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Perhaps one of the more promising off-label uses for Gabapentin is for the treatment of anxiety disorders. There is mounting evidence that Gabapentin may be an effective intervention for various types of anxiety including: generalized anxiety disorder, social anxiety disorder, and panic disorder. Gabapentin’s off-label uses—meaning prescribing gabapentin for a problem not on the FDA approval list for this medication—that physicians are finding include: Alcohol withdrawal; Anxiety; Cocaine withdrawal; Fibromyalgia; Headaches; Hiccups; Hot flashes; Hyperhidrosis; Insomnia; Migraines; Mood disorders; Pain syndromes; Peripheral However, their off-label use for anxiety disorders, such as generalized anxiety disorder (GAD) and social anxiety disorder (SAD), is on the rise. Clinical trials show that about 50% of GAD patients report improved symptoms when treated with gabapentin. This use of gabapentin for the treatment of anxiety is referred to as an off-label use, meaning there is limited data on its effectiveness to treat anxiety. Other off-label uses include treating alcohol withdrawal for alcohol use disorder and hot flashes associated with menopause. Caused a cavernous angioma in my brain to bleed (we didn't know about that until months after this happened). I couldn't get off of it after that because whenever it wore off, I would have tremors and seizures. I had to slowly wean off of it. It was horrifying. I don't know what all was caused by the bleed or by the gabapentin but it was hell. Gabapentin was originally approved by the US Food and Drug Administration (FDA) for the treatment of partial seizures in 1993, 1, 2 with subsequent approval for postherpetic neuralgia in 2002. 3 – 5 Within a decade of initial FDA approval, gabapentin’s second most common use became off-label prescription for psychiatric disorders. 6 Gabapentin is another antiepileptic medication, approved for partial seizures and nerve pain. It’s frequently used off-label to treat anxiety disorders and post-traumatic stress, as it Dependence: Abruptly stopping high doses of gabapentin can produce anxiety, disturbed sleep, confusional states, disorientation, and agitation. This has usually been associated with persons misusing the drug, but milder forms of withdrawal disturbance have been seen after therapeutic doses. While there’s limited evidence that gabapentin helps with anxiety, some doctors may prescribe it off-label to treat the mental health condition. Off-label gabapentin (Neurontin) got a bad rep when it missed the mark in bipolar disorder, but there may be something worth salvaging in this drug. Here, we weigh its pros and cons for anxiety, substance use disorders, sleep, pain, and hot flashes, and compare it to its underutilized cousin, pregabalin (Lyrica). In today’s video, we explore the off-label uses of Gabapentin, also known as Neurontin. While Gabapentin is FDA-approved for partial seizures and postherpetic neuralgia, its off-label uses are more extensive, especially in psychiatry. Gabapentin is a medication that can be used off-label to treat anxiety. Learn how it works, its benefits, and considerations for taking it for anxiety. Gabapentin has been approved by the United States (US) Food and Drug Administration (FDA) for postherpetic neuralgia and as adjunctive therapy for focal seizures. 1 However, a recent analysis of US physician office-based prescription practices between 2011 and 2016 found that less than one percent of gabapentin prescriptions are for such indications. 2 In 2020, gabapentin was reported to be Numerous other off-label and investigational uses for gabapentin have been described, including alcohol dependence, 1, 2 bipolar disorder, 3 posttraumatic stress disorder, 4 essential tremor, 5 and perioperative anxiety. 6, 7 Pregabalin, approved for clinical use in the United States in 2004, is indicated for postherpetic neuralgia and partial Pregabalin has also been used off-label for anxiety disorders, especially in Europe, where it is approved for generalized anxiety disorder (GAD). This medication acts on calcium channels in the brain, modulating the release of neurotransmitters like glutamate, norepinephrine, and substance P, which play key roles in anxiety and mood regulation. Gabapentin is widely used in the United States for a number of off-label indications, often as an alternative to opioid therapy. Increasing evidence has emerged suggesting that gabapentin may not be as benign as once thought and may be associated with substance abuse in concert with opioids. Key takeaways: Gabapentin (Neurontin) is FDA approved to treat seizure disorder and nerve pain from shingles. But it’s also used off-label to treat many other conditions, including anxiety, nerve pain from diabetes, and hot flashes. In addition to being used to treat pain, gabapentin is used off label to treat anxiety, alcohol use disorder (AUD), alcohol withdrawal, depression, substance use disorders (SUDs), sleep problems, and more. However, the data to support these off-label uses of gabapentin are mixed, especially for long-term use. Objective: Gabapentin is widely prescribed off label in medical practice, including psychiatry. The U.S. Food and Drug Administration (FDA) warned of risks associated with gabapentin combined with central nervous system depressant (CNS-D) drugs, which are commonly prescribed in psychiatric treatment. This study examined off-label outpatient gabapentin use for psychiatric indications and Gabapentin has also been prescribed off-label for anxiety despite a lack of research evidence supporting such use . It was found to be efficacious in a small ( N = 69) randomized, double-blind, placebo-controlled study in SAD ( 62 ).
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