Psychiatry & Medication

Gabapentin for Anxiety

The Bottom Line

  • Gabapentin is a generic medication used off-label for anxiety.
  • It is not approved by the FDA for anxiety.
  • Available in tablets, capsules, and oral solution.

What is Gabapentin?

Gabapentin is a generic anticonvulsant/antiepileptic used for anxiety in adults. It is a generic formula for Neurontin. Primarily, it is approved only to treat seizures. Off-label indication involves the treatment of anxiety, mood disorders, and certain withdrawal symptoms from abuse of drugs or alcohol. It is occasionally prescribed when no other medication responses or causes severe side effects. It is not intended for use in pediatrics for anxiety disorders.

The precise mechanism of how Gabapentin provides anti-anxiety effect is unknown. Still, the medication is believed to imitate the gamma-Aminobutyric acid (GABA) action, and thus, to affect certain chemicals in the brain in charge of nervous system activity.

It is available in oral tablets, capsules, and oral solution.

Can Gabapentin be taken for Anxiety? 

Gabapentin is prescribed only as an off-label medication to treat anxiety. It can only moderate its symptoms. In particular, physicians may use it in psychiatric conditions such as bipolar mania or schizoaffective psychosis where anxiety comes as a symptom. But, still, there are no confirmed indications of this medication for anxiety.

Is Gabapentin FDA approved for anxiety?

In 1993, Gabapentin was first approved by the Food and Drug Administration (FDA) to treat nerve pain, control seizures in adults and children. Off-label use for anxiety, hot flashes, withdrawal symptoms is not approved by the FDA. In 2009, the FDA additionally suggested using it with caution as it increases suicidal thoughts in both adults and children.

What research supports Gabapentin for anxiety?

There is limited evidence on the efficacy of Gabapentin for anxiety.

  • Gabapentin has been researched involving a 59-year old woman with depression, and anxiety disorder. For 70 days, she took the dosage of 600mg daily. After 70 days, the subject was assessed, and the results demonstrated fluctuating levels of anxiety. In particular, a medication helped achieve remission from anxiety symptoms during the study. The study showed usefulness of Gabapentin with 600-900mg doses daily with a generalized anxiety disorder (GAD).
  • Gabapentin has been researched using a systematic review approach. About 988 abstracts of existing clinical trials and previous research were studied by two reviewers. The results summed up that Gabapentin is linked to relief in some anxiety disorders but has no major response to bipolar disorder anxiety.
  • Gabapentin has been studied generally as a medication from the anticonvulsant group to treat anxiety disorders. Clinical trials, meta-analysis reviews were included in the research. Extensive evidence has been found on Gabapentin to work for social anxiety but no much data on use in panic disorder.

What do experts say about Gabapentin for anxiety? 

Andrew Saxon, M.D., chair of the American Psychiatric Association’s Council on Addiction Psychiatry says “Non-pain related conditions like anxiety and alcohol withdrawal can benefit from gabapentin.”

What are the possible side effects? 

Gabapentin has precaution information from the FDA, as it may increase suicidal thoughts and behavior. 

Patients may notice side effects such as drowsiness if increasing the dosage in the first days of treatment. Other possible side effects are:

  • drowsiness;
  • fatigue;
  • fever;
  • memory loss.

The medication is linked to withdrawal symptoms in case of sudden discontinuation such as anxiety, sleep problems, and excessive sweating. Reduce a dose gradually.

Gabapentin prescribed to children over 3 may be associated with behavioral abnormalities such as aggression, distracted attention. Children under 3 are not commonly prescribed with this medication. 

There is no clinical evidence about anxiety medication Gabapentin in terms of abuse or dependence. 

In animal studies, Gabapentin has not been linked to fatal consequences. Some mice and rats have had overdose events with the supporting symptoms of double vision, and diarrhea. 

If you have signs of overdose, seek emergency help immediately (call 911).

Does Gabapentin have interactions with other medications?

Gabapentin taken alongside other medications may be linked to dangerous interactions resulting in side effects.

Do not take it alongside antacids and morphine, as they are believed to affect Gabapentin concentration in blood.

Do not combine it with opiates, they may cause drowsiness.

Abstain from drinking alcohol alongside this medication, it may cause dizziness and drowsiness as well as impairment in thinking. 

Always consult your doctor about taking other medications alongside Gabapentin.

Can you take Gabapentin while pregnant or breastfeeding?

There is no evidence about the effect of Gabapentin for anxiety in pregnant women. In animal studies, it has been found fetotoxic causing poor chondrosteosis of bones.  

Do inform your doctor if you are pregnant or plan to become pregnant while taking Gabapentin, as it may not fit your health condition.

The medication is believed to secret in human milk, however, the effect is not clearly understood. Its intake in breastfeeding women is possible in case if a doctor believes the benefits prevail risks.

Can children take Gabapentin for anxiety? 

Children are most likely to receive Gabapentin only to treat seizures. There is no evidence about the usefulness of the medication in treating anxiety disorders.

How to take Gabapentin?

Gabapentin is individually prescribed to patients with anxiety based on their age, health condition, and symptoms. 

A doctor may start Gabapentin treatment with the lowest dosage of 300mg which can be then increased. The tablets can be cut in half to take 3-4 times per day.

In the case of discontinuing treatment with Gabapentin, a doctor will recommend reducing the dose gradually. Ideally, it should take a minimum of a 1-week time frame.

How long does it take for Gabapentin to work for anxiety? There is no clear information, however, the medication effect in other health conditions is linked to a 1-2 week time frame.

Are there alternatives to Gabapentin?

Prescription medications as Alternatives to Gabapentin for Anxiety 

Gabapentin is an antiepileptic medication used off-label to treat anxiety. It is not approved by the FDA for anxiety disorder. Thus, you may need a different medication or approach to address your health condition. Speak to your doctor about alternative prescription medications. Some of them are:

  • Klonopin
  • Valium
  • Lexapro
  • Prozac
  • Buspirone
  • Xanax
  • Inderal
  • Cymbalta
  • Tofranil
  • Hydroxyzine
  • Zoloft

There are various alternatives. If you’d like to learn more about whether Gabapentin, another medication or treatment modality is right for you, we recommend that you speak with a licensed psychiatrist. Here are the best online psychiatry platforms so you can speak with someone right away!

Therapy as an Alternative to Gabapentin

Learn more about different therapy options for anxiety here

Energy & Holistic Modalities as an Alternative to Gabapentin

Learn more about different energy & holistic modalities for anxiety here

Tech & Devices as Alternative Treatments to Gabapentin

Learn more about tech & devices for anxiety here

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

By Natalie Kirilova

Natalie is a writer with a focus in medical research with over 10 years of experience