Gabapentin-Induced Severe Vivid Nightmares: A Case Series and Brief Review.

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.