Gabapentin for Anxiety: Effectiveness, Dosage and Side Effects

gabapentin for anxiety

Gabapentin is an anticonvulsant medication that is known by several names, including Neurontin, Gralise, Fanatrex, and Gabarone. It was originally licensed for seizure control (1), nerve pain relief (2), and the management of restless leg syndrome. (3) However, when it became accessible, Gabapentin for anxiety became popular use. It was also used to treat post-traumatic stress disorder (4) and substance abuse. (5)

Gabapentin was originally used to alleviate anxiety associated with schizophrenia and bipolar disorder, but not to treat the underlying causes of these diseases. (6) However, it was thought to have anxiety-relieving qualities over time, and it was used as a supplement to other anxiety treatments. Although it is regarded to be beneficial, it is not licensed as a stand-alone therapy for anxiety disorders.

Gabapentin’s efficacy has been investigated in several research investigations. Gabapentin may be an effective adjunct to anxiety therapy, according to a review published in the American Journal of Psychiatry. (7) Some characteristics imply it might be used as a stand-alone treatment, but additional study is needed because there is not sufficient empirical data.

Gabapentin has also been shown to help with panic attacks and social phobia, both of which are commonly associated with performance anxiety. Although the treatment appeared to be more effective, it was not as efficacious as a stand-alone anxiety medication. Gabapentin is thought to be effective in the treatment of anxiety when combined with other therapies.

Can you use Gabapentin for anxiety?

Although Gabapentin is classed as an anticonvulsant medicine that is often used to treat epileptic seizures and nerve pain associated with shingles, research has revealed that it may also be used as an off-brand therapy for anxiety. In reality, research demonstrates that patients with generalized anxiety disorder have less agitation and depressive symptoms, have a decreased inclination to use or misuse alcohol as a form of self-medication, have improved phobic aversion, and have less anxiety when contemplating upcoming scenarios. (8)

Depending on the ailment that Gabapentin is being used to treat, various forms of Gabapentin may be administered. Since trouble getting or staying asleep is another indication of high-functioning anxiety, Gabapentin has been demonstrated to benefit persons with insomnia.

Various investigations on the efficacy of Gabapentin in the treatment of anxiety disorders have been conducted throughout the last several decades. Gabapentin was approved for commercialization in the United States by the FDA in 1993. (9) Although it is solely authorized as an anticonvulsant, it has also been used to treat restless legs syndrome, tremors, hot flashes, chronic pain, and a variety of mental illnesses. Further research revealed that Gabapentin might be beneficial in two ways: as an add-on medicine for people with anxiety disorders, or as a standalone therapy for certain anxiety disorders.

How does Gabapentin work?

Gabapentin has become quite popular among physicians for several off-label therapies due to its very safe use. Gabapentin is commonly used instead of other drugs because it replicates the properties of gamma-aminobutyric acid (GABA), a naturally occurring amino acid that functions as a neurotransmitter in the nervous system. (10)

GABA is known as an inhibitory neurotransmitter because it blocks or inhibits specific brain signals while reducing nervous system activity. GABA has a calming impact when it binds to a protein in your brain called a GABA receptor. As a result of this chemical response, tension, anxiety, and even fright can be reduced. It may also aid in the prevention of convulsions. (11)

Since it mimics GABA’s effects on brain activity, clinicians prescribe it in a variety of conditions when other drugs might have major adverse effects or lead to drug addiction. Certain forms of anxiety disorders are routinely treated with beta-blockers for anxiety, benzodiazepines, and other selective serotonin reuptake inhibitors. Gabapentin, on the other hand, has been proved to be a safer alternative to benzodiazepines, which are extremely addictive. It may be used as an additional drug or as a solo therapy.

Benefits of Gabapentin for anxiety

gabapentin for anxiety

Gabapentin has been demonstrated to be effective in the treatment of anxiety, with the following advantages:

Reduces frustration

Gabapentin consumers who have been treated for anxiety are less irritable following therapy. The medicine lessens the demand for alcohol as a kind of self-medication, as well as the irritation associated with alcohol withdrawal. (12) It provides a sense of serenity, reducing the impulse to strike out at others.

Resolves sleep issues

Anxiety sufferers frequently struggle to sleep, and sleeplessness exacerbates their symptoms. Gabapentin helps patients with insomnia, allowing them to obtain a full night’s sleep while also minimizing the detrimental effects on the brain. (13)

Minimizes stress levels

The fact that Gabapentin calms the brain and makes individuals feel less worried while predicting the future is maybe the most essential aspect of using medication for anxiety. It also reduces the need for public avoidance, lowering the danger of panic episodes caused by constant stress.

How fast does Gabapentin work? 

