Gabapentin is a medicine first made for seizures and nerve pain. Now, doctors sometimes use it to treat anxiety, even though the FDA hasn't officially approved it for this use. Some studies show it might help certain types of anxiety, but we need more research to be sure.
Key Takeaways
Gabapentin might help certain types of anxiety, especially social anxiety and pre-surgery nerves, but we need more studies compared to proven treatments.
Effective doses range from 300-3,600mg daily, but sometimes lower doses work just as well as higher ones due to how your body absorbs the medicine. Some trials used lower doses (300–900 mg/day), while other regimens in practice go up to 3,600 mg/day. Doctors usually start low and slowly increase.
Gabapentin needs close doctor supervision for side effects, drug mixing problems, and mental health changes, especially when taken with other medicines that affect your brain.
What is Gabapentin?
Gabapentin (brand name Neurontin) is a pill that affects nerve signals in your brain. The FDA approved it in 1993 for seizures and nerve pain from shingles. It's been sold as a cheaper generic drug since 2004. Unlike other anxiety medicines, gabapentin works on calcium channels in your brain instead of other brain chemicals.
How Does Gabapentin Work for Anxiety?
Gabapentin blocks certain channels in your brain cells that let calcium through. This helps calm down overactive nerves that might cause anxiety. The medicine also affects GABA, which is your brain's main "calm down" chemical.
Think of it like turning down the volume on an overly loud radio. Gabapentin helps quiet the noise from anxious thoughts and feelings.
How Often Do Doctors Use It for Anxiety?
More doctors are giving gabapentin for anxiety, but it's not the official use. A big study in 2015 looked at how well gabapentin works for mental health problems. The study found some proof that gabapentin might help certain anxiety disorders, but there were no studies on generalized anxiety disorder.
What Types of Anxiety Might It Help?
Research shows gabapentin might work for:
Before surgery anxiety: Taking 800 mg of gabapentin helped reduce anxiety in people having surgery
Social anxiety: Being scared of social situations
Cancer survivor anxiety: A study of 420 breast cancer patients found that both 300mg and 900mg doses worked better than fake pills
Panic attacks: Results are mixed - it helps some people but not others
Gabapentin Dosage for Anxiety
When doctors give gabapentin for anxiety, they usually use 300mg to 3,600mg per day. For social anxiety and panic attacks, doctors often use 900-3,600mg daily.
Doctors usually start small and slowly increase the dose:
Starting: 300mg once daily
Increase by: 300-600mg every few days
Maximum: 3,600mg daily, split into several doses
Because gabapentin only lasts about 6 hours in your body, you need to take it 2-3 times per day.
Gabapentin has an unusual way of being absorbed. At 900mg, your body only absorbs 540mg. At 1,200mg, you only absorb 564mg. At 2,400mg, you only get 816mg. This happens because your body can only absorb so much at once.
Gabapentin Side Effects and Safety
The most common problems people have with gabapentin are dizziness, sleepiness, and swelling in hands or feet. Other common issues include:
Feeling tired
Trouble with balance
Dry mouth
Weight gain
Upset stomach
Serious Safety Warnings
The FDA warns that gabapentin can cause serious breathing problems, especially when mixed with other drugs that make you sleepy. These include pain pills, anxiety medicines, antidepressants, and allergy medicines.
All seizure medicines, including gabapentin, can increase thoughts of suicide. Patients need to watch for mood changes or thoughts of hurting themselves.
Stopping the Medicine
If you stop gabapentin suddenly, you might have withdrawal symptoms like anxiety, trouble sleeping, nausea, pain, and sweating. Always work with your doctor to slowly reduce your dose.
When to Call Your Doctor
Call your doctor right away if you have:
Thoughts of hurting yourself
Hard time breathing
Big mood changes or depression
Allergic reaction signs (rash, swelling, trouble breathing)
Bad dizziness that causes falls
Your doctor should check on you by:
Asking about your mental health regularly
Testing your kidney function (gabapentin leaves through your kidneys)
Looking for drug interactions
Seeing if the medicine is working
Sources
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