A. H. (2016). Mechanisms of the gabapentinoids and α 2 δ-1 calcium channel subunit in neuropathic pain. Pharmacology research & perspectives, 4(2), e00205. https://doi.org/10.1002/prp2.205

Eghrari, N. B., Yazji, I. H., Yavari, B., Van Acker, G. M., & Kim, C. H. (2025). Risk of dementia following gabapentin prescription in chronic low back pain patients. Regional Anesthesia & Pain Medicine, rapm-2025. https://doi.org/10.1136/rapm-2025-106577

Almuntashiri, N., Sharazly, B. M. E., & Carter, W. G. (2025). Are Cannabis-Based medicines a useful treatment for neuropathic pain? A systematic review. Biomolecules, 15(6), 816. https://doi.org/10.3390/biom15060816

Xu, D. H., Cullen, B. D., Tang, M., & Fang, Y. (2020). The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Current pharmaceutical biotechnology, 21(5), 390–402. https://doi.org/10.2174/1389201020666191202111534

Modesto-Lowe, V., Bojka, R., & Alvarado, C. (2018). Cannabis for peripheral neuropathy: The good, the bad, and the unknown. Cleveland Clinic Journal of Medicine, 85(12), 943–949. https://doi.org/10.3949/ccjm.85a.17115

Choi, J., Li, G., Stephens, K. L., Timko, M. P., & DeGeorge, B. R. (2025). The Use of Cannabinoids in the Treatment of Peripheral Neuropathy and Neuropathic Pain: A Systematic Review. The Journal of hand surgery, 50(8), 954–965. https://doi.org/10.1016/j.jhsa.2024.09.015 

Further reading

Should you microdose THC for pain?

Do Buzz Packs help with pain?

Is sativa or indica for pain relief?

Is Delta 8 or Delta 9 better for pain?

What terpenes are good for pain relief?

nama CBD FDA & legal disclaimer

Our cannabis products are not intended to diagnose, treat, cure, or prevent any disease. They are not a replacement for prescription medications and have not been evaluated by the Food and Drug Administration (FDA).

The information provided on this website does not and is not intended to constitute legal advice or any statements of the status of any laws. Any information, content, and materials available on this site are for general informational purposes only and are not intended to be relied upon for any purpose.

Readers of this website should contact their attorney to obtain advice concerning any particular legal matter, including decisions on what products are, or are not, legal to sell, possess, or consume. No reader, user, or browser of this site should act or refrain from acting based on information on this site without first seeking legal advice from their counsel in the relevant jurisdiction.

Only your attorney can provide assurances that the information contained herein—and your interpretation of it—is applicable or accurate for your particular situation. Use of, and access to, this website or any of the links or resources contained within the site do not create an attorney-client relationship between the reader, user, or browser, and website authors, contributors, contributing law firms, or committee members and their respective employers.