Gabapentin’s efficacy varies from person to person, depending on the intensity of your anxiety and other circumstances. Effectiveness takes roughly three weeks on average, although it might happen sooner or later. It is crucial to keep in mind that while Gabapentin may be beneficial to some people, it may not be beneficial to you. If you wish to use Gabapentin to treat your anxiety, talk to your doctor first. Together, you can find out the best option for you.

Gabapentin dosage for anxiety

The optimal gabapentin dose for a person is determined by several factors, including the kind and brand of Gabapentin they take, the product’s potency, the severity of their anxiety, their kidney function, their weight, age, and overall health. Individuals will differ in the number of daily dosages, the time between doses, and the length of time they take Gabapentin.

To begin, your doctor will often prescribe 300 mg once a day, generally in the evening. Every three to five days, the dosage will be raised. Some people will take 600 mg per day, while others will go up to 3,600 mg per day, which is the FDA’s maximum dose.

The dosage is normally between 900 and 2,000 mg per day if taken as a mood stabilizer or antidepressant. It might, however, be raised for greater outcomes. About a week after commencing therapy, some patients see a difference in their symptoms. Others take roughly a month to notice a substantial difference. Gabapentin has a six-hour half-life, thus it has to be consumed three to four times per day.

It is important to take Gabapentin just in the authorized dosage and not for longer than a doctor recommends. If a person forgets to take a dosage, they should follow the directions on the label or seek assistance from a pharmacist.

If a person forgets to take a gabapentin dose, they should take it as soon as they recall. The only time this does not apply is when it is time to take the next dose. In this scenario, the consumer should just skip the missing dosage and resume their regular schedule. Two doses of Gabapentin should never be used at the same time.

How to discontinue Gabapentin?

Gabapentin, like other psychotropic medicines, should be tapered off gradually. Several withdrawal symptoms are well-known. This is most commonly caused by those who abruptly cease taking large doses of the medicine. You should only stop taking this medication immediately if you are experiencing a major adverse effect, and even then, only under your doctor’s supervision.

Efficacy of Gabapentin for other off-label usages

The primary purpose of Gabapentin is to prevent or control seizures. It works by reducing seizure severity and frequency by relaxing nerve activity. This medication is suitable for both children and adults. 

Neurontin, a brand-name medicine, can be used to treat one kind of epilepsy in children as young as three years old. To treat epilepsy symptoms, some patients combine Gabapentin with additional drugs. (14)

Referring to research published in BMC, Gabapentin can also assist with post-herpetic neuralgia, a frequent consequence of shingles that causes burning or stabbing nerve pain. (15) According to a 2017 analysis, a daily dosage of 1,200 mg of oral Gabapentin helps alleviate moderate to severe nerve pain caused by shingles or diabetes. (16)

There have been some clinical studies that suggest Gabapentin may give enough pain relief for people suffering from chronic pain caused by peripheral diabetic neuropathy or postherpetic neuralgia. According to the research, around half of the patients studied reported better sleep patterns, less exhaustion and despair, and an overall increase in quality of life.

Another widespread off-label use of Gabapentin is to help patients recover from substance abuse, such as alcohol or a variety of narcotics. Gabapentin has been demonstrated to be an effective treatment for people suffering from alcohol withdrawal symptoms. It is also been used to treat the adverse effects of substances including opiates, cannabis, and benzodiazepines, as well as to help with withdrawal symptoms like anxiety, cravings, cognitive difficulties, and other physical symptoms of substance withdrawal syndrome.

Gabapentin has also been proven to be an efficient and beneficial RLS therapy. Gabapentin has been proven to enhance sleep, daytime performance, and symptoms of RLS, according to a study presented at the 28th Annual Meeting of the Associated Professional Sleep Societies. It may be especially useful if the symptoms are seen as less severe but still uncomfortable. (17)

Drugs that interact with Gabapentin 

gabapentin for anxiety

Gabapentin oral capsule has the potential to interact with several different drugs. Different encounters might have various outcomes. Some, for example, might impair a drug’s effectiveness while others can exacerbate negative effects.

Tell your doctor and pharmacist about all prescriptions, over-the-counter, and other medications you are taking before starting Gabapentin. Also, let them know if you use any vitamins, herbs, or supplements. You can avoid possible encounters by bringing this up.

According to the findings of a 2017 study, the following are some of the primary drugs that interact with Gabapentin: (18)

Gabapentin with caffeine

The anticonvulsant characteristics of Gabapentin can be altered by medication interactions, according to both basic and clinical investigations. Combining Gabapentin with caffeine, for example, can diminish Gabapentin’s anticonvulsant effects. Both acute and chronic caffeine reduced Gabapentin’s protective potential in the case of newer antiepileptics. (19)

Gabapentin with opioids

Opioids can have serious side effects when used with Gabapentin. Morphine, hydrocodone, and oxycodone are examples of these medications. When you combine Gabapentin with an opioid, you run the risk of experiencing extreme drowsiness, respiratory depression, coma, and even death. (20)

Gabapentin with antacids

Gabapentin levels in the blood are reduced by antacids. Certain medicines used to address stomach acid issues might limit the quantity of Gabapentin in your body when used with Gabapentin. It may become less effective as a result of this.  As a result, Gabapentin should be taken at least 2 hours after taking antacids. (21)

Side Effects of Gabapentin 

Gabapentin oral capsule side effects can range from moderate to severe. The following is a list of some of the most common adverse effects associated with gabapentin use. This is not a comprehensive list of all possible adverse effects.

Common side effects

Viral infection, fever, nausea, and vomiting, problems speaking, aggression, and jerky movements are some of the most prevalent adverse effects associated with gabapentin use.

The rates of adverse effects are based on participants over the age of 12, as reported in clinical studies for Neurontin, the brand equivalent. Viral infection (11 %), fever (10%), nausea and/or vomiting (8%), weariness (8%), and hostility (8%) were the most prevalent symptoms among pediatric patients aged three to twelve.

Aggressive or violent conduct, an extraordinary increase in activity and talking, odd changes in behavior or mood, emotional changes, aggression, difficulty focusing, and restlessness are other possible side effects.

Breathing problems

People with respiratory risk factors who take multiple brands of Gabapentin may develop substantial breathing issues, according to the Food and Drug Administration (FDA). Before taking Gabapentin, those with chronic obstructive pulmonary disease or asthma should see their doctor. 

Suicidal Thoughts

According to studies, when using Gabapentin or other anticonvulsants, some persons may have suicidal thoughts or act terrifyingly. If a person or a loved one detects any changes in their mood or behavior, they should seek medical help right away.

Overdose Risks

Despite the study, it is not always obvious if suicide actions among gabapentin users are caused by the medication or are due to a pre-existing mental health issue. It is evident, however, that if a person additionally has a mental health problem like depression, the chance of overdosing from the medication is higher.

Furthermore, when taking Gabapentin, a person should keep a close eye on oneself to ensure that they are not taking the incorrect dosage. People should keep an eye on their loved ones and youngsters who are taking this drug and seek help if they develop suicidal thoughts or behaviors.

Allergies

This medication should not be taken by anyone who is allergic to Gabapentin. In addition, the drug might include additional substances that cause allergic reactions in certain people. As a result, people should see a doctor before using Gabapentin if they have any medication or food sensitivities. If you have signs of severe allergic response, you should seek immediate medical attention. (22)

Gabapentin can make you drowsy, so you should be careful driving or using machinery if you are taking it. People should also avoid or restrict their intake of alcohol while consuming Gabapentin since there is a chance of negative side effects.

Warnings for people regarding consumption and withdrawal of Gabapentin

gabapentin for anxiety

People with Epilepsy

Do not abruptly stop using Gabapentin. This can put you at risk of developing a condition known as status epilepticus. This is a medical emergency that occurs when a person has small or lengthy seizures that last 30 minutes or more. Gabapentin can create issues in children with epilepsy aged 3–12. It increases their chances of having mental and behavioral issues, such as being hyper and behaving angry or impatient.

Pregnant women

Gabapentin usage during pregnancy has not been researched in humans. In animal studies, the medication has been found to have harmful effects on the fetus when the mother takes it. Animal studies, on the other hand, do not necessarily anticipate how humans will react. If you are pregnant or intend to become pregnant, talk to your doctor. Only take this medicine if the potential benefit outweighs the possible danger to the fetus. If you become pregnant while using this medication, contact your doctor immediately.

Breastfeeding women

Gabapentin can enter into breast milk and produce major negative effects in a kid who is nursing. If you are nursing, let your doctor know. You and your partner should discuss whether you should stop taking this medication or discontinue nursing.

Seniors

Kidney function may deteriorate as people become older. This medicine may take longer for you to process than it does for younger individuals. To prevent too much of this medicine from building up in your body, your doctor may start you on a lower dose. It is harmful to have too much of a substance in your body.

Conclusion

Gabapentin can assist with anxiety, but it is important to consult with a primary care provider or another skilled health expert to monitor the drug’s effects on your health.

Medication has varying effects on different people. Keep in mind that what works for one person may not work at all for another while recovering from anxiety or helping someone with anxiety. While taking Gabapentin, you may need to consider other counseling options to address the more psychological aspects of anxiety.

Table of Contents