Gabapentin is a prescription medication that belongs to a class of drugs called anticonvulsants. It is mainly used to treat seizures and nerve pain caused by shingles, but it can also be prescribed off-label for other conditions, such as anxiety 1.
Gabapentin was first discovered in the 1970s by researchers at Parke-Davis, a subsidiary of Pfizer. It was initially developed as a muscle relaxant, but later showed promise as an antiepileptic drug. It was approved by the FDA in 1993 for the treatment of partial seizures in adults and children 2. Since then, it has been widely prescribed for various indications, including neuropathic pain, restless leg syndrome, bipolar disorder, and anxiety 1.
The exact mechanism of action of gabapentin is not fully understood, but it is believed to affect the activity of certain neurotransmitters in the brain, such as gamma-aminobutyric acid (GABA) and glutamate. GABA is an inhibitory neurotransmitter that reduces neuronal excitability and has a calming effect on the nervous system. Glutamate is an excitatory neurotransmitter that stimulates neuronal activity and is involved in learning and memory. Gabapentin may enhance the effects of GABA and reduce the effects of glutamate, thereby restoring the balance between these two neurotransmitters and reducing anxiety 3 4.
The evidence for the use of gabapentin for anxiety is limited and mixed. There are no randomized controlled trials on the effectiveness of gabapentin for generalized anxiety disorder (GAD), and only a few case reports and small studies on its use for other types of anxiety, such as social anxiety disorder (SAD), panic disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) 5 6.
A 2020 review of seven clinical trials found that gabapentin may be better than a placebo for situational anxiety, such as public speaking or medical procedures, but not much better. The review also found that gabapentin may have some advantages over benzodiazepines, such as less sedation, less dependence, and less withdrawal symptoms 5.
A 2017 meta-analysis of 12 studies found that gabapentin may be effective for alcohol withdrawal syndrome, which often co-occurs with anxiety disorders. The meta-analysis concluded that gabapentin can reduce alcohol consumption, craving, withdrawal symptoms, and anxiety in people with alcohol use disorder.
However, more research is needed to confirm the efficacy and safety of gabapentin for anxiety and to compare it with other treatments.
Gabapentin should be taken with or without food as directed by the doctor. It should not be crushed, chewed, or broken. It should be swallowed whole with plenty of water. It should not be taken with antacids containing aluminum or magnesium within 2 hours of taking gabapentin, as they may interfere with its absorption.
Gabapentin should not be stopped abruptly without consulting the doctor, as this may increase the risk of seizures or withdrawal symptoms. The dose should be tapered off gradually over at least a week.
Gabapentin is generally well tolerated by most people, but it may cause some side effects or adverse reactions in some cases. The most common side effects are drowsiness, dizziness, fatigue, headache, nausea, vomiting, diarrhea, dry mouth, weight gain, edema (swelling), blurred vision, tremor, and difficulty concentrating 1.
Some people may experience more serious side effects or adverse reactions, such as allergic reactions (rash, itching, swelling), breathing problems (slow or shallow breathing), mood changes (depression, hostility, agitation), suicidal thoughts or behaviors, memory impairment, confusion, hallucinations, seizures, or kidney problems 1.
Gabapentin may also interact with other medications or substances that affect the central nervous system (CNS), such as opioids (painkillers), antihistamines (allergy medications), antidepressants, antipsychotics, alcohol, and marijuana. These interactions may increase the risk of CNS depression, which can cause excessive sedation, respiratory depression, coma, or death 1 .
Gabapentin is contraindicated in people who are allergic to gabapentin or any of its ingredients. It should be used with caution in people who have kidney disease, liver disease, heart disease, diabetes, mental health problems, or a history of substance abuse or dependence 1 .
Gabapentin may have some positive aspects or advantages over other treatments for anxiety, such as:
Gabapentin may also have some negative aspects or disadvantages compared to other treatments for anxiety, such as:
Gabapentin is a prescription medication that is mainly used to treat seizures and nerve pain, but it can also be prescribed off-label for anxiety. The evidence for its use for anxiety is limited and mixed. It may be better than a placebo for situational anxiety and alcohol withdrawal syndrome, but not much better. It may have some advantages over benzodiazepines, such as less sedation, dependence, and withdrawal symptoms. However, it may also cause various side effects or adverse reactions in some people. It may interact with other medications or substances that affect the CNS. It may have a potential for misuse or abuse in some people. Therefore, gabapentin should be used with caution and under the supervision of a doctor for anxiety.
1: Gabapentin (Oral Route) Proper Use - Mayo Clinic
2: Gabapentin - Wikipedia
3: Gabapentin for Anxiety: Benefits, Risks, and Alternatives - Psych Central
4: Gabapentin (Neurontin) - NAMI
5: Gabapentin for Anxiety: A Systematic Review - PubMed
6: Gabapentin for Depression, Mania, and Anxiety - PsyCom
: Efficacy of Gabapentin in the Treatment of Alcohol Use Disorder in Patients With Alcohol Withdrawal Symptoms: A Meta-analysis of Randomized Controlled Trials - PubMed
: Gabapentin (Oral Route) Side Effects - Mayo Clinic
: Sexual Side Effects of Antidepressants: SSRIs and SNRIs - Healthline
: Gabapentin Prices, Coupons & Savings Tips - GoodRx
: The Misuse Potential of Gabapentin and Pregabalin: A Systematic Review - PubMed
Neurontin (Gabapentin) has been used for years for anxiety. In this video I explain how Gabapentin works and why it works for Anxiety as well as seizures. I talk about my personal experience taking Gabapentin and how it worked for me.