Gabapentin for Anxiety and the Dosage of Gabapentin for Anxiety

About Gabapentin

There are many drugs used to treat anxiety. New studies are now showing that Gabapentin has been a successful treatment for individuals who suffer from anxiety. However, there are no randomized controlled trials on the effectiveness of this medication in generalized anxiety disorder (GAD), and there are only a few case reports.

People with GAD who take Gabapentin have shown to be less irritable, reduce the use of alcohol as self-medication, have fewer depression symptoms, feel less anxious anticipating the future, improve in phobic avoidance (going out in public more and experiencing a significant decrease in panic disorder and reduction of panic attacks).

Gabapentin is an anticonvulsant drug that is primarily used to treat seizures and the pain that follows after an episode of shingles. Gabapentin is considered an off-brand drug used to treat anxiety. Neurontin is the most common brand name for Gabapentin, as well as Horizant and Gralise. Gabapentin has shown to help people with sleeping better, as insomnia is a symptom of anxiety.

How Gabapentin Is Used to Treat Anxiety Mood Disorders Like Depression

Gabapentin isn’t usually used to treat anxiety alone. More often, it’s given to ease anxiety symptoms for someone who also has depression or bipolar disorder. (Anxiety is common comorbid with depression and bipolar.) The reason is that it may not be effective for just anxiety. A close look comparing seven different clinical trials on how successful gabapentin is for anxiety shows that gabapentin may be better than a placebo to treat generalized anxiety disorder (GAD), but not much better. Results may be slightly more promising for social anxiety disorder.

The clinical trials for treating depression with gabapentin are also pretty lackluster. To date, there are no scientific studies showing it’s effective—either on its own or as part of some other therapy. Still, there is some anecdotal evidence that it’s helpful, especially with patients who don’t seem to improve with more standard antidepressants.

How Gabapentin Is Used to Treat Mixed Bipolar States

More specifically, can it prevent future episodes of mania and depression? Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. High-quality, randomized controlled studies found that gabapentin was not effective.1,2

Gabapentin and Alcohol Use Disorder

Gabapentin may be helpful in treating alcohol use disorder and withdrawal. Between 2004 and 2010, The Veterans Affairs Department conducted a double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women over 18, struggling with alcohol dependence.3 The results of the study showed that gabapentin (particularly the 1800 mg dosage) was effective in safely treating alcohol dependence and relapse-related symptoms including insomnia, dysphoria, and cravings.

Side Effects of Gabapentin 

Like all medications, there are several side effects to taking Gabapentin. Side effects that you experience are relative to your personal reaction to the drug. Everyone is different, so you may not experience side effects that others do or don’t. Some side effects can be nausea, vomiting, tremors, dizziness, sleepiness, double vision, loss of control of bodily movements, fluid retention, difficulty speaking, jerky movements, unusual eye movements, double vision, and unsteadiness.

If you begin to experience any of these symptoms, speak with your doctor immediately. Get emergency help if you suspect you are having an allergic reaction like; swelling of your face, lips, tongue, or throat, hives, and difficulty breathing. If you notice that your symptoms are worsening, contact your doctor immediately. You may not notice symptoms until weeks after taking Gabapentin.

Gabapentin Dosage for Anxiety

When you are prescribed Gabapentin to treat your anxiety, your doctor will determine the correct dosage necessary for you. Additionally, doctors will usually start with a lower dose of Gabapentin and gradually increase to the dosage that will become their full intake. Gabapentin comes in capsules of 100, 300, and 400 mg. Gabapentin tablets are available in 100, 300, 400, 600, and 800 mg. Do not change your dosage or stop taking your medications without talking to your doctor first. According to MedicineNet, the starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate-release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily. The starting dose for treating panic attacks is 0.5 mg 3 times daily.

How Long Does Gabapentin Take to Work for Anxiety

The effectiveness of Gabapentin is different for everyone, again also depending on the severity of your anxiety amongst other factors. The average timeline for effectiveness is about 3 weeks, but it could be sooner or later. It is important to remember that while Gabapentin may be helpful for some, it may not be helpful for you. If you want to consider using Gabapentin, consult your doctor and together you can make the best decisions regarding treating your anxiety.

Can Gabapentin be Used for Anxiety, Depression, and Bipolar Disorder ?

Gabapentin is an anticonvulsant prescription drug that goes by several brand names including, Neurontin, Gralise, Gabarone, and Fanatrex.

It was approved by the FDA in December 1993 for the following main uses.

    1. Controlling certain types of seizures in people who have epilepsy
    2. Relieving nerve pain (think: burning, stabbing, or aches) from shingles
    3. Calming restless legs syndrome

But since it’s been available, gabapentin has also been used off-label in psychiatry to treat patients with treatment-resistant mood and anxiety disorders as well as alcohol-withdrawal and post-traumatic stress. It works by decreasing abnormal excitement in the brain for seizures and changing the way the body senses pain for nerve pain. Researchers don’t know exactly how it works for psychiatric conditions. (*Note: Some states have recently classified gabapentin as a controlled substance due to the potential for it to be abused and contribute to death from overdose.)

Treatment with Gabapentin: Important Things to Know Before Taking Gabapentin

Before you start gabapentin therapy, you should have a thorough medical exam to rule out any medical issues. This includes any blood or urine tests. Medical evaluations are important as gabapentin can induce hormonal imbalances. Like any other drug, you should not take gabapentin if you’re allergic to it.

There are side effects—more on that in a minute. But a few of the most important things your doctor will want to find out before prescribing gabapentin is if you have or have had any of the following:

    • Diabetes
    • Drug or alcohol addiction
    • Kidney problems (or if you’re on dialysis)
    • Liver or heart disease
    • Lung disease (see the warning above on respiratory issues)
    • Mood disorders, depression or bipolar; or if you’ve ever thought about suicide or attempted suicide
    • Seizures (unless, of course, you’re taking it for seizures)

You should also know that not enough studies have been done to understand the exact risks of gabapentin if you’re pregnant or breastfeeding.

How Gabapentin Is Used to Treat Anxiety Mood Disorders Like Depression

Gabapentin isn’t usually used to treat anxiety alone. More often, it’s given to ease anxiety symptoms for someone who also has depression or bipolar disorder. (Anxiety is common comorbid with depression and bipolar.) The reason is that it may not be effective for just anxiety. A close look comparing seven different clinical trials on how successful gabapentin is for anxiety shows that gabapentin may be better than a placebo to treat generalized anxiety disorder (GAD), but not much better. Results may be slightly more promising for social anxiety disorder.

The clinical trials for treating depression with gabapentin are also pretty lackluster. To date, there are no scientific studies showing it’s effective—either on its own or as part of some other therapy. Still, there is some anecdotal evidence that it’s helpful, especially with patients who don’t seem to improve with more standard antidepressants.

How Gabapentin Is Used to Treat Mixed Bipolar States

More specifically, can it prevent future episodes of mania and depression? Right now, there is no good evidence that gabapentin can be used for treating people with bipolar disorder. High-quality, randomized controlled studies found that gabapentin was not effective.1,2

Gabapentin and Alcohol Use Disorder

Gabapentin may be helpful in treating alcohol use disorder and withdrawal. Between 2004 and 2010, The Veterans Affairs Department conducted a double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women over 18, struggling with alcohol dependence.3 The results of the study showed that gabapentin (particularly the 1800 mg dosage) was effective in safely treating alcohol dependence and relapse-related symptoms including insomnia, dysphoria, and cravings.

Gabapentin for Fibromyalgia

Research suggests that people with fibromyalgia have too much glutamate in certain parts of their brain, so gabapentin has long been prescribed for it. But is it effective? Research is mixed.

Two reviews of the evidence disagree. One released in 2016 found that gabapentin is an effective fibromyalgia treatment,3 while another, published in 2017,4 reported only low-quality evidence.

In studies comparing gabapentin with pregabalin (Lyrica), including one published in The Journal of the American Medical Association, pregabalin appeared to perform better.

Gabapentin Dosage

Gabapentin is usually started at a low dose and then gradually increased. Be sure to follow your doctor’s instructions. A typical dose ranges between 900 mg and 1,800 mg daily, divided into three doses. You shouldn’t stop taking gabapentin suddenly. Be sure to talk to your doctor about the proper weaning procedure for the dose you’re taking.

Gabapentin Side Effects

Like all drugs, gabapentin comes with a risk of side effects.5 Some are potentially dangerous, while others are not. If you have any of the following side effects while taking gabapentin, call your doctor immediately:

  • Severe weakness or tiredness
  • Upper stomach pain
  • Chest pain
  • New or worsening cough along with fever
  • Difficulty breathing
  • Severe tingling or numbness
  • Rapid, back-and-forth eye movements
  • Pain or difficulty with urination, or no urination
  • Fever
  • Sore throat
  • Swelling in the face or tongue
  • Burning eyes
  • Rash

Side effects that aren’t cause for immediate concern include:

  • Fatigue
  • Dizziness
  • Headache
  • Falling asleep
  • Weight gain

Children taking gabapentin may experience a different set of side effects. Contact your doctor immediately for the following:

  • Changes in behavior
  • Memory problems
  • Inability to concentrate
  • Restlessness, hostility, or aggression

Gabapentin may react negatively with other drugs. Be sure your doctor and pharmacist know everything you’re taking.

Is Gabapentin Right for You?

With evidence being weak and mixed, gabapentin has one clear advantage over Lyrica—it’s generic, and therefore much less expensive. Price, however, is far less important than efficacy.

We all react differently to medications. Some people who fail on other drugs, including Lyrica, may find relief from gabapentin. Talk to your doctor about the benefits and drawbacks gabapentin may have for your overall treatment regimen.

How Are Depression and Erectile Dysfunction related?

For some men, depression can accompany the condition of erectile dysfunction (ED). It is common for men with ED to feel angry, frustrated, sad, unsure of themselves, or even less “manly.” Such feelings may lead to a lack of self-esteem and, in severe cases, to depression.

Depression that accompanies ED is treatable. The first step in addressing your concerns about ED-related depression is to be honest with yourself, your partner, and your doctor. After depression has been brought out into the open, coping with it will be easier and less stressful.

Antidepressants and other psychiatric medicines may cause Erectile Dysfunction

      • Amitriptyline (Elavil)
      • Amoxapine (Asendin)
      • Buspirone (Buspar)
      • Chlordiazepoxide (Librium)
      • Chlorpromazine (Thorazine)
      • Clomipramine (Anafranil)
      • Clorazepate (Tranxene)
      • Desipramine (Norpramin)
      • Diazepam (Valium)
      • Doxepin (Sinequan)
      • Fluoxetine (Prozac)
      • Fluphenazine (Prolixin)
      • Imipramine (Tofranil)
      • Isocarboxazid (Marplan)
      • Lorazepam (Ativan)
      • Meprobamate (Equanil)
      • Mesoridazine (Serentil)
      • Nortriptyline (Pamelor)
      • Oxazepam (Serax)
      • Phenelzine (Nardil)
      • Phenytoin (Dilantin)
      • Sertraline (Zoloft)
      • Thioridazine (Mellaril)
      • Thiothixene (Navane)
      • Tranylcypromine (Parnate)
      • Trifluoperazine (Stelazine